Role-Play Preceded by Fieldwork in the Teaching of Pharmacology: from “Raw Sap” to “Elaborated Sap”

ABSTRACT Background: The task of teaching abilities, attitudes and knowledge, which can sometimes be complex, related to the safe and efficient use of medications, stands as a great challenge faced by medical schools nowadays. The role of the prescriber, therefore, who promotes the rational use of medication at undergraduate level gains importance in professional training, with a direct impact on public healthcare. In this context, the implementation of teaching methods that allow an active, critical and reflexive medical training for students is desirable in order to enable them to develop the skills required to manage the main pharmacological classes used by the general practitioner. We intend to describe and analyse role-play preceded by fieldwork as an educational strategy. Methods: Following the fieldwork regarding the utilization of the main pharmacological classes used in primary healthcare, 5-6 groups of students prepared scripts and staged role-plays involving practical aspects of pharmacokinetics, pharmacodynamics, side effects, and potential drug interactions regarding the main drug types. The intervention was assessed using students’ responses to questionnaires coupled with Likert scales, the Dundee Ready Education Environment Measure (DREMM) and semi-structured interviews. There was a correlation between participation in teaching practice and performance in multiple-choice questions in the final course evaluation. Results: All students felt involved and motivated in the activity. 78.5% strongly agreed and 19% partially agreed that the method allowed reflection on knowledge, abilities and attitude, all important to professional practice regarding rational therapeutic prescribing. The DREMM revealed a score of 129.23, consistent with a more positive learning environment in a reliable sample (Cronbach's alpha=0.86). Analysis of the open interviews allowed us to infer that the students considered the method efficient, dynamic, fun, and enjoyable, which enabled greater understanding and consolidation of the content. The strategy was considered stimulating regarding group activities, with active participation. Furthermore, it allowed students an opportunity to experience their future professional reality. The main weaknesses found were the unequal involvement of individuals in some groups and the great length of time spent in the preparation of activities. In the final exam, the students who participated in the intervention had, on average, a higher performance than those who did not take part in it. However, there was no statistically significant difference. Discussion: Role-play preceded by fieldwork proved to be a promising pedagogical strategy and may be used in other basic sciences.

**摘要 背景**：传授与安全、高效用药相关的知识、技能与态度，此类教学内容往往较为复杂，是当前医学院校面临的重大挑战。因此，在本科阶段推动合理用药的处方医师角色培养，其在专业培训中的重要性日益凸显，且直接影响公共卫生医疗质量。在此背景下，亟需构建能够让学生获得主动、批判性与反思性医学培训的教学方法，帮助学生掌握全科医师常用主要药物类别的相关技能。本研究旨在描述并分析以实地调研为前置环节的角色扮演教学策略。

**方法**：在完成基层医疗常用主要药物类别的实地调研后，5至6组学生编写脚本并开展角色扮演，内容涵盖主要药物类型的药代动力学（pharmacokinetics）、药效动力学（pharmacodynamics）、不良反应及潜在药物相互作用等实践要点。本干预措施通过学生对李克特量表（Likert scales）问卷的作答、邓迪教育环境感知量表（Dundee Ready Education Environment Measure, DREMM）以及半结构化访谈进行评估。研究发现，参与教学实践与课程期末多项选择题考核成绩存在相关性。

**结果**：全体学生均表示积极参与本次活动并获得充分激励。78.5%的学生完全认同，19%的学生部分认同该教学方法能够促使其反思专业合理处方所需的知识、技能与态度。邓迪教育环境感知量表（Dundee Ready Education Environment Measure, DREMM）得分为129.23，结合克朗巴赫α系数（Cronbach's alpha）=0.86的可靠样本数据，表明本次教学的学习环境更具积极性。对开放式访谈的分析显示，学生认为该教学方法高效、生动且富有趣味性，有助于加深对教学内容的理解与巩固。此外，该策略被认为能够有效促进小组协作与主动参与，同时让学生提前体验未来的职业场景。本次研究发现的主要不足包括部分小组内成员参与度不均，以及活动准备耗时过长。在期末考试中，参与本次干预教学的学生平均成绩高于未参与者，但该差异未达到统计学显著性水平。

**讨论**：以实地调研为前置环节的角色扮演教学策略展现出良好的应用前景，可推广至其他基础科学课程的教学实践中。