According to a first study of its kind, medical clowns, who come to entertain children in hospitals, allow them to overcome crises and orient themselves towards therapeutic treatment thanks to their communication skills.
The study was conducted under the direction of Prof. Orit Karnieli-Miller and Dr. Lior Rozental from the Department of Medical Education at Tel Aviv University, in collaboration with Dr. Doron Sagi, Prof. Amitai Ziv, Orna Divon-Ophir and Liat Pessah-Gelblum of the National Medical Simulation Center in Israel. It was published in the leading journal Qualitative Health Research.
According to the researchers, clowns not only help children, but also parents and the healthcare team, and contribute to the achievement of medical goals.
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“Medical clowns are professionally trained to change the hospital environment through humor. For many years, studies have been carried out on their positive influence and their various skills in specific situations”, écrit the Friends of Tel Aviv University website.
No precise study had until now been carried out to identify the “magical secret” of these medical clowns, and to characterize the skills they use and their therapeutic advantages.
Dr. Elisha Waldman with medical clowns in the pediatric oncology department at Hadassah Medical Center, in 2009. (YouTube screenshot)
“Furthermore, it was generally not understood how clowns can help children, adolescents and their parents cope with difficult situations and sometimes their distress in dealing with painful medical procedures and treatments, which sometimes leads to a reluctance to adhere to the therapeutic recommendations of the medical teams. »
This study thus focused on systematically, qualitatively and in-depth identifying the skills of medical clowns by observing and analyzing their actions during difficult encounters with adolescents, parents and medical personnel. The research team analyzed dozens of videotaped simulations of medical clowns in various situations, and conducted in-depth interviews with experienced medical clowns trained and recruited by “Dream Doctors”, a non-profit association that employs therapeutic medical clowns as part of the paramedic system of Israeli hospitals.
The researchers’ results showed that the medical clowns had about 40 different skills to achieve four therapeutic goals: establishing an immediate relationship and connection with the needs and desires of patients; the management of emotions and difficulties; increasing motivation to adhere to the therapeutic program and strengthening the feeling of control; thoughtfulness and encouragement of patients.
Their work thus allows a better connection to the emotions of the patient, and to establish a personal relationship with him. The patient will also better communicate his difficulties to the medical staff, and will be more motivated to adhere to the treatment provided, while diverting his attention from the pain and creating a playful atmosphere. Thus, according to the results of the study, the importance of clowns goes far beyond simply “bringing a good mood” to patients.
Clowns wearing protective gear entertain a COVID-19 patient in the intensive care ward for coronavirus patients at Shaare Zedek Medical Center in Jerusalem, November 23, 2020. (AP Photo/Oded Balilty)
“In fact, from the moment they enter the room, the clowns choose to connect with the patient, empower them and give them power and status within the medical system,” Prof. Karnieli. “They do this through a primary connection to the voice of the patient, and even to their reluctance to implement treatment recommendations; an emotional bond that subsequently leads the patient to change their position and cooperate with the medical staff. The medical system is hierarchical and it is difficult for the patients who come into contact with it. Therefore, one of the skills of medical clowns is to position themselves in the lowest place in the medical setting. This is how they empower patients, give them power and control, including the choice of whether or not to allow the clown into the room as well as the ability to dictate the nature of his role vis-à-vis the clown. live from them. This allows for an increased sense of control and gives courage to the patient in their difficult situation. »
“Characterizing the skills of medical clowns and their goals improves understanding of their role and actions and can help other healthcare professionals recognize their working methods and the benefits of incorporating them into treatment,” adds the teacher. Karnieli-Miller. “Furthermore, other healthcare professionals can themselves implement some of the identified skills when faced with these challenges. »
“This research is important because it allows the clowns themselves to build a training program and develop the application of various skills to achieve the different therapeutic goals that will suit different patients, while helping to help healthcare professionals to collaborate with the medical clowns. If they know when and how to cooperate with them, they will be able to help patients overcome challenges and, at the same time, may be more tolerant of ‘disruptions’ caused by clowns in the order of care hospitable. This will provide them with the time and space to connect with patients, helping and encouraging them to become more active participants in their therapeutic program,” concludes Prof. Karniali-Miller.
