Medical Improv Teaching Sample: Collaboration Activity

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Once participants learn the core principles,  there are all sorts of activities that can be used to facilitate vital learning. “Dr. Know-it-All” is a great one for reinforcing basic principles while progressing into slightly more complicated play.  This activity requires speaking up, listening, and cooperation.

120px-Chairs_by_SheratonBasically 3 people sit side by side and are instructed to answer open-ended questions from the audience going from left to right and one word at a time.  The answers do not need to be factual, but do need to have a sensible flow.  The audience is engaged with instructions to ask these open-ended questions about the mysteries of life or anything they’d like to know about.  Participants find themselves thinking ahead to how they would answer questions like “Why is the sky blue?’ or ‘How do you teach children how to bake chocolate chip cookies?”.  But they have to be ready to go in a direction different than they are planning because of what the person next to them says.  It is helpful to have folks begin their answer with the question to get them going and would look something like this:

Question:  Why is the sky blue?

Nurse:  The

Nurse Managersky

Surgeon: is

Nurse: blue

Nurse Manager: because

Surgeon: atmospheric

Now at this point the surgeon may have an idea about atmospheric pressure and visual physiology that might seem like the most sensible path for the story to continue, yet does not know what the nurse next in line is thinking or will say.  In this case, the nurse may be thinking more along the lines of a spiritual component of blueness that relates to a flow of water.  Here, in these moments, there are rich opportunities to flatten the hierarchy of human relationships. And so the nurse struggles a bit to come up with a word to follow ‘atmospheric’, that will fit the story.  All this without having complete knowledge or agreement of the surgeon’s planned path.  In between each person’s contribution is a rich field of listening, flexibility, critical thinking, assertiveness, and cooperation.  Coaching includes reminders of one word at a time, continue moving forward even if someone makes a mistake, and building a sensible response.

Nurse: instruments120px-Clear_Blue_Sky

Nurse Manager: have

Surgeon: measured

Nurse: The

Nurse Manager: colors

Surgeon: while

Nurse:  painting

Nurse Manager: blue

Surgeon: gas.

Typically, the other participants are paying fast attention as they watch and wonder how the answer will turn out as it comes to a natural ending. There is value to their role in stimulating thinking that requires open-ended curiosity rather than asking questions to make an assessment.  There are wonderful visceral teaching moments in observing one player’s reaction as s/he is expecting the conversation to go in one direction and must adapt to a different course.   This is healing for doctors, nurses, and others as they learn to relate to each other as equally valued human beings trying to think on their feet and work in concert.  And all stakeholders will be more empowered to weave in and out of hierarchal roles. When the traditional hierarchy serves patient care, it can resume out of mutual respect and with effective collaboration.

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