In this study we report the use of theatrical presentations performed by medical students in a lecture about headache to make medical students more active as learners. More than 90% of participating students agreed that the theatrical performance made it easier to understand the topic. Open-ended questions showed that the lesson was thought of as fun, good and useful by most students who also suggested that this type of lesson promoted "sustainable" or "sticky" knowledge both for performing and observing students. The headache questions in the final exam showed results that were similar to average exam results for other questions. Even though a higher percentage of the students with correct answers to the headache questions had participated in the theatrical headache lecture the difference was not statistically significant.
Some of the performing students in this study were more involved with the patients' stories than with the physicians' roles in the scenarios. Similar understanding of the illness experience and greater empathy for patients were observed by Shapiro et al. They used two one-person shows, dramatically addressing AIDS and ovarian cancer [8
In our study the teachers coached students not only to be good at presentations but also to understand the roles of a teacher. After this group experience, performing students were used to request mentorship from the teachers on other subjects, too. The study thus worked as an icebreaking activity between teachers and students in crowded classes. The performing students need to collaborate for the theatrical presentations promoted mutual respect and cooperation between students and their teachers, and enhanced communication skills within a teamwork setting.
Contrary to the traditional "knowledge transmission view of learning" some authors describe a different perspective focusing on knowledge construction and social exchange [10
]. When students are encouraged to set their own goals, and take more responsibility for learning, then teachers become facilitators of learning rather than knowledge providers [11
]. Also, shared group experiences of attending a theatrical performance may strengthen bonds among participants and facilitate open communication among performing students [8
]. Parallel to these resolutions students in our study were encouraged to set the scenarios and performances in a group work which was accepted to be collaborative and enjoyable in the performing students' own words. As it is emphasized by Lycke et al. group learning processes can promote self-regulated learning and enhance more active engagement in group activities than traditional programs [12
In some of their qualitative studies Baerheim and Alraek gave the individual student a group-based opportunity to reflect on possible consultation strategies through an actress acting as a patient. Students that were "learning through reflection", "improving a humanistic manner" and "utilizing theatrical tools to facilitate this reflection" were main arguments [13
]. Some other researchers noted that the support performing students received from other students and from teachers facilitated student centered learning and promoted student confidence [15
]. Familiarizing the students with the topic, providing resources and information, allowing students to ventilate their feelings, offering counselling to use their own skills, and encouraging were all suggested means to facilitate the students' preparation. The supervising teachers in the present study used all of these interventions. This type of tutorial support may be one of the reasons for the performing students' positive feedback.