Yes,...
HI Banner best.jpg

Current Thoughts

No sharp distinction between his work and his play

Well, hello, last week’s entry was a little heavy on ideas, not fully formed ones at that! This week I will try to be more concrete and provide a more tangible benefit to you, my trusted reader. We will talk recent and upcoming events, then discuss how Healthcare Improv got to this point that I think would be helpful to anyone considering starting to teach how improv can be used in healthcare education.

 

Recent events include finishing up the Faculty Development workshops for the year. There are two units that we do in the Fall semester and two units in the Spring semester. Each unit has one workshop dealing with interpersonal communication and one workshop dealing with group communication. Unit 1 was focused on Empathy and Adaptability, and Unit 2 was focused on Listening and Body Language (last evening). The Intro to Improv for Healthcare Professionals continues on, and we are looking forward to our class show on December 17th. The improv team that I have been on for the longest has our show next Friday at The Backline here in Omaha.

 

Now for a story of erasing the distinction between work and play

The TLDR is…

1.     Tons of people helped me along the journey, and not just a little help, but crucial roles in the development of where things are now. There are too many people and not enough positive words to give the appropriate amount of thanks. These are people from the improv world as well as the healthcare world. Shout out to my wife and kids too for putting up with all of this silliness

2.     At every step, I have been filled with self-doubt and questioning what the hell I am doing. I am experiencing that as I write this now. I have taken too many lumps to count as well: things have not worked as I had planned, people haven’t shown up to events I poured my heart into, I didn’t perform as well as I hoped, I didn’t live up to the ideals I was espousing are a few of the major examples

3.     I’ve grown more than I ever could have imagined. Whatever I am now, I would have been much worse without going on this journey. 

 

This is the “more full” story, but not quite the full story

It started in a peer mentoring session where I casually mentioned on a form that I wanted to use improv to formally teach patient communication and provider wellness. A colleague asked me to explain that comment towards the end of the meeting. I did not have a grand vision; it was simply saying I would like to pursue the idea of it. I knew that it was done at various institutions throughout the country, but I didn’t really know what it entailed or what was needed to get it off the ground. From that one comment on the form, the colleague put me in touch with the head of Faculty Development at my institution. She was kind enough to ask if I wanted to help run the Body Language portion of an upcoming series of Faculty Development workshops geared towards helping faculty become better at public presentations. I said, “Of course!” In my head, I had a few ideas to wrestle with before the workshop, which was two weeks away. First, I had no idea what I was going to say about body language as I mostly went up on stage and acted like a goofball. Second, I was not a great presenter. Not uncommon events at my presentations were my voice cracking or having an audible swallow noise at an inappropriate part of a sentence. Third and most concerning for me, I was wrestling with the idea that up until that point, I had kept it quiet at work that I did improv. If I did tell colleagues, I said it was a Duke Silver situation (any fans of the show Parks and Rec?). All these concerns weighed on me as I prepared but the desire to show others how improv had helped me allowed for moments of ignoring those concerns. I successfully completed that workshop in a manner that was not great, but satisfactory. I did have an intense moment of reflection following the workshop. I think that was when I crossed the threshold. I could no longer go back to being a doctor at work and an improviser on nights and weekends. I think that that shook my identity, and I didn’t know how to handle it. I include this information to help someone else in their journey more than anything. I felt vulnerable telling other professionals that I was involved in this silly activity. So as a warning, it takes vulnerability to start down this path and you will likely have to dig around in the caves you fear the most.

 

The workshop on presentations had gone okay, I was alive, and colleagues at the hospital were not gathered around the metaphorical water talking about what a loser I was. With the help of Faculty Development and local experts in communication, I was able to put together five workshops for the fall of 2018. The marketing materials for them only passingly mentioned that the workshops were going to involve improv theater techniques. The workshops sold out and actually had waiting lists to attend. I needed extra people to help facilitate this many people in the workshops. I was able to collaborate with the specialists on our hospital’s Patient Experience team. Before each workshop, I emailed the facilitators the itinerary for the workshop with explanations of the exercises. I asked that the facilitators come up with an example of how each exercise might apply to patient care. Then I went through the exercises and how I thought they could apply to patient care for about 30 minutes before each workshop. Beyond that, the facilitators did not have any special training. There were some huge successes that came from those initial workshops, but I noticed waning attendance following the third of five workshops. 32 people signed up for each workshop and the original workshops in 2018 were attended by 21, 26, 20, 13, and 15 attendees. The interprofessional nature of the faculty development workshops was universally noted as a positive in post workshop feedback. One of the successes was that Library Department requested a series of workshops specific to changes that their department was going through. This led me to develop three additional workshops based on my discussions with the Library Department’s leadership team.  With the drop in attendance in the original workshops after three workshops and now a total of eight workshops created, I set out to make changes to allow the workshops in the winter of 2020 to be the best yet. There would be 2 four workshop series. One series for individual communication skills (Empathy, Listening, Wellness, and Emotion) and one series for group communication skills (Adaptability, Body Language, Growth Mindset, and Trust). In the marketing materials for these workshops, it was clearly labeled as using improv theater techniques in the workshop. There was much less of a response. Attendees who have attended three or more past workshops are offered the opportunity to facilitate future workshops. There are currently 64 potential facilitators that fit this category on our campus. In addition to being functionally helpful to running the workshops, this has provided me with many meaningful experiences. To see people that attended the workshops enjoy and connect with the ideas enough that they come back to help facilitate future workshops for new attendees provided me with a deep sense of connection. This also helped refined which activities are the most impactful in each workshop as well as help understand how people connect with the ideas presented. This has also led to doing new workshops with different groups on campus. I was able to do a workshop for Physical Therapy exchange students to help them acculturate to American medical system, as part of professional development for Genetic Counsellors, for Palliative Care providers to battle empathy fatigue, and Physician Assistant and Medical students in their preclinical education. It also led me to people on my campus as well as in the city of Omaha who are interested in similar topics. It has served as a gateway to the humanities for me as well as the people who have helped with these workshops. The interprofessional nature of the original faculty development workshops is what allowed the improv theater activities to expand. Having previous attendees from diverse professional backgrounds serve as facilitators has also provided an increased richness to the experience of subsequent workshops; these facilitators provide different perspectives and are actually connected to the communication skills needed in their hospitals and clinics. 

This quote below was something I came across while in residency and living in New Orleans, long before I had started doing improv. It seemed like a good goal at the time. Onward!

“A master in the art of living draws no sharp distinction between his work and his play; his labor and his leisure; his mind and his body; his education and his recreation. He hardly knows which is which. He simply pursues his vision of excellence through whatever he is doing, and leaves others to determine whether he is working or playing. To himself, he always appears to be doing both.”