Comparison of drama and standardised patient method to develop humanistic approach in breaking bad news training

Medicine is inherently a humanistic profession. However, recent studies have emphasised the need for medical students to develop humane attitudes and behaviours. Breaking bad news is also one topic where a humanistic approach needs to be developed. The purpose of this study is to investigate the effects and differences between drama and the standardised patient (SP) method in objective structured clinical examinations (OSCEs) on fostering a humanistic approach in breaking bad news. This is a comparative case study, a qualitative research method, encompassing content analyses of observer notes and transcripts of audio recordings from debriefing sessions. The study includes fifth-year medical students from Karadeniz Technical University Faculty of Medicine, with 20 volunteer students participating as the sample. The listed students, those with odd numbers, were assigned to the SP-based OSCE group, while those with even numbers were assigned to the drama-based OSCE group. Data was analysed using Creswell's content analysis approach. A total of 20 students participated in the study, with half evaluated through SP-based OSCEs and the other half through drama-based OSCEs. A comparative analysis of drama-based and SP-based OSCE debriefings revealed unique strengths and challenges. Drama-based OSCEs fostered empathy, emotional engagement and reflective practice, aiding students in managing emotions. SP-based OSCEs enhanced structured communication but sometimes led to emotional desensitisation and performative empathy. Overall, the drama method proved to be a more humanistic approach effective in nurturing natural empathy and supportive communication, particularly in breaking bad news. This study highlights the strengths of drama-based OSCEs in fostering empathy and emotional engagement while maintaining structured communication frameworks. By directly comparing drama and SP methods, our findings underscore the potential of drama-based approaches to enhance humanistic medical education and patient communication. Integrating the complementary strengths of both methods into medical training can better prepare students for compassionate, effective patient interactions, addressing both emotional and technical aspects of clinical care.