Have you ever tried to teach students about caring for patients with chronic mental illness, only to get blank stares in response? Do your students seem hesitant to care for these patients on the clinical unit? Incorporating Readers Theatre into your classroom teaching may turn those blank stares into enthusiastic smiles and improve the care your students provide once they start their nursing practice.

Readers Theatre is an active, problem-based teaching and learning strategy in which student volunteers read unrehearsed scripts to the class. Playing the roles of nurses and mental-health patients, the “actors” read aloud the teacher-constructed dialogue, which centers on the concepts to be learned and features a scenario that illustrates them. Readers put themselves into the roles, and audience members observe the characters being portrayed.

Readers Theatre doesn’t entail acting—just reading with feel-ing and emotion as indicated by the script. The scripts provide an introduction to patient and family experiences with the healthcare system and foster students’ appreciation for them. Readers Theatre isn’t limited to nursing education; it’s used in medical schools and other allied health educational programs as well.

Altering students’ attitudes

According to the American Psychiatric Nurses Association, mental illness is perhaps the most misunderstood health condition. Mental illness is shrouded in stigma and stereotypes. The public and healthcare community alike harbor fears and negative attitudes toward those with mental illness. Improving attitudes can lead to better patient care.

Using Readers Theatre in the classroom before students begin their clinical experiences may help alter negative attitudes and improve the care they eventually provide. By integrating the personal experiences of the patient and nurse with classroom discussion, it promotes learning at a deeper level of understanding for all participants.

Affective teaching and learning

Readers Theatre creates an affective learning environment where student voices communicate patient situations, life experiences, and emotions. As nurse educators, we must promote affective teaching and learning, and implementing Readers Theatre is one way to do this.

An affective environment provokes students to consider their own deep-seated attitudes, emotions, and values, which can cause bias and stereotyping. Affective strategies are especially crucial for nursing students and others who will care for patients with mental illness. Readers Theatre fosters empathy, commitment, and professionalism by stimulating students to reflect on the scenarios in the script, helping them to develop empathy and nonjudgmental attitudes toward the mentally ill.

Implications for nursing

Using Readers Theatre helps students understand mental illness and psychiatric nursing on a more personal level, which can lead to improved attitudes toward and better care for the mentally ill. It keeps students engaged, whether they are script readers, audience members, or participants in the small-group and larger class discussions that follow. Exposure to real-life scenarios involving difficult mental health-related situations promotes cognitive and affective learning, both of which involve expressing empathy. Readers Theatre connects classroom theory with real-life patient scenarios, links textbook concepts with practice experiences, and encourages reflection and critical thinking.

Using Readers Theatre scripts to teach mental health concepts can enhance cognitive and affective understanding at a more meaningful level, which students can apply to real-life situations. Nurse educators need to familiarize themselves with Readers Theatre and other affective teaching strategies to become comfortable executing them in a classroom and to measure their effectiveness.

Developing scripts

To develop Readers Theatre scripts, consider these guidelines:

• Take time to contemplate which mental health concepts students find hard to understand.
• Keep scripts simple, with just two or three characters, to maintain focus on the concept being taught. (See A sample Readers Theatre script by clicking the PDF icon above.)
• Center the script around nurse-patient communication related to the concepts being taught in the classroom.
• To save time developing a script, you may want to use prewritten scripts from case studies and adapt them to your purpose. One source is Medical Readers Theater: A Guide and Scripts, edited by Todd L. Savitt (2002); the medical scripts could easily be revised for nursing education. Another resource I’ve used for script ideas is Clinical Decision Making: Case Studies in Psychiatric Nursing by Betty K. Richardson (2006).
• Limit script readings to 10 minutes so you don’t lose the attention of the audience.
• Develop meaningful, open-ended questions to use in small groups after the script reading, to enhance reflection and critical thinking.
• Hold small-group discussions first; then come back to the whole group for the “take-away” lesson.

Why not give Readers Theatre a try in your classroom? Chances are, you’ll find it heightens creativity and engagement in the classroom, enhances students’ understanding and empathy, and improves the quality of care they provide.

Selected references

Emrich K, Thompson TC, Moore G. Positive attitude: An essential element for effective care of people with mental illnesses. J Psychosoc Nurs Ment Health Serv. 2003;41(5):18-25.

MacRae N, Pardue KT. Use of readers theatre to enhance interdisciplinary geriatric education. Educ Gerontol. 2007;33(6):529-36.

Pardue KT. Introducing readers theatre! A strategy to foster aesthetic knowing in nursing. Nurse Educ. 2004;29(2):58-62.

Savitt TL. Medical readers’ theatre as a teaching tool. Cambridge Q Healthc Ethics. 2010;19(4):465-70.

Shultz CM. Building a Science of Nursing Education: Foundation for Evidence-Based Teaching-Learning. New York, NY: National League for Nursing; 2012.

Trossman S. Overcoming stigma: Education and advocacy can make a difference in mental health care and services practice issues. Am Nurse. 2011;43(2):1, 6, 9.

Kathy Holloway is a faculty member in the online RN-to-BSN Degree Completion Program at AmeriTech College based in Draper, Utah.