Krista Hoffmann-Longtin, PhD Improv(ing) Teaching and Learning in Medicine What the Principles of Improvisation Can Teach Us About Distance Education Krista Hoffmann-Longtin, PhD Assistant Dean for Faculty Affairs and Professional Development Assistant Professor of Communication Studies Indiana University & IUPUI

OBJECTIVES Define the basic principles of improvisation when applied to the medical education context Experiment with creative collaboration techniques designed to build partnerships across roles Assess challenges and develop strategies to mitigate those, when implementing new teaching strategies

WHAT MAKES OUR JOBS HARD?

WHY IMPROV? Applied Improvisation Principles and Theories Definition of Applied improvisation + range of applied improvisation work and contexts Viola Spolin (1999), the mother of modern improvisation, believed that an approval/disapproval paradigm kept her students from full, rich experiences—in acting and in life. Students never moved forward in their acting because they were too fearful of winning the approval of others, of being judged, of failure. Spolin developed a series of experiential games that would help students free themselves to explore new ideas, trust one another, and encourage that all voices are heard. “When it bogs down,” Spolin stressed, “play a game.”

The skills and ways of thinking required for expert improvisation are applicable when we have to establish relationships, adapt to quickly changing environments, and work collaboratively with teams.

YES, BUT… YES, AND Points of concentration: Yes and/Acceptance/Support offers Dynamic listening; paying dynamic attention

PRINCIPLES OF IMPROVISATION Yes, and… Follow the follower. Make your scene partner look good. Recognize everything as a gift. By definition, improvisational theatre is a form in which most of a play or scene is produced spontaneously by the actors in the scene. The ability to do this does not come naturally. Rather, professional improvisers develop the ability to listen closely, focus, accept others’ ideas, and support one another through improvisation games that allow them to practice and hone these skills. Applied improvisation facilitators adapt both improvisational theatre games and principles to teach learners in non-performance fields similar skills. Some AI facilitators refer to these games as “drills” or “exercises” because, like an athlete’s drill or musician’s scale, the games simulate consolidating tasks into memory through repetition.   Yes, And: Translating “yes, and...” into the clinical context means that all patient communication is an opportunity to learn something and build upon it. Gifts: Looking for “gifts” allows clinicians to reframe errors and mistakes as opportunities to grow and provide quality care. This tenet encourages physicians to practice mindfulness with both patients and team members. Scene partner: All individuals are “scene partners” in the improvisation mindset. This tenet encourages physicians to recognize patients and care team members as equal partners. It discourages ego-centered mindsets that hinder collaboration.

COUNTING IN PAIRS Points of concentration: Yes and/Acceptance/Support offers Dynamic listening; paying dynamic attention

IMPROV: A LENS & A TOOL Medical Education Contexts Communication as co-creation of meaning rather than message transmission Breaks away from idea that content is king --focuses on learning habits, practicing, building competence rather than just teaching concepts Moves away from approach of focusing on formulas and prescriptions for communicating correctly … instead helps build emotional presence, openness to being changed by the other …

MIRROR Points of concentration: Yes and/Acceptance/Support offers Dynamic listening; paying dynamic attention

Improv is to communication, what drills are to sports and scales are to music.

WHAT MAKES OUR JOBS HARD?

Uncovering challenges and building skills in… Listening Reframing Perspective-taking Adapting Empathy Trust Conflict

Getting Started Try incorporating a game Use standard debriefing techniques (What? So what? Now what?) Read! Twelve Tips for Incorporating Applied Improvisation in Medical Education Medical Improv: A Novel Approach to Teaching Communication and Professionalism Skills Improv(ing) the Academy: Applied Improvisation as a Strategy for Educational Development

OBJECTIVES Define the basic principles of improvisation when applied to the medical education context Experiment with creative collaboration techniques designed to build partnerships across roles Assess challenges and develop strategies to mitigate those, when implementing new teaching strategies

Questions & Discussion