Medical Improv
Medical Improv is an emerging field that adapts the YES AND philosophy and activities from theater improvisation for improving communication-related skills & critical outcomes in healthcare. Related articles and trainings are showing up in organizations, online, and educational institutions. This is exciting because there is so much we can learn which can positively impact key outcomes. Yet, understanding how it works can be a bit mysterious. Accepting the common roots of critical outcomes and putting YES AND under a microscope for learning potential will help!
Common Roots of Critical Outcomes
Patient safety, patient experience, workforce health, and cost-effectiveness are critical outcomes that have important common roots. They’re all impacted by our ability to communicate effectively and respectfully[1][2]! Challenging, in part, because communication involves underlying emotional intelligence, which is hard to develop and practice, especially in high-stakes, high-stress work[3] or in toxic cultures[4].
Further, our ability to communicate impacts our ability to form healthy professional relationships, work in teams and be effective leaders. And even further, these all involve individual, group, and organizational behaviors which are interrelated notoriously hard to change!
Medical Improv can help us with all these outcomes because it addresses persistent and pervasive problems related to these skills and behaviors. To understand this better, we can examine the philosophy behind improv.
YES AND Philosophy
YES AND is the golden rule of improv and basically means that you agree to accept what someone else offers (the YES) and then add something to it (the AND)! There are literally hundreds of activities and variations of play that are based on this philosophy.
There are several ways to experience the power of YES AND. They include: participating in an improv workshop, taking this YES AND tutorial or joining me for one of two free online intros on July 13th and August 3rd.
In this article, we’ll explore YES AND by:
- Watching an activity called “Word at a Time Story”.
- Exploring YES AND learning.
- Creating context for assimilation and relevance.
The Activity
“Word at a Time Story” is a fun activity with many variations. Watch as Mindfulness Teacher, Liz Korabek-Emerson, MFA and I make up the story, “The Wise Women & the Eggs” – one word at a time!
Hopefully you enjoyed our little tale and can see how fun it can be even without any learning. Now let’s look at YES AND through a multifaceted lens of emotional intelligence, communication, teamwork, complexity and more!
YES AND Learning
As Liz and I share in the storytelling, you may have noticed moments in between our words where one of us was surprised. Or maybe you noticed some subtle tension, confusion, skepticism or other expressions in the space between our words. Nevertheless, we followed the rule of YES AND. In doing so, Liz and I might be experiencing a lot more!
YES AND – Emotional Intelligence
The YES nudges me to be aware of what Liz is saying and maybe thinking and feeling. Awareness of others is related to developing empathy. The AND helps me to develop a sense of self including awareness and confidence such as when I struggled a bit at [3:10). Also, as we let go of our ideas and try to build on each others’ we practicing perspective-taking. All of this helps us to develop our emotional intelligence.
YES AND – Communication
One of the most obvious lessons with YES AND is in communication. YES requires us to practice listening. AND requires us to practice speaking up. In fact, you can not participate properly in an improv activity without developing these skills!
YES AND – Teamwork
Practicing collaboration is another obvious opportunity for growth. The YES calls upon us to use the other person’s idea. This means letting go of our own plan, making room for others, and ultimately learning how to share power by letting others have it. The AND requires us to offer ideas and step up to take on more power. This is a particular area of growing for me and if you watch the clip closely you’ll notice I often add words that don’t add much to the story such as: an, the, and. That’s okay. I’m learning to be a team player and fully contribute.
YES AND – Complex Adaptive Systems
Complex adaptive systems, like flocks of birds, schools of fish, and healthcare teams have many properties that are relational. Adaptability, flexibility, and the butterfly effect are examples and discussed more in this HealtheCareers’ article. When our relationships are based on trust they have a positive impact on the outcomes of the systems they are part of. And when they are not trusting, the impact is often counterproductive or worse. The YES helps us to develop trust for others while the AND helps us to develop trust for ourselves. Somewhat abstract, I know!
YES AND – Acceptance and change
I recently did a workshop for the mental health professionals at a telemental health treatment program for youth ages 12-18. One of their founding principles is about acceptance and change and how important it is to feel the former in order to accomplish the latter. This made me realize that when we say YES we are accepting our partners’ idea and when we add something to it, with the AND we are evolving or changing the story.
YES AND – Presence
Liz is a wonderful and MTI Certified Mindfulness teacher. (Check out some of her free recordings). We’ve designed workshops that combine improv and mindfulness in unique ways. While meditation helps us to be present with ourselves, improv helps us to be present with others!
Assimilation & Relevance
In order to assimilate deep learning and solidify relevance to healthcare outcomes, care must be taken in crafting debriefing and reflection questions as well as making the learning possibilities visible before and/or after the activity. This is typically part of the experiential workshop design and woven in with any accreditation criteria and objectives for the workshop and guided coaching during the activity.
For instance, in a workshop on CORE Competencies of interprofessional communication (IPEC), this might include incorporating an image, discussion and review of skills with an invitation for individuals to choose any competencies they’d like to develop before playing the activity. After experiencing the activity, we’d discuss areas of growth and relevance to healthcare which can be reiterated with reflective questions that are designed to enhance ongoing learning.
Part of the magic of Medical Improv is to see how individuals in the same activity have different insights and areas of growth!
Summary
It is easy to dismiss activities like “Word – at – a -Time Story” as a silly or frivolous use of time. Or to only see how improv could be useful to reduce stress (which it absolutely can do!). Yet there is much much more available. Watching the video clip again or trying it with a friend now that you know, will likely provide additional affirmation.
When properly facilitated to ensure a psychologically safe environment for YES AND activities and with integration of learning into accreditation objectives, debriefs, and reflection questions, Medical Improv can improve critical outcomes.
Please join my mailing list to learn more about programming, my colleagues, gain access to many videos and articles, and be notified of events like the two free online intros on July 13th and August 3rd. We can create a positive rippling effect in healthcare!
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