A key element in the setting up of A DRAW scenario is the identification of a springboard moment. This is the moment in the drama where the doctor is faced with her difficult decision. She must now act; but how? The problem has been explained by the previous dramatic action; the class is emotionally involved in the dramatic situation; and now the doctor faces her problem — there has been a mistake, bad news must be broken, expectations must be managed, competence has been questioned, and so on. All eyes are on the doctor. She opens her mouth to speak — and the video is paused. Now a postgraduate junior doctor is selected from the class and the role-play begins, with the DRAW facilitator playing the part of the other party — the relative, the patient, the colleague, as appropriate.
Examples of springboard moments? (though remember that the suitability of each of these will depend strongly upon the context and intensity of the surrounding drama). Here’s half a dozen.
- the wife of a dangerously ill patient asks “He will be all right, won’t he, doctor?”
- a senior colleague challenges the competence of the consultant in change of the doctor’s firm. He has some doubts of his own, but his boss has supported him through difficulties that he has had. What will he reply?
- a significant incident has occurred. Will it be reported? The doctor holds the evidence in his hand.
- a patient has died, but the relative is not considering that possibility: “Are you saying he is bad, doctor?”
- a mistake has been made and the patient is aware of it (and angry): “But the other doctor told me it wasn’t cancer!”
- a patient has died because of a delay in seeking and obtaining specialist assistance. The doctor who feels responsible is about to admit his fault to the relatives when a senior colleague arrives and takes over the conversation. What will he say?