Where some industries have the benefit of conducting ethnographic or observational research to gain insight into key conversations or decision-making moments, this is not always the case in healthcare. With most of my research in pharmaceuticals, it can be difficult to gain access to some of the most important conversations to learn from, because they happen behind exam room doors, and rightly so—patient privacy is top industry priority. Because of the challenge—and the inherent desire to learn from those “closed door” conversations—I’m pleased to share how role-play allows Escalent’s Health team to unlock those insights for our clients!
The gold standard for real-world insights is immersive, ethnographic research. I fully agree, and I’m incredibly grateful for the opportunities I’ve had to conduct immersive research with physicians in their practices and patients in their homes. However, there can be significant barriers that limit our abilities to conduct this style of research—particularly when our goals are to understand a specific decision or conversation that takes place in the journey of a disease state.
The answer is simple—simulation. As a moderator, I simulate conversations with physicians frequently in the context of in-depth interviews. “Doctor, I’d like you to speak to me as if I were your patient and you were explaining this product to me.” It is an effective tool—except that the physician’s response is typically the abbreviated version, lasting about 45 seconds for a conversation that we know often takes close to 30 minutes.
Role-play, as a research tool, takes the same idea but immerses respondents in the full context of the conversation. The research team provides context, a simulated environment, a prepared actor—and we ask respondents to engage in a given conversation as they would in the real world.
You may be surprised to learn how comfortable physicians are with role-play; in fact, it’s a core part of their medical training. Given that they speak with patients every day, placing them in a scenario to have a natural, reflexive conversation reveals more truth than asking them to recount such conversations artificially.
Role-play is an especially valuable methodology when the core research objectives seek to understand a specific conversation, interaction or decision-making process. Where we might have preferred ethnographic or in-situ observation, role-play provides a time- and cost-efficient alternative that yields similarly rich insights. Specific objectives that are a great fit for role-play include:
To help bring this idea to life, I’ll set the scene: One of our clients, a global pharmaceutical company, was preparing for the launch of a first-in-class oncology treatment indicated for an advanced tumor. When approved, this product would change the existing treatment paradigm as an addition to the current standard of care and, ultimately, change the nature of treatment conversations that physicians would have with patients.
Our client was keen to understand the dynamics and dialogue of today’s current treatment conversations. Because their product would be indicated as an additional adjuvant therapy, our client needed to ensure that their product’s positioning had synergy with the existing standard of care. But, the client was also eager to learn how that treatment conversation would change with the addition of their product.
We could easily have relied on technology and applications to learn about the treatment conversations, or even pursued other ways of simulating the conversation, such as virtual reality. However, we felt strongly that to really understand the human interaction between physician and patient, we needed a methodology that would allow us to fully explore both the rational and emotional dynamics of the conversation.
Much like actual theater performance, all the hard work happens behind the scenes with role-play. Leveraging our foundational patient research and deep knowledge of the disease state, we developed our scenarios and our patient personas. The actors that we cast to portray our patients were provided with more than a medical history—they were given in-depth lifestyle and family background, emotional character development, and specific context about their disease (how they came to be diagnosed, their reaction in that moment, their underlying fears about the disease). We work to ensure that when these actors enter the simulation with a physician, they are prepared to behave, speak and emote as realistically as possible.
We know physicians will tailor their dialogue and explanations based on the patient’s needs and personality, so we prepared two different patient types that we came to understand in our patient research:
For the research engagement, we prepared physicians at the recruitment phase to expect role-play as part of their participation in the research. The discussion began with a brief discussion of their practice, the challenges of treating this tumor type, and then setting the scene for the first role-play by providing a patient chart and explaining that this was their first consult with Joe or Madelyn, where they would be reviewing the treatment plan. After observing the conversation, we debriefed with the physicians to understand why they chose a certain language or made certain decisions. Then, we showed a product profile and asked them to engage in a second role-play—this time in the hypothetical future when “Product X” was available. Again, our patient came in, and the physicians engaged in the simulated “future state” conversation, followed by another debrief before the interview closed.
After conducting these role-play simulations in markets across the US, we discovered that by examining the dialogue of these conversations we were also revealing key emotional learnings and valuable product insights. Our human approach took us beyond the conversation and into the unmet needs within this tumor setting, and helped us understand what was most important to physicians through what they shared with our patient actors.
The unexpected and beneficial outcomes of the research included…
In employing role-play as a health research methodology, we have a few notes from the director’s chair to help ensure success…
At Escalent, we are relentless in finding creative ways to access real-world human insights, even when the behaviors and decisions that we are after happen behind closed doors. Role-play is just one of our ways behind those doors—send us a note if you would like to talk about the creative ways we can help uncover your next human insights.