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The Role of Improvisation in Leadership Training

“Improvisation is practice in being a better human being.” —Kelly Leonard

Good leaders must continuously build proficiency in two key areas: the ability to listen and mindful collaboration. We can demonstrate and assess listening skills in the training environment but how does one teach collaboration? And once taught, what tools can we provide learners to foster further development outside the classroom?

Building Leadership Agility Through improvisation

Improvisation is not just for performers. You and I do it every day in real life. When improv is introduced as a learning opportunity in the classroom — with no consequences for mistakes — learners get to immerse themselves in situations and examine new ways to be truly present.

Kelly Leonard, author of critically-acclaimed “Yes And – How Improvisation Reverses “No, But” Thinking and Improves Creativity and Collaboration” (HarperCollins, 2015) calls this being fiercely present.

In this very short TedTalk, Mr. Leonard adeptly describes what improv is and how its use benefits people and organizations seeking to improve social skills and team dynamics.

 

 

Leadership Skills in Healthcare

“Across industries, U.S. companies spend $14 billion per year on leadership development, and still, their executives believe that they do not have a sufficient supply of leadership talent to support their growth and strategic ambitions. And nowhere is this shortage felt more acutely than in healthcare.” —Jessica Sweeney-Platt

Healthcare research is catching up with other industries in embracing social skills and team connectedness as foundational elements of leadership.

In this article, The secret of Mayo Clinic’s physician-leader training program,  Mayo Clinic and Athena Healthcare present ground-breaking data that link real-world impact with the development of core skills in leadership and communications.

“The intent is to build social capital, the trust and interconnectedness of the organization, beyond leadership development itself.” —Steven Swensen, M.D.

In an associated article entitled The Mayo Clinic’s culture of ‘socialism run by Republicans,’ athenahealth’s Jessica Sweeny-Platt asks Stephen Swensen why the culture at Mayo Clinic is so successful. He speaks of co-production and problem solving as a way of focusing on the staff’s needs — a primary concept in culture and leadership development.

Two outstanding features of Mayo’s program are the commitment to include leadership and communication capabilities training throughout curriculum and the depth of its program for developing core strengths in cooperative problem solving and social communication.

To see a dynamic example of how improvisation impacts leadership, see The Role of Improvisation in Leadership Training

 

Medical Improv — What is it and Who Benefits?

It’s easy to learn, leverages skills already in use, and quickly demonstrates the value of clear, culturally-capable, mindful communication.

Improvisation (improv) is an experiential learning technique that takes the principles and practices of theater and applies them to communication, interpersonal relations, and approaches in critical thinking.

When Improvisation is applied to the specific skills, situations, and outcomes important to those in the medical field, it is called Medical Improv.

While considered an emerging field, specialties have developed centering on the use of Medical Improv for leadership development, cultural change, communication, and interpersonal relations. The newest front in Medical Improv is its use as an education modality in medical training and education.

Medical Improv is addicting because it works, feels affirming, and positively impacts relationships.

Medical Improv has a measurable positive impact on medical practitioners and is being adopted by leaders in healthcare delivery and education. Numerous studies demonstrate the positive impact Medical Improv has on physician and resident perceptions of communication skills and sense of wellbeing. A longitudinal study conducted by Mayo Clinic demonstrated a reduction in resident burnout by introducing arts and humanities techniques through Medical Improv. New research into nursing and allied health professions demonstrates improvement in creative thinking, confidence, trust and collaboration. Hospitals and medical schools are beginning to integrate Medical Improv into their teaching practices and ongoing professional education including Mayo Clinic, Cleveland Clinic.

Medical Improv Improves Communications and Interprofessional Relations

Medical Improv is an effective and inclusive teaching tool. Mayo Clinic, for example, is using Medical Improv in numerous ways, some of which were developed by the founder of Namaste Logic.  Examples of Mayo’s use of Medical Improv include the Florida campus’ unique program of applied improvisation in simulation, and the launch of Medical Improv in nursing. Kicked off at Nursing Grand Rounds in October of 2016, Mayo’s nursing Medical Improv program is aimed at improving nursing communication and interprofessional dynamics. The offering was picked up and expanded upon by the Florida campus Cardiac nursing staff and is scheduled to continue through 2017. Another program — both an ongoing research project and Humanities in Medicine program embedded in the residency program at Mayo Clinic nationally — leverages Medical Improv as one of several solutions aimed at reducing resident burnout.

With serious consequences to patient outcomes and reimbursement, communication and interpersonal relations are an emerging priority in Healthcare today. Healthcare institutions need medical professionals to work together as cohesive teams to deliver patient care while communicating clearly and openly.  Delivering care that merely heals is no longer the only indicator of quality patient outcomes. Care that patients themselves experience as high quality and satisfying has lasting impact — on both consumer choice and healthcare reimbursement. Additionally, the complicating factors of lean staffing ratios and sicker, more complex patients, makes interprofessional relations and communications high-stakes issues.

Medical Improv has a lasting impact on interprofessional relations and communication. Improv is easy to learn, leverages skills medical professionals already use, and quickly demonstrates what it feels like to be on the giving and receiving end of clear, culturally capable, and mindful communication.

Examples of Improv tenets that can be learned quickly include:

  • “Yes and…” Affirming what is said and adding new information or direction, as opposed to “no but,” which stops the exchange of information cold.
  • The ability to react in-the-moment to information as it is presented, avoiding limiting ideas, diagnostic momentum, or confirmation bias
    The ability to be mindful in communication; using true and focused listening
  • The ability to be open to “failure” of ideas or concepts in light of new or developing information
  • The ability to recognize how status impacts our verbal and non-verbal communication in every interaction, and how to use status to heal

Medical Improv is addicting because it works, feels affirming, and positively impacts relationships.  The bottom line:  everyone benefits from Medical Improv — especially the practitioner, who learns to give the gift of being present and open while benefitting from improved relationships everywhere they practice Improv from patient interactions to personal relationships.

References and Additional Reading:

Boesen, Kevin, et al. “Improvisational exercises to improve pharmacy students’ professional communication skills.” American Journal of Pharmaceutical Education. 2009; 73: Article 35. link
Boynton, Beth. “Nursing Research Shows Improv Techniques Improve Communication.” 2016. link
Brotman, Barbara. “Northwestern med students practice improv.” Chicago Tribune February 15, 2010. link
O’Reilly,  Kevin B. “Comedic skills for a serious role: Improv class teaches med students to think on their feet.” American Medical News. March 7, 2011. link
Hammer, Rachel, et al. “Telling the Patient’s Story: using theatre training to improve case presentation skills.” Medical Humanities. 2011; 37: 18-22.  pdf
Henry, Tanya. “Preventing burnout in residency programs: Mayo Clinic’s unique approach.” AMA Wire. 2016 link
Hoffman, Ari, Brynn Utley and Dan Ciccarone. “Improving medical student communication skills through improvisational theatre.” Medical Education. 2008; 42: 537–538. link
Lestch, Corinne. “Pathology residents and grad students in the Bronx take new improv class to communicate better.” Daily News. August 7, 2012. link
Shochet, Robert, et al. “‘Thinking on my feet’: an improvisation course to enhance students’ confidence and responsiveness in the medical interview.” Education for Primary Care. 2013 Feb; 24(2): 119-24.
Stokes, TA; Watson KL; Boss, RD. “Teaching Antenatal Counseling Skills to Neonatal Providers.” Seminars in Perinatology. 38 (2014) 47-51. pdf
Watson, Katie. “Perspective: Serious Play: Teaching Medical Skills With Improvisational Theater Techniques.” Academic Medicine. 2011 October; 86(10): 1260-5. link