Medical Improv is the study and practice of improv theater philosophy and techniques as applied to the unique challenges and environment of healthcare for the benefit of improved health and well being of providers and patients.
In order to achieve effective collaboration among healthcare professionals, and thus provide safe, quality care, optimal patient experience, and job satisfaction, leaders and staff must be able to give and receive constructive feedback, think on their feet, and have significant emotional intelligence. Further, professionals are at different places on the continuum of developing these skills and capacities. Medical Improv (aka applied improvisation) is an experiential learning process that promotes individual and team growth in these areas all along the continuum.
The effectiveness of improvisational teaching methods and application to the realm of healthcare challenges is best explained with examples relevant to dynamics common in healthcare systems.
A post-op patient is horrified to see a nurse pick up soiled wound gauze from the floor after discarding her gloves and said to the surgeon, “It was disgusting”. The surgeon told the patient “This is unacceptable. I will find out who is to blame for this incompetence ” and proceeds to yell at the nurse manager, “Your nursing staff is incompetent and unprofessional and I want the person responsible off this unit”. The nurse manager found the nurse and yelled at her, “How will we ever stop these complaints when you do something as stupid as that?” The nurse mumbled to the patient before giving her an IM injection, “I got in a lot of trouble yesterday about the gauze on the floor. “ The patient was surveyed and offered very critical feedback. News of the incident reached the CEO and she held a meeting with the CNO to investigate.
Sample Case After Medical Improv Training-Ownership, collaboration, and co-creative-problem solving:
A post-op patient is horrified to see a nurse pick up soiled wound gauze from the floor after discarding her gloves and said to the surgeon, “It was disgusting”. The surgeon responds, “Oh boy, that sounds disgusting to me too. I’ll talk with the nurse manager and see what’s going on. He catches up with the nurse and takes her aside saying, “Hey, Sally, got a minute? Mrs. Smith said she noticed a nurse not wearing gloves while disposing of an old wound dressing. Was that you? “ And Sally said, “Oh I know, I went to grab gloves in the bathroom, but it was empty, another patient’s IV pump alarm was going off and visitors were coming in. Thanks for calling me on it. I’ll apologize to Mrs. Smith. “ The surgeon followed with, “I’ll talk with the nurse manager and see what’s going on with stocking rooms.“ Sally, apologized to Mrs. Smith, and Mrs. Smith felt confident of the care she was receiving. The nurse manager found several rooms were out of gloves and contacted central supply to discuss solutions. Neither the CEO nor CNO know about the incident, but did send out a congratulatory message to all staff for improved patient experience numbers.
The overall process of teaching improv requires learning a set of core principles and then practicing increasingly complex games. Facilitated discussion, side coaching, and individual reflection/action plans are guided using leadership driven learning priorities, such as; communication skills, professionalism, and/or conflict management. Customized training schedules including full-day, half-day and series’ workshops are available. Ideal group size is 8-16.
|Core Principles||Categories of Activities|
|“Yes and…” (teaching sample)||Trust building|
|Surrender your plan/Co-create||Listening|
|Avoid questions||Speaking up|
|Support each other||Status|
|You have everything you need||Collaboration (teaching sample)|
In summary, many skills associated with communication, collaboration, and emotional intelligence that have varied growing edges among healthcare professionals will evolve with ‘medical improv’. Most healthcare professionals already know the intellectual aspects about such topics as; guidelines for giving and receiving constructive feedback, principles of effective listening, or the complexity of assertiveness. What’s been missing up until now, are safe opportunities for developing awareness and practicing new behaviors among peers.
- Safe care
- Optimal patient experience
- Rewarding healthcare careers
- Effective frontline problem-solving
There is also a full-length video on YouTube called: “Medical Improv: Exploring Learning Experiences that Promote Safe Care, Patient Satisfaction, & Rewarding Careers”.
 This working definition comes from Professor Katie Watson, JD at Northwestern University & Belinda Fu, MD at the University of Washington.