Teaching medical students by role playing: a model for integrating psychosocial issues with disease management.

BACKGROUND: Medical students on third-year rotations seem to be focused more on the particulars of disease management than on patient management. They often pay too little attention to the psychological and social needs of the patient and to the importance of working in a multidisciplinary team. The authors postulated that a model for teaching breast cancer management that included role playing, self-study, and active student involvement would facilitate the integration of psychosocial and affective issues into scientific content and would demonstrate the importance of the team approach in managing patients with breast cancer. METHODS: One month following a problem-oriented, case-based, interactive session focusing on clinical management of breast disease, each student was assigned the role of either "patient" or one of four "specialists"-1) a general surgeon, 2) a medical oncologist, 3) a radiation oncologist, or 4) a plastic surgeon. A packet of readings containing discipline-specific information was distributed to each "specialist" and a similar preparation packet was distributed to each "patient." One week later students from each specialty met in "multidisciplinary groups" and five "patients" with written scenarios of recently diagnosed primary breast cancer rotated among them. Important decision-making choices were discussed in each consultation. Following their consultations in the "multidisciplinary" groups, the "patients" met with the entire group of 20-25 students and with physician faculty to discuss differences in the information obtained. They compared "specialists'" styles of presentation and attitudes. Specific issues involving coordination of care among "specialists" were carefully highlighted. RESULTS: All students participated and the teaching sessions were well received. CONCLUSIONS: Role playing facilitates the discussion of psychosocial issues and aptly demonstrates to students the need for a multidisciplinary approach to breast cancer treatment. This model is applicable to other types of cancer and to other groups of cancer educators.