Adolescent Actors

In general, adolescents are physically healthy. Health concerns are focused in risk behaviors, and thus the relationships that help young people make sound behavioral choices and experience healthy emotional and social development are critical. Adolescent health and development depend heavily on functional connections with adults and community resources. Effective health services for adolescent patients require that the clinician be skilled in building trust relationships, in eliciting accurate and sometimes sensitive information, and in intervening effectively where risk is identified. The skillful clinician assesses psychosocial as well as medical issues in order to assist the adolescent in making choices that cumulatively constitute healthy development.

The Adolescent Actors Teaching Project (AATP) trains health professionals in interviewing, assessment and intervention skills through role playing clinical situations with an adolescent actor who is trained to give feedback.

Introduced as part of the Resident Training Program in Adolescent Health in 1997, the AATP built upon pilot work done earlier in the School of Nursing. The psychosocial approach to clinical services which is the backbone of the AATP weaves throughout the month-long residency rotation. This includes an introductory didactic on "Providing Care for Adolescents"; two training sessions which combine interviewing skills instruction and role-play practice with adolescent actors; a didactic on "Clinical Interventions"; a final role-play practice session incorporating history-taking, issue(s) identification and intervention; and an interactive didactic in which residents review with instructors their interviewing skills training experiences and their on-site clinical experiences.

Trainees in the Pediatric Residency Program, in two graduate nursing programs (Graduate Studies in Adolescent Nursing and Pediatric Nurse Practitioner Programs), in the Internal Medicine Residency Program (by elective), and in the Child Psychiatry Residency Program now participate in AATP training. Trainees role-play one-on-one clinical interviews of about 20 minutes duration and are videotaped. Actors and facilitators provide feedback regarding the trust level and rapport established, the effectiveness and thoroughness of the interview, and alternative directions in which the interview might have been taken. The trainee has the opportunity to review his/her video and identifies an aspect of the video for discussion at the closing didactic.

Adolescents ranging in age from 14 to 20 years of age are employed by the Project. Actors make a minimum one-year commitment to the Project. They come from varying backgrounds and diverse populations. They participate in a 1-1/2 day training program to prepare them for interacting with and giving feedback to the health care trainees. Periodically throughout the year, the acting company comes together for additional training and to participate in Project development.

Findings from trainees completing self-report questionnaires before and after the interview training suggest that participation in these sessions is associated with increased levels of confidence in conducting adolescent health screening interviews (t=9.24, p<.001) and sexual risk behaviors (t=6.89, p<.0011).

The AATP has demonstrated the effectiveness of adolescents as teachers regarding teen issues and the skills of interacting with teens. Requests for adolescent actors to participate in educational and training workshops are steadily increasing. Training for current providers is being developed in collaboration with private health care organizations in the Twin Cities. An outreach project targeting a specific neighborhood and aimed at improving the quality of adult - adolescent interactions in that neighborhood is also being explored. An impact study would be a part of that initiative.

Mae Seely Sylvester
Adolescent Actors Teaching Project
Division of Adolescent Health and Medicine
Department of Pediatrics
University of Minnesota
200 Oak Street SE, Suite 260
Minneapolis, MN 55455-2002
Phone: (612) 626-0162
Fax: (612) 626-2134
E-mail: sylve001@umn.edu