Quality & Safety Intersection: Medical Improv & Health Care!

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“Improvisation is about teamwork, being in the moment, doing the best you can with what you have,….and so is medicine”.  —Katie Watson, Medical Improv originator)

Health care practitioners and improvisers are driven by the same paradox:  the need to prepare for unpredictability.  Improvisational theater teaches practitioners to accept uncertainty and ambiguity as the conditions in which they must perform, rather than reflexively trying to impose order on something that hasn’t yet unfolded.  Participants are told they have all the information they need for a scene, and no one is “wrong”.  Stepping into the abyss of risk-taking is met with overwhelming support and applause!

A common misconception is that improv is comedy, so the term “Medical Improv” might appear confusing.  Comedy is focused on humor, whereas improvisational theater is focused on honesty and spontaneity.  What makes improv so enjoyable is the way participants are behaving, which in turn makes us laugh!  That’s why Medical Improv is considered “serious play”… the method is fun, but the content is serious.  Listening, observing, and being emotionally present are essential.  It’s both an art form and a skill set, a performance and a practice.  It can even be designed to develop self-esteem, spontaneity, problem solving, empathy, collaboration and professionalism…..enabling teamwork that creates productive, open, and trusting partnerships.

The core princDoctor woman funny speech at conference isolated on white backgroundiples of Improvisation include:

  • Never say, “No”.  Denying another person’s idea can stop a scene dead in its tracks.  Instead, players ought to build on their scene mate’s suggestion, always responding “yes, and…”, which focuses on establishing agreement and cooperation.
  • Avoid questions because they put the burden back on the other person instead of sharing responsibility for building a scene together.
  • Be expert in everything.  If the setting is a cockpit, a player should not impede the scene by professing ignorance about aviation.  Players must pretend to be knowledgeable to keep the scene progressing.
  • Give gifts…that is, add information to the scene by explaining who they are, why they are there or how they relate to the other players in the scene.

There are hundreds of Improv activities, many variations, and gradients of difficulty.  Here are a few introductory Improv exercises that are often used when working with healthcare professionals:

  • Yes,…and   (Focuses on establishing agreement and cooperation)   Lesson:  No ideas are crazy, and participants are challenged to give every idea an opportunity for development.  By respecting every idea in Improv, we open the door to more respect for others (ie., patients in healthcare settings).
  • Gibberish Translator  (Focuses on how body language and tone communicate content and emotion, independent of words)  Lesson:  Patients “hear you” in ways larger than what you verbalize- eg., if you say something “nice” in a flat tone while typing data into a computer, your words probably won’t be received by the patient in the same way that you intended.
  • Split Focus and Story Repetition (Focuses on conversational skills and comfort skills in verbal patient interactions)  Lesson:  How to empathize when listening, observing, being receptive, reassuring and choosing words carefully
  • Dr. Know-It-All  (4-7 participants with linked arms, acting as multi-headed person (also with multiple doctorates!), answering questions as a group) Lesson Rudimentary teamwork.  There’s no wrong answer.  A “group mind” can create something unique that no individual would have thought of.
  • Status Walk (Discussion and focus on how people communicate their “status” non-verbally.  How do we encourage and show respect and empathy for everyone?)  Lesson:  Separating role (titles, socially conferred expectation of authority) from status (actual power in the room)

Healthcare organizations and practitioners are encountering critical examination by patients and their  insurers.  “Pay for Performance” has become a common phrase, and providers are increasingly being evaluated for their ability to accept feedback, adapt to change, handle stressful situations and establish rapport. Medical Improv for Healthcare Professionals builds the skills needed to handle these difficult situations, interact with diverse cultures, and become sensitive to ever changing healthcare environments.

In addition, health care data measurement assesses the quality of care and cost of care in order to determine reimbursement rates .  This ongoing trend is pushing healthcare organizations and practitioners to improve their interpersonal relationship skills in order to enhance positive “patient experiences”.

In summary, Medical Improv is:

  • Listening (no words are necessary, includes body posture, emotions and disposition)
  • Cooperation (it’s a “team sport” that celebrates dialog and shared respect)
  • Observation (the ability to process large amounts of crucial information and translate it into action)
  • Adaptability (letting go of  preconceived notions and being mindfully committed to new ideas)

Healthcare may be structured, but it can’t be scripted.  That’s how the link between medicine and improvisation manifested!

References:

Watson, K. Perspective:  Serious Play:  Teaching Medical Skills With Improvisational Theater Techniques. Academic Medicine:   October 2011-Volume 86-Is

the 50 Faces Project

sue 10-pp1260-1265.

 

Stephanie Frederick, M.Ed., RN is passionate about providing positive patient experience through Integrated Healthcare.  She attended the first Medical Improv “Train the Trainer” Intensive, taught by Katie Watson, JD at Chicago’s Northwestern University Feinberg School of Medicine, in June, 2013.

www.stephaniefrederick.com

Katie Watson is a lawyer, medical ethicist, improv performer and faculty member at Second City (Chicago).  She is assistant professor of medical humanities and bioethics at Northwestern University Feinberg School of Medicine where she teaches improvisational theater to medical students.

Are you curious to learn more?  Medical Improv:  Exploring Learning Experiences for Promoting Safe Care, Patient Experience, & Rewarding Careers” will air on Google +!  11:00 AM EST-save the date and time to catch it live!

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4 Responses to Quality & Safety Intersection: Medical Improv & Health Care!

  1. Pingback: Med Improv Articles

  2. Pingback: What Would a Medical Improv Pilot Project Look Like in a Hospital? Say, for a Med-Surg Unit?

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  4. Thanks for this great article, Stephanie. You really found wonderful language to help healthcare leaders explore and understand how extremely valuable medical improv is. I love teaching it and as you suggest, “it builds the skills needed to handle difficult situations, interact with diverse cultures, and become sensitive to ever changing healthcare environments”. In addition, it helps to eliminate ‘silo’ mentalities and when taught early on, such as in orientation programs or undergraduate programs, prevent them. Another consideration is that it helps to reduce stress and don’t we need that in heatlhcare? I hope that more and more healthcare facilities will consider adopting the techniques and educational institutions will incorporate it into undergraduate curricula.

What are your thoughts?