Understanding the Processes of Role Adoption in Pedagogical Role-Play Games (RPGs): A Narrative Dramaturgical Perspective on “Social RPGs” in Health Professions Education

Background Health professional training interventions based on role-playing games (RPGs) have been shown to be an increasingly popular way to advance health professional students’ skills in communication and empathetic engagement with patients and colleagues. However, role adoption itself is largely assumed, with little research focusing on how students come to engage, or fail to engage, in role play. Objective This study aimed to identify the processes by which healthcare professionals and trainees (HCP/Ts) adopt roles in role-based serious games designed for health professions education (HPE). The theory of narrative dramaturgy informed this qualitative study, to illuminate the relationship between the participant and the role. Methods Four focus groups were conducted at the conclusion of four iterations of an RPG, in which different groups of healthcare professionals participated, focused on joint deliberation over a case in pediatric oncology. The data were analyzed thematically. Results & Conclusion Four themes were developed that characterize the process of role adoption: role commitment; simultaneous evocation of front and back stages; reflexivity; and visceral lingering. Our findings contribute to delineating the processes of role adoption that suggest specific conditions under which role play may or may not be beneficial, and how it can be taught and enhanced in health professional education. In doing so, the study draws attention to an under-researched form of RPG – a “social RPG” – grounded in interaction.