Lights, camera, education!

The potentials of forum

theatre in a learning disability nursing program
Alex McClimens
a,
*
, Rachel Scott
b
a
Department of Mental Health and Learning Disability Nursing, University of Shefeld,
Rotherham S63 7ER, United Kingdom
b
Dead Earnest Theatre Company, Shefeld, United Kingdom
Accepted 21 April 2006
Summary Learning disability nurse education, with a current emphasis on inclusive
practice and a history of listening to the person with the disability, is well placed to
take advantage of more experimental forms of classroom teaching. In this article
we argue for the use of forum theatre as a method of addressing topics from practice
within an educational setting. Based on our emergent and exploratory work with stu-
dents we detail at length the theoretical background that supports such an approach
andcontextualisetheissues withreferencetoa short pieceof dramawehaveusedsuc-
cessfully with different student groups. We feel that the success of this method is due
to the involvement of students in directing their own education as well as the inclusion
of individuals labelled with learning disability as an integral part of the process.

c
2006 Elsevier Ltd. All rights reserved.
KEYWORDS
Reection;
Education;
Drama/theatre;
Learning disability;
Nursing
. . .all theatre is necessarily political, because all
the activities of man are political and theatre is
one of them.
Augusto Boal, 1979
Introduction
Foucault asserts that
any system of education is a political way of main-
taining or modifying the appropriation of dis-
courses, along with the knowledge and powers
which they carry (1981: p. 64).
Hence, anyone who stands before a group of stu-
dents to deliver a lecture or tutorial is engaged in a
political act as surely as if they had registered their
vote. Likewise anyone who cares for another hu-
man being is also involved in politics because such
actions invoke power relations. When we bring to-
gether the two domains of nursing and education
the political is personal. With the addition of the
contested concept of learning disability the per-
sonal becomes political.
In this article, we will draw on our experience
derived from a small pilot study aimed at realising
0260-6917/$ - see front matter

c
2006 Elsevier Ltd. All rights reserved.
doi:10.1016/j.nedt.2006.04.009
*
Corresponding author. Tel.: +44 112 222 9665.
E-mail address: A.McClimens@shef.ac.uk (A. McClimens).
Nurse Education Today (2007) 27, 203209
intl.elsevierhealth.com/journals/nedt
Nurse
Education
Today
the potential of using forum theatre in teaching
sessions. The students were in their rst year of
a pre-registration learning disability nursing pro-
gram. We found that drama appears to bring to-
gether many elements considered to be essential
for a successful teaching and learning experience.
The work, and student feedback conrms this,
suggests that learning is enhanced when a more
proactive approach to topics is taken. Students
are more engaged, more inclined to participate
and more likely to remember. In short, students
learn better.
This article then begins with some discussion of
related theoretical aspects from three interlinked
arenas; education, research and theatre. When
aligned with the use of drama in education these
perspectives combine to form a persuasive argu-
ment for an approach that addresses the need to
engage students more actively in their own
education.
It says here. . .
The literature on education, research approaches
and the political uses of theatre is divergent in its
scope but convergent in its desire to produce
change/action. This goes beyond a simple stimu-
lus/response model and aims for the kind of perma-
nence associated with lifelong learning (Yeaxlee,
1929; Knowles, 1998). Williams further endorses
this with her comment that
the rapid changes in health care, diminished life-
span of useful information, and increasing com-
plexity of practice make it essential that nurses
maintain competence throughout their careers
(2004: p. 277).
In order that the system can produce practitio-
ners of a suitable calibre thinking in nurse educa-
tion has adopted certain strategies proposed by
early theorists. A contemporary of Yeaxlee, John
Dewey emphasised particular aspects of learning.
For Dewey, learning was almost a by-product of
thinking (1910/33) and most famously his assess-
ment of this is captured in the term reection
(1938).
For our purposes though, the salient points are
to be found not in the varieties of reection iden-
tied by Dewey, nor even in the many volumes that
have since been inspired by his work, but in that
very necessary corollary to reection: action. As
Rodgers observes,
. . .for Dewey, reection must include action
(2002: p. 855).
Jackson connects this to drama when he ob-
serves that at the very heart of Boals work is the
dual meaning of the word act, to perform and
to take action (2002: p. xxii).
Freire, a compatriot and contemporary of Boal,
was overtly political in his work. His emancipatory
intentions were apparent in the way he saw educa-
tion as a shared process where the student was en-
gaged in a dialogue with the teacher. This is far
removed from the curricular approach to education
that emphasises the distances in this pedagogical
relationship. Freire wanted, in all of his work, to
free the learner from the constraints of a formal
approach. This complements current thinking
which seeks to promote self-directed learning
within higher education. We shall return to this
theme in more detail later with a discussion on
the uses of theatre.
The expert/lay dichotomy will be familiar to
those working within the nurse education arena
generally and the learning disability branch in par-
ticular. It is as expert/lay that the lecturer/student
relationship is often characterised. This produces a
tendency to make the student reliant on the tea-
cher. And it is precisely in this arrangement that
Freire wanted to see a change in the relationships
of knowledge production with more emphasis being
given to the student as a self-directed learner. Fre-
ire called this conscientization.
1
More recently
Knowles has indicated support for this position.
He says that
. . .self-directed learning is conceived of as per-
sonal autonomy. . .[which]. . .means taking control
of the goals and purposes of learning and assuming
ownership of learning. This leads to an internal
change of consciousness in which the learner sees
knowledge as contextual and freely questions what
is learned (1998: p. 135).
Still the question remains, how are we to act in a
way that promotes reection in the students in our
care? One obvious and commonsensical answer
would be to provide a stimulating educational
experience. Curricular restraints, however, do not
always allow for such an imaginative approach.
And yet in order for students to be engaged
there is some onus on the lecturer to present mate-
rial in such a way that what Andersen refers to as
the pragmatic difculties associated with
authentic contexts do not impinge too much
(2004: p. 283).
It was in response to a situation like this that our
own intervention began. The remit was to provide
1
Learning to appreciate the social contradictions apparent in
society and reacting against this oppression.
204 A. McClimens, R. Scott
a session on user involvement in learning disability
practice to rst year students. As a policy back-
ground to this the white paper Valuing People
(2001) is founded on four principles of rights, inde-
pendence, choice and inclusion. The educational
response is to make students aware of the issues
within a theory based session with a view to imple-
menting these principles in a practice setting.
Typically this had been achieved through a stan-
dard didactic format with a presentation to stu-
dents of relevant literature followed by some
discussion on examples from practice with debate
on how to promote more user involvement.
Our feeling was that a session on user involve-
ment was compromised without genuine user
involvement and so, with input from individuals in
receipt of services, we set about devising a script
that we felt would address this issue. We will de-
scribe this in more detail later but for now it is time
to consider the inuence of research. In particular,
we will examine the contribution of the participa-
tory research paradigm.
Peru, potatoes and participatory
research
In a discussion on participatory action research
Sample (1996) outlines how a project Transition
into Community Life, designed to assist young
adults with developmental disabilities to access
leisure and recreation facilities, borrowed method-
ologically from earlier work by Rhoades and Booth
(1982).
Rhoades and Booth were interested in the agri-
cultural application of shared knowledge produc-
tion. In Peru seed technologists were working
alongside local farmers to increase storage capac-
ity. An immediate problem arose with a failure on
the part of the experts to recognise uses for what
they classied as spoiled potatoes. When the farm-
ers had highlighted how these could be used for
animal feed the experts then further compromised
their status by designing excellent seed trays that
were way beyond the budget of their hosts. Again
native knowledge provided a solution with the pro-
vision of locally available materials by which all
parties were satised. This brief example illus-
trates well the way that a combination of thinking
that takes account of native or lay perspectives
can produce better results.
In the literature on the research process as it
implicates learning disability issues there is some
debate on the political advances that may be made
available with an emancipatory approach. Thomas
provides a useful denition that can easily be
applied to the purposes of education with the
following:
Emancipation refers to the process of separation
from constraining models of thinking or acting that
limit perception of and action toward realizing
alternative possibilities [1993: p. 4].
Learning disability nursing has always explored
these alternative possibilities both in practice
and in education. The principle of normalisation,
for example, (Wolfensberger and Nirje, 1972; Wol-
fensberger, 1992) and the social model of disability
(Oliver, 1992) have both, in recent years, been
inuential in changing policy and practice. In self-
advocacy too learning disability has been promi-
nent (Charlton, 1998; Goodley, 2005).
Allied to this the place of research has been
instrumental in securing better lives for those in-
volved (Chappell et al., 2001; Coles, 2001).
Atkinson is aware that such claims can be re-
garded suspiciously and concedes that while some
varieties of research cannot offer material gains
they may yet enable people labelled with learning
disability to develop historical awareness and thus
to view their lives differently (2004: pp. 692/693).
It is in adopting this perspective, of viewing things
differently, of exploring alternative possibilities
that we aim to promote a change in attitude for
our students and a desire for change in the lives
of the people they care for.
So far it appears as if research approaches that
value the involvement of participants share some
key concerns with education; crucially around the
need to produce change/action in the minds of
those most closely involved. In the following sec-
tion we will nd out whether theatre can comple-
ment this by providing a vehicle by which to
facilitate the process. Here we investigate in more
detail the work of Augusto Boal.
Boal and forum theatre: question
challenge and change
Boal shared Freires concern for oppressed minori-
ties and all of his theatre work is aimed at redress-
ing what he saw as the imbalance of power
between the audience and the stage, and by anal-
ogy, between the indigenous populations of South
America and their governments. In dramatic terms
he essentially wanted to relieve the theatre audi-
ence from the passivity of their role by removing
the monologue that characterises much stage
drama. The parallels here between what goes on
in a typical classroom are plain. In both situations
Lights, camera, education! The potentials of forum theatre in a learning disability nursing program 205
a paid professional takes a central position before a
seated audience and delivers spoken content. Fre-
ire refers to precisely this with his remarks that
A careful analysis of the teacherstudent rela-
tionship at any level, inside or outside the school,
reveals its fundamentally narrative character. This
relationship involves a narrating Subject (the tea-
cher) and patient, listening objects (the students)
(original emphasis)(1972: p. 45).
In order to get away from what he described as
the banking method of teaching, by which teach-
ers deposit information in the minds of their stu-
dents (known locally as the mug and jug scenario)
Freire then went on to outline what he called
problem-posing education. Now better known in
nurse education at least as problem based learn-
ing the intention was to allow students to reect
on their own experiences in order to arrive at their
own solutions.
Boal too was unsatised with this arrangement
and attempted to create dialogue, by which the
audience is encouraged to interact and become
part of the performance. He did this as part of
his agenda for social change. His insistence on
the transformation of the audience is clear from
the following:
In order to understand this poetics of the
oppressed one must keep in mind its main objec-
tive: to change the people spectators, passive
beings in the theatrical phenomenon into sub-
jects, into actors, transformers of the dramatic
action (1979: p. 122).
Boals way of producing this transformation
came in the shape of forum theatre. He rejects
Aristotles Coercive System to Tragedy where the
world is known, complete and ultimately, imposed
upon a passive audience. The characters experi-
ence the trials and triumphs for the audience,
who then vicariously feel the emotion. The audi-
ence is encouraged to absolve themselves of
power, pass on the responsibility to the character,
but come away purged, through second hand
catharsis. This, Boal argues, ultimately disempow-
ers the audience. Real action, real life action is
substituted for the false, dramatic action and the
audience gives up its ability to make changes on be-
half of themselves.
Boal was no more impressed by the Brechtian
model. Here the audience is encouraged to think
(rather than feel) on behalf of the characters. They
see, for example, Mother Courages plight and are
enraged by the circumstances that force her to sac-
rice her children. This thought means that the
world is organic, and truth subject to change. How-
ever, this change is conned to the truth of the
stage and the theatre, and not that which goes
on outside.
Boals essential contribution takes us a stage
further. Historically, Boals method of forum the-
atre came about as a tool for social and political
change. Forum theatre is over 20 years old and
has its beginnings in the barrios (slums) of Brazil
where the peasants were encouraged to stand up
to their oppressors, in this case the landlords. It
has since become an international tool for social
and political change, a means of giving [all] people
the strength and condence to overcome oppres-
sions. (Jackson, 2002: p. xxii).
Boal sought to break down the fourth wall that in
the Stanislavskian model separated action from
audience. This fourth wall exists today most recog-
nisably in the form of television where we are not
invited to participate in the lives of the characters.
Their actions and words will remain the same de-
spite any wish on our part to intervene. This paral-
lels Freires desire to move away from didactic
modes of education. In his introduction to Educa-
tion for Critical Consciousness Goulet highlights
Freires encouragement for us to adopt a method
which fosters dialogue and reciprocity. . . (2005:
p. x).
Boal and Freire abhor man as mere spectator.
Freire likens the term spectator to that of object,
or that which reduces a persons humanisation.
Boal coined the term Spectactor, so that the
watcher becomes empowered and takes part in
the action in a real and meaningful way. Similarly,
Friere extols the position of Subject over Object in
the world, so that the human is part of the world,
with the power and capacity to change it, rather
than the world being something that happens to
him . . .no longer mere spectators. . .[they] de-
mand intervention. . .they want to participate
(1974: p. 11).
Transferring these thoughts into the realm of
nurse education, the learner learns best when they
actively participate in the world. In this case the
world of the real life scenario as acted by the edu-
cators. As the audience/learners are encouraged to
nd solutions to the problems presented, the ac-
tors/educators become the educated and the
power shifts for the student to become spectators,
and subjects of the scenario. Solutions are found
with the students, not presented to them as al-
ready having been discovered and imposed upon
them. They become the experts. In this way, the
educator (in forum theatre, the actors) does not
try to impose their view. Rather He can discuss
[the students] respective positions (Freire,
1974: p. 9).
206 A. McClimens, R. Scott
Through forum theatre this discussion becomes
action, and new scenarios are created. There is
not only one right answer. The only absolute is that
the original scenario is not the best way to deal
with things. The students are encouraged to try a
range of scenarios. This is particularly important
within nurse education as what will work for one
person as a practitioner may not work as effec-
tively for another. This form of education, identi-
ed by Friere, allows people to reect on
themselves, their responsibilities. . . (1974: p. 13).
Learning lessons?
When we consider the lessons from educational
theory, from participatory action research (PAR)
and from forum theatre there are clear areas of
commonality in their goals and those that we aspire
to in nurse education. Principal among these is the
necessity to promote some change in behaviour by
manufacturing circumstances that enable students
to take a more proactive role in their own
education.
This is alluded to by Elden and Chisholm who
note that action research typically contains these
elements: commitment to values, a situated con-
text, aims for change, is participatory and nally,
disseminates knowledge (1993: p. 124). As a tem-
plate for nurse education it could hardly be
bettered.
In this example there are clear echoes of an older
call toarms rst articulatedby Marxwhenheencour-
aged thinkers to move beyondreection and into the
realm of action (Marx: pp. 1842/1970). Today we
have the term action learning which suggests that
its authors were familiar with Marx. In dening the
term McGill and Beaty, for example, emphasise the
need for change/action when they describe it as a
continuous process of learning and reection, sup-
ported by colleagues, with an intention of getting
things done (2001: p. 11).
Above all else Freire believed in the practical
relevance of learning. This surely speaks to nurse
education. Rolfe describes it this way. He said,
For Freire, the learner must start with concrete
examples from her own experience. However,
these examples are reected on not only to learn
about the world, but more importantly, to learn
about learning, that is, to learn how to change
ones position in the world (2001: pp. 22/23).
If we extend this to the nurse education realm
then it offers the possibility of a truly autonomous
learner, released from the bonds of simply listening
to the teacher. Just as Boal wanted the audience to
dispense with the articial boundaries that separate
the stage from the auditorium so Freire and Rolfe
are looking to a more independent learner/audi-
ence, released from the connes of the curriculum.
With this in mind we set about to provide some
learning opportunities for the students that would
simultaneously allow then to draw on their own
experiences while giving them the opportunity to
act, and effect change in a safe environment.
Tales of the unexpected
Pfund et al. highlight how the very unpredictability
of practice can place sudden and severe strain on
student nurses (2004: p. 112). The curriculum can-
not cover every eventuality and some students will
inevitably be faced with emotionally challenging
situations that they are not necessarily prepared
for. The idea that shared reection can help to
work through these feelings is suspect if it is done
in a vacuum.
In seeking to address this we have found that by
using forum theatre students can bring a problem
from practice, and through the medium of drama,
explore alternative courses of action before they
reect on it. This reinforces Boals assertion that
forum theatre is a rehearsal for reality.
To enact this in a live setting we co-opted the
members of Words & Actions, a theatre group com-
prising people with a variety of disability/impair-
ment, to perform with us in the session on user
involvement. We rehearsed the piece several times
before presenting it before the student group.
Our chosen scenario was played out by Words &
Actions with Rachel as facilitator and Alex as in-
jured party and members of the group playing
other parts. The action progresses with Alex, play-
ing the part of someone with a learning disability.
His carer is escorting him to his GP for treatment
to an injured ankle. A brief consultation ensues: a
medically focused outcome unfolds one that
leaves the learning disabled patient frightened
and confused. The story ends at this point.
As the scenario is re-run the audience is invited
to stop the action to suggest alternative ways for
the characters to behave. These suggestions are
then performed by the actors. Typically these fo-
cus on the quality of communication and the ne-
glect of the person with the learning disability as
a person with an overemphasis on their subordinate
role as patient. Ultimately, and ideally, an audi-
ence member is invited to take the oor and dem-
onstrate what they see as a preferable course of
action. In this way the audience become the per-
formers and the opportunities to explore alterna-
tive scenarios increase exponentially.
Lights, camera, education! The potentials of forum theatre in a learning disability nursing program 207
Our example is just that; an example. Any num-
ber of situations from practice would readily lend
themselves to the forum experience.
Reections
From our experience we identify three main areas
that arose from our work.
Power relations suffuse learning disability as a
concept, the practice of learning disability nurs-
ing and at a structural level inform a societal
response to individuals so labelled.
Theatre/drama has a universal appeal.
Reection is now an established part of nurse
education. From Dewey through Schon and Ben-
ner to Rolfe the advantages are clear: engaged
students just learn better.
We will comment on each briey by turn.
Power relations are not only apparent in the way
that society is structured with regard to those
minorities labelled with a variety of disability/
impairment but they are equally plain in the
education system. The hierarchy, however, can
be temporarily suspended. As Wasylko and Stick-
ley note, for the teacher who is prepared to
release some control to their students, drama
as a learning medium can be empowering and
promote personal growth (2003: p. 445).
Further to this point we are nding that learn-
ers are made more aware of these power rela-
tions when individuals labelled with learning
disability perform the forum theatre. This gives
added impetus to the educational content since
the learners are made more aware of the impact
that diagnosis can have on an individual. And by
taking part in the session they are coming to
appreciate what Cooper meant when he said
that Through responsibility for ourselves we
become socially responsible (2004: p. 84).
The universality of theatre is plain from the pop-
ularity that attaches to a wide range of social
and cultural values invested in various media.
From the opera house to soap opera audiences
are attracted to staged drama. However, even
if we ignore the therapeutic benets that accrue
students were very clear in their feedback that
they enjoyed their own participation in these
sessions. This is something as educators that
we cannot ignore.Fundamental to the success
of forum theatre as an educational tool is the
safe challenge it presents to the Spectactors.
As Jackson remarks, anyone can act. And cru-
cially participants are acting as they themselves
would in any given situation so no performance
experience is necessary.
This leads into the nal point. Students who
enjoy their classroom time are more likely to
be motivated to study and so to make connec-
tions between theory and practice. The reec-
tive component is prominent within forum
theatre and this aspect is valuable in promoting
the idea of the much sought after reective
practitioner.
Conclusion
The need for change/action to consolidate reec-
tion has been the focal point of many inuential
educationalists and thinkers. Researchers who are
motivated by political imperatives share similar
concerns. Thus researchers who adopt qualitative
methodologies and participatory paradigms are
further coerced by beliefs about ownership and
authority. The need to effect change/action is still
primary.
With reference to a small pilot project we have
highlighted how our own efforts have amalgamated
these ideas and have been successful in beginning
to alter the way students think about topics.
In nurse education in general, and in learning
disability nurse education in particular, with a pol-
icy emphasis on rights, independence, choice and
inclusion, there is an added onus on the would-be
practitioner to effect some change in the lives of
the people they work with. By using forum theatre
we feel that we have given these students a useful
tool for affecting future change. To paraphrase
Marx, while nurse educators and practitioners have
thus far interpreted the world of health and social
care, the point, surely, is to change it.
Acknowledgements
Acknowledgement is due to the students in the
department and to the members of Words & Actions
for their contribution to the paper. We would also
like to thanks the two anonymous reviewers whose
comments enabled us to produce this article.
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