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Using improv techniques in a health care setting, Episode 1: Fundamentals of medical improv

Published Date

Join us this season for a conversation with Shana Merlin, an Austin-based professional communication trainer specializing in medical communications, to explore how improvisational techniques can be used by physicians to enhance conversations and relationships with patients, colleagues, and staff members.

 



Also available on Apple and Spotify. A transcript of this podcast is found below.

 

Additional episodes in this series:

 

Episode 2: Dealing with difficult patients

Episode 3: How to improve patient interactions

Episode 3 Bonus: “Signposting”

Episode 4: Interprofessional medical communications

 

 

Transcript

 

Shana Merlin (preview):
“Improv skills are the skills in helping people be present, responding in the moment, um, being a better communicator, getting out of your head and into the moment, focusing on what the other person wants, needs, and understands. So, these improv skills are actually fundamental medical communication skills.”

 

Tony Passalacqua:
Hello and welcome to this edition of TMLT's podcast, TrendsMD, Answers for health care's digital trends. I'm your host, Tony Passalacqua.

This season on TrendsMD, we will be exploring how physicians can increase their communication skills through the art of improvisation. Our guest will be Shana Merlin, an Austin-based improv instructor who founded her own improv school, Merlin Works Institute for Improvisation.

Merlin Works specializes in teaching improvisational comedy techniques to individuals and corporations to help increase team building, communication, persuasion, leadership, and creativity. In the health care sector, Shana has helped such clients as Dell Medical School at The University of Texas at Austin, the Texas A&M Health Science Center, the Methodist Medical Center, Region 4 Public Health, and TMLT to improve medical communication skills – between the physician and patient; physician and staff; and physician to physician.

Shana is an associate at Center for Health Communications at the University of Texas and was a professor of improvisation at St. Edwards University. You can learn more about Shana and Merlin Works at www.merlin-works.com.

Thank you, Shana, for joining us today. One of the big questions I know our listeners will have is: what is improv? Can you give us like a real good definition, or a good idea of what improv is for anyone who may not know or understand what it is?

Shana Merlin:
Yes, so improv is making up scenes and stories, songs and dances on the spot inspired by audience suggestion.

So, that might happen at your local improv comedy club or theater. You might watch Whose Line Is It Anyway on TV or YouTube. You might watch Curb Your Enthusiasm. Those are all shows that have unscripted, um, live comedy on them. And And improv is not Saturday Night Live, that's sketch comedy. So those, uh, are written.

There's stand-up comedy where someone an individual is in front of the microphone, and they are delivering prewritten jokes from their point of view.

So those are all different kinds of comedy, but improv comedy is usually done live on stage with a group of people making up as characters on the spot playing scenes and stories. And what we're talking about today is really applied improv. So not necessarily for comedy or for performance but using the tools and techniques from the world of improvisational theater to help people be more present, more in the moment, better communicators, and more fun to work with.

 

Tony Passalacqua:
And I know just before we started this this podcast, Shana and I were talking behind scenes about some of these different games. Could you explain some of those different games to us?

 

Shana Merlin:
Oh, sure. So, some like classic improv game?

 

Tony Passalacqua:
Yeah, I think one of them was like Zip Zap. Yeah, how did those work?

 

Shana Merlin:
Yeah, a lot of those. I'm going to give you a game that we could do just the two of us together. So that'll maybe translate a little better onto audio here. So, we'll play a game called First Letter Last Letter. And, um, this is when I teach a lot in my medical communication courses because it's a game that's going to help you really focus on listening, getting out of your head, getting into the moment, and focusing on the other person.

So, you and I, um, are going to have a conversation, and the only rule is the last letter of whatever you say is going to be the first letter of my response, and the last letter of whatever I say is going to be the first letter of your response. Okay, we'll start off very slow so everybody can kind of catch up with us.

So, the first thing I want you to do is to just give me a conversational opener, something you might say to help start a conversation chat me up.

 

Tony Passalacqua:
All right. “Good morning, Shana. How are you doing?”

 

Shana Merlin:
Great. So that ends with a letter G. Um, so G is going to be the first letter of my response. “Good. I'm excited to be here today.” That ends with the letter Y. So, the Y is going to be the first letter of your response.

 

Tony Passalacqua:
Yikes. Um, well, that's a tough one to start with.

 

Shana Merlin:
Well, you already had yikes, so you can just keep talking. Yeah.

 

Tony Passalacqua:
Yeah. “Yikes. Well, hopefully it could be better.”

 

Shana Merlin:
“Remember, we're just here to have fun and have a conversation.” So that ends with N. So, you're going to respond with the N.

 

Tony Passalacqua:
I'm totally wrecking this one. So, I'm putting my hands way up in the air and then I am bowing forward. And what was that again? Yes. I'm sorry. I messed up or here you go on a podcast. Thank you everybody. I appreciate everyone's attention to that.

 

Shana Merlin:
But you're what your experience is the game's a lot harder to do than it sounds

 

Tony Passalacqua:
Really is.

 

Shana Merlin:
Like you're, "Oh, That's easy. I get that" and then you're "Like, and wait, what?" or maybe even missed that I ended my sentence with n because you're thinking about what you're going to say. So, this game gives you a couple of challenges and this is a great one to practice if you're in the car with somebody right now, practice this game, First Letter, Last Letter. It has two challenges. One: there's this problem-solving challenge You get the letter n and you’re trying to talk about our podcast, and you've got to kind of solve what word starts with N that can keep this conversation in flow. And there's a second challenge that's even more important, which is this game disrupts verbal planning.

It's hard to think ahead about what you're going to say because you don't know what letter you're going to get. And that way it forces you to listen, all the way, until the person is done talking. And that for many of us is an unusual experience. We're used to getting the gist of what someone is going to say and then we start thinking about ourselves and what we're going to say in response. Um, and so we miss out on a lot of information. We're not listening fully, and we're not listening to understand. We're listening to respond. This game helps slow us down to listen fully before we respond, realizing that there's time after someone's done talking for us to think through our response.

Now this gets to those fundamental improv rules I've been talking about. Why? Why are we always thinking ahead about what we're going to say? Why don't we just listen to people fully? I would say it's because we don't want to mess up. We're so anxious about not looking foolish, not going blank, not having things to say, that we're always thinking ahead about what we're going to do to avoid mistakes and errors.

But when we're always thinking ahead to avoid failure, we’re never in the moment. So, this is why if we want to be more present and “in the moment,” we have to change our relationship with failure. If we're always worried, if we can't tolerate mistakes, then we're always going to be thinking ahead or we're going to be thinking behind, thinking about woulda, shoulda, coulda, all the mistakes we have done.

If we can start to make friends with failure and be okay with it, that frees up our brain to be present in the moment. And when you're not perseverating, ruminating, working, working, working on all those mistakes and all that anxiety, you've got a lot more mental space to take in what's happening right in front of you, which is the most important thing that's happening in any medical interaction, seeing what's going on right in front of you.

The third piece of that is trusting yourself. You have to know as a health care provider: I know myself. I know what I'm doing. I don't need to think, think, think so much about it. I shift my focus onto the other person. What do they know? What do they need? And trust myself to respond in the moment. I just actually, this is something I just saw yesterday because I get all my wisdom from TikTok now.

(Laughs) But I saw this quote that was like, "The bird doesn't sit on the branch because it knows the branch is strong. The bird sits on the branch because it knows its wings are strong." And when you trust yourself to be able to handle whatever happens, then you can kind of land anywhere.

 

Tony Passalacqua:
Shana, what does improv have to do with practice and medicine?

 

Shana Merlin:
Yeah, it sounds kind of counterintuitive, right? That why would you want, uh, your doctor to know improv? Because medicine should be all about, um, following plans and evidence based and research and all those kinds of things and making sure everything is measured and correct, and those are true.

And, at the same time, um, Improv skills are the skills in helping people be present, connecting with people, responding in the moment, um, being a better communicator, getting out of your head and into the moment, focusing on what the other person wants, needs, and understands. So, these improv skills are actually fundamental medical communication skills.

And it's interesting, when I was delivering a training, um, for TMLT at one of the hospitals in Dallas, somebody came up to us after the workshop and said, you know, this, this workshop was so great, this medical improv workshop, because we get workshops about new medications or new treatments, and maybe I can use those on 10 percent of my patients or 20 percent of my patients.

This training, I use it with every patient, and I get to use it with all my interprofessional communications as well. So, there's a lot of applicability for improv and medicine.

 

Tony Passalacqua:
There's so much going on for providers. How can they possibly be more present during their time with their patients?

 

Shana Merlin:
Yeah, I've been working with medical professionals for over 10 years now. And what I've come to understand is that both in medical education and in medical practices, there is so much going on that is pulling them out of being in the moment and connecting with the person right in front of them. They have time limits.

They have medical records and charting to do. They have these computers. They have you know, their phones in their pockets. There’re so many things that take you out of being present in the moment. And all those things are helpful and important, but at the same time, my job here with using medical improv is to help people in that moment when they come in that exam room to be able to look someone in the eye, connect with them, introduce themselves, really see what's going on.

One of the things that's powerful about improv training is it helps you see things that other people don't see. When you are fully present, you're really aware of the full picture and so you're going to get a lot more information, more quickly. And a lot of the techniques that we're going to talk about, even though it feels like there's no time and how can I add one more thing to my list?

The goal is and the evidence says that this stuff will save you time in the long run. So, it'll save you time in those dreaded doorknob conversations. So those are the conversations you think the visit is over, you head to leave the room, you touch the doorknob, and they go, wait, I didn't mention this major thing that's happening in my life or this major health problem that actually is what needs to be addressed first.

So, making sure that you're really listening, that you are getting a full assessment and that you're understanding what's important to deal with in that moment is really important. And a lot of the patient complaints in terms of getting better HCAP scores, the patient complaints are, "I wasn't heard. They didn't listen to me. They didn't hear my story." Not, "I didn't get the prescription I wanted; I didn't get the outcome I wanted,” even. It's really, you know, they've waited for weeks or months for this appointment, they have something they want to say, and they felt like they were not heard and it was not addressed.

So, I like to think about reframing this really as coming back to health care providers as healers. And there's a lot of healing and helping that happens through fully listening to what's going on with a patient. As well as fully listening, helping us, um, treat and, and diagnose a patient better.

 

Tony Passalacqua:
I'm sure a few of our listeners out there are listening to this and they're thinking to themselves, well, we are already dealing with quite a bit of burnout right now. And this feels like some of these techniques may add to additional burnout. What's your thoughts on that?

 

Shana Merlin:
Right. This phrase, "How do you pour from an empty cup," right? If you're already burned out and empty, how much more can I give to my patients? You know, I've done a lot of reading and research around this topic of patient communication in medicine, and I came across this great resource, this book called "Compassionomics" by Dr. Stephen Trzeciak, and it's his story of being a burned-out physician. What is burnout? It is a feeling of depersonalization. So, you don't see people you're working with as people. It's just another number, another diagnosis, another problem. You feel a lack of effectiveness.

You feel like what I do doesn't matter. It doesn't really help or change anything. You feel a sense of deep fatigue. Those are some of the top indications of what burnout is like, and he was really meeting that criteria. And he was getting advice that a lot of people get when they're burned out, kind of the classic advice. Take a break. Go on vacation. Do some yoga. Try and kind of replenish yourself in that way. And he did those things, and he came back to work, and he was still burned out. He might have felt better at the end of the vacation, but a few hours or days back in and it really doesn't last. And so, he started doing a really in-depth analysis of thousands of research papers about burnout and he found that the answer is really counterintuitive. The solution is not by "checking out," going on vacation, compartmentalizing. The answer is about leaning in and being more compassionate. So, when he was more compassionate, cared more, expressed more compassion - and we'll get into exactly how we do that in a, um, later in the session - he found that it really helped him as a provider because it increased his sense of personalization. He was connecting with these individuals and not just, "Okay, there's a diabetic in room one and ...um, you know, and uh, flu in room three."

These were individual people that he was connecting with. And it helped him improve his sense of efficacy, that he was really making an impact because he was expressing compassion and helping these people. The people, when he was, uh being a more compassionate provider, people were more compliant. So, it increased the level of people filling their medications and taking them, completing what was recommended, which increases your sense of efficacy as a physician.

It also helped the bottom line in a lot of the health organizations. So, it improved scores, it improved financials of people not having to be readmitted and things like that. So, this idea of kind of a compassionate intervention, which doesn't have to take a lot of time. In his example, it's 40 seconds, can really improve things for providers, for patients, and for health care systems.

It's counterintuitive, but there's a lot of evidence to say that the answer is going more compassionate and that the reason a lot of doctors are burned out is because the system is pushing them to be less compassionate and that is really distancing them from the reason they became health care providers in the first place.

Most people become health care providers because it's a calling. They want to help people, and when you feel like you aren't helping people it's really hard to stay motivated. And you're focused on billing and insurance and numbers and this and that. So, it helps us really reconnect with the purpose as a healer and one of the things that I talk about is really maximizing the placebo effect.

We think of the placebo effect. You all know what the placebo effect is, right? So, it's something that's been eternally measured and studied. So, the placebo effect, you know, as you know, is if, um, you're given a sugar pill instead of a medication pill, right? You're given a placebo. So, there's no effective medicine in that pill, but there is something in being prescribed a pill and taking a pill that has a measurable, consistently measurable healing effect.

Right? And it's big. It can be from, you know, 10, 20, 30 percent or more of this placebo effect. And traditionally, in medicine and in science, we think, well, we need to get rid of and ignore that placebo effect because that's not real medicine. So, we measure the placebo effect against the medicine we're giving. 

But this placebo effect is like a treasure trove. It's saying when a patient feels treated, they feel like you're addressing their issue. There's something going on that heals them, maybe not fully, but can reduce pain, improve their experience, improve their wellbeing. So, we want to really instead of ignoring or hiding that placebo, we want to maximize that placebo effect.

And we do that by what's called creating a therapeutic alliance. So, we talk about this a lot in our in our trainings, this great study out of Canada where people used a TENS unit on a patient who's having back pain. And the patient, there's four versions of this in this experiment. One time the patient comes in, they have back pain, they get this TENS unit put on, but they don't put the power to it.

They don't switch it on. But they're left in the room for 25 minutes just with this TENS unit on. Placebo, right? Nothing's actually happening except for they have a provider there that's putting something on them. So, they're experiencing a treatment, right? Those people get kind of that 20 to 30 percent improvement in pain, reduction in pain experience. That's the placebo effect, right? But the TENS unit is effective. So, in the next round, if they put it on another, uh, participant, they put the TENS unit on, they turn on the switch, provider leaves the room for 20 minutes, the patient feels even better - 50 percent reduction in pain.

Now, then, uh, what happens is when they have a second round of the placebo. They come in, they put the TENS unit, they don't connect it, but they stay in the room and they talk with the patient for that 25 minutes and they create a therapeutic alliance with that patient, expressing compassion and understanding for their suffering, seeing them as a person, saying they're going to help them with this problem, they're going to be a team dealing with this, creating that therapeutic alliance.

The results are even better than the TENS unit. Right? Even better than the actual treatment. And when those are both combined? Wow. You get the highest efficacy. So of course, we believe in medicine and science and treatments. And when those are combined with a therapeutic alliance, it creates an extreme impact in both the patient experience and the provider experience. And creating a therapeutic alliance doesn't have to take a long time, it can take just a few moments, and it can have a huge impact for both people involved.

 

Tony Passalacqua:
Shana, that sounds like a lot of great advice. One of the things that I've noticed, at least, is that burnout seems to be kind of a common term that we're hearing right now. And what you've just said seems to be one way of being able to help physicians re-find that joy of medicine. Do you have any other techniques or tips to help physicians continue to find that joy of medicine again after maybe venturing into the burnout?

 

Shana Merlin:
Yeah, I think this is a great moment to kind of talk about the rules of improv. So, if you haven't learned about improv, you haven't done improv, I'm going to give you a quick and dirty intro to improv and talk about how it can help medical professionals, okay? So, I have an improv comedy school here in Austin. We teach improv, stand-up comedy, uh, storytelling, and musical comedy. And I also do applied improv, going to all kinds of businesses, organizations, health care centers, medical schools, and teaching the tools and techniques from the world of improv theater, not to help them be funny and tell jokes, but to help them build all these skills that we've been talking about. So, but the rules are the same wherever I go, my rules, my improv rules. So, the rule number one is have fun. And we talk about why it's so important to have fun even when you're doing something really serious, So, uh, having fun is important for learning and growth.

So, if you're having fun, you're going to learn more, you're going to retain more, you're going to come back. If you're having fun, you're going to stick around as an employee, right? If you're having fun, it's contagious in a good way, right? So, if you're having fun, the people you're working with are having fun.

So fun is a really big primary value of improv, whatever kind of improv you're doing, and it's really important in medical improv. Now, that doesn't mean you can laugh and joke around in a serious moment. Of course not, right? You have to find the fun and find the times that that is important. Sometimes that fun is about solving a challenging problem. That's one way of fun, right? And sometimes that fun is laughing and joking with the people you're, you're working with.

I love to give this example. I once did, uh, training for the city of Brownwood, Texas, a kind of small town near Austin. And it was for all the city employees. It was their day off and they were coming there for this kind of team building, improv team building. And I asked this question, I always ask, which is, you know, why is it important to have fun at work? And a fella in the back of the room raised his hand and I called on him and he was wearing kind of like, uh, a jumpsuit, like he worked in, on streets and construction and something like that. And he said some days I am out fixing the sewers, and I am chest deep in sewage.

Like literally, right? And he's like, and if I don't have fun with my colleagues at work, what, what is the point? And obviously we don't, hopefully most of us are not spending our days that way, but what a vivid example, right? I mean, it feels that way for a lot of us, right? A lot of us are, are just deep in something really yucky.

Um, so we have to find those moments of fun and relief. So fun is a really primary value of improv. So that's rule number one, have fun. Rule number two: dare to fail. So, this one can be challenging in a medical environment. So, we want to try to succeed, but we want to dare to fail and take risks. Now, what kind of risks am I talking about?

Cause I'm not talking about the improv risk of like going into a surgery and going, "Oh, what if I tried this cut, blah, blah, blah," right? That is not at all what I'm talking about when I'm talking about taking risks. The risk I'm talking about is being present in the moment, which means you're not a hundred percent in control of what's happening. But that means you're open to understanding what's actually going on and unfolding in the moment.

The risk I'm talking about is social emotional risk. Like the risk of being compassionate, the risk of asking questions, the risk of getting feedback. These are social emotional risks of behaving in new ways that could really help us grow and develop. So, these are these stretch goals, these risks that we want to, that we want to take.

Not game day, surgery day, prescription time risks, not those, um, sloppy mistakes. Those sloppy mistakes give us information like you need to rest, you need to have some coffee, you need to drink some water. But really those intentional risks from learning and growing. So we want to number one, have fun.

Number two, dare to fail. And number three, we want to be a good sport. So, I'm going to throw this back to you because I ask this question a lot. What do you think bad sports do? What do bad sports do when they mess up? What does that look like? What does that sound like?

 

Tony Passalacqua:
Oh, well, you know, I think you can see that sometimes when you're watching a, like a sporting event and someone gets really angry and you see, you know, like, I don't know. Each sport has its own thing, right?

So, softball, you see those dugouts and they empty out and everyone goes into the field. Or sometimes the other one that you'll see is, uh, you know, hockey, you watch them throw their gloves on the ground and they start just going at it. That, that's, that's usually what I think.

 

Shana Merlin:
Yes. I think it's great looking at sports. Uh, if you have kids, you know what bad sports are like when they lose, playing Monopoly. Um, so bad sports, they get angry. They get angry at each other. They get angry at other people. They get angry at themselves. They blame; they excuse; they minimize; and most importantly, they quit.

They take their ball, and they go home. That's what bad sports do. And they're not going to learn and they're not going to grow. And they're not, people are not going to want to be on their team. So, we want to be really good sports in life and in work. Good sports are able to laugh things off, let things go, and try again.

They're accountable. They own their mistakes. They get curious and see what happened and want to do better. So, one way we think about this is we want to take the work seriously and ourselves not. Take the gain seriously and yourself not. And that's a way to kind of have that nice balance of, of course your work is important and of course it's serious, but if you take everything seriously, it's going to be hard to have that joy of medicine and that camaraderie. You can't just white knuckle it through 40, 50, 60 hours a week. You've got to find the fun where, where those moments happen. So, we have a specific way we deal with all the mistakes that happen all the time.

When we're improvising, we don't know who we are, where we are, what's going on at the beginning of every scene. So, we're constantly making mistakes and having fun with it. And we do that by doing this "failure bow." So, this is something I teach in every workshop I do. Any time we feel like we goofed up, we messed up, it didn't go the way we wanted, we put a smile on our face to let everybody know we're okay. We lift our arms up in the air to take responsibility. "I did that." I'm not going to hide it or cover it. And we say these magic words: "I failed." And everybody applauds us. Hooray! You took a risk. You tried something new. You're owning it. You're accountable and that gives your body and your mind a way to let it go, so you can get resilient.

Get back in the moment. Bounce back and get back to the work at hand. Because we know a lot of times it’s not the mistake that gets you. It's the cover up. It's the rumination. And the ability to acknowledge it - laugh it off, let it go, and do that in your culture, in your practice - can be really powerful.

Now, I will say, because we are talking about some serious moments in medicine, we're going to talk about delivering bad news in a little bit. That's obviously not a time to smile and laugh and cheer. You know that. I know that. Right? I like to use my favorite, one of my favorite kind of parenting catchphrases, which is, “Laugh when you can, cry when you can't," right?

If there's a possibility, um, you know, this as a parent, as a friend, as a provider, if there's a possibility to make it light and laugh. Let's do that. If not, let's feel those feelings and move through them as well. Um, number one, have fun.

Number two, dare to fail. Number three, be a good sport using our failure bow. And now I'm going to talk a little bit about how to have more fun in whatever you're doing. And that's this idea of EPIC. So EPIC is an acronym I've come up with to make anything you do more fun for you, more fun for anybody who you're working with, and more fun for anybody who might be watching.

Now the tragedy of this is that I came up with this acronym EPIC before I started working with medical providers. And, as you probably know if you're listening to this podcast, EPIC is also the name of a, uh, health record management system that is NOT fun for many, many people. So, we're going to reframe.

This is our reframe on EPIC, okay? We're going to reclaim this amazing word, EPIC, and we're going to think about how this can help us have more fun in whatever we're doing. So, the E in EPIC stands for energy. We like to work with people that bring energy to the team, energy to the project - physical energy, vocal energy, emotional energy.

That energy, just like that fun, is contagious. So, if you show up to work and you go, "How are you doing?" And you go, "Uh, well, you know, it's been, I didn't sleep good, and traffic was terrible and blah, blah, blah." You're bringing that energy in, you're going to get that energy bad, right? Um, so we want to try and have a positive energy, a high energy - not manic, don't need to scream or be, be wild, but a relaxed, focused, upbeat, positive energy, as much as you can bring that to, to, um, to the activity.

P is for pacing. In improv we like to go fast because we like to out race our brains and take risks. In applied improv, it's more like we want to be in sync with the people that we're working with. If you were talking about acute care, urgent care, it's go, go, go. It's quick, it's fast. You've got to pick up your personal pace to be in sync with the team.

If you might be in long term care, it might be a slower pace, right? And we'll see. lower deliberation, or maybe you're trying to change a software system in your organization. That is a slow process, right? So, you have to speed up or slow down your personal pace to match the people that you're working with or the patients in the room.

I is for "In the moment." We like to work with people who are making eye contact with us; who listen to the things we say and seem to respond to them and be affected by them; who are not on their devices; who are not making their grocery list; who are in the moment. And those are signals - like you're giving me right now - you're nodding. You're making eye contact, probably going to repeat a word I say. Those are great signals to show that we're in the moment. And for one of my big, uh, basic pieces of advice to keep in the moment is listen and repeat. Make sure you are listening and repeat back a word or phrase that you heard. And that's going to make you stay in the moment and it's going to let them know that you're in the moment with them.

So, you've got energy, pacing, in the moment, and the C is for commitment and that is that take the work seriously and yourself not. So, we want to be committed to our choices, committed to the activity. Maybe you got assigned to a shift or a team or a project that you wouldn't have chosen but it's what you're doing so commit to it.

 You're going to get more out of it, if you put more into it. Um, so as well as delivering your, um, ideas with commitment and kind of saying things like you mean it. So, any of those things, energy, in the moment, and commitment can help you have more fun in whatever you're doing and can help that fun spread throughout your team. So that could be, how could you make your huddle more EPIC, your team huddle at the beginning of the shift? How could you make your patient interactions and a pediatric checkup, how could you make that more EPIC and bring that energy and pacing and in the moment and commitment? Um, it's a fun thing, you know, even, even if, you know, something that's kind of redundant, something that's kind of boring to do.

If you kind of see, okay, let me see how fast I can go, how many charts I can get done in this next hour. You time it out, you chunk it up. There's a way to make things more fun for yourself.

 

Tony Passalacqua:
So, do you think improv could possibly work as an environment for physicians to go to? Like, let's say they sign up for one of your classes to maybe work on some of those techniques in a safe environment.

 

Shana Merlin:
Yeah. So, um, in my company, Merlin Works, I kind of have two main branches. So, one, I have this improv comedy school, and we get people from all walks of life coming to take these classes. And I've had many doctors and nurses, and health care providers come take my improv classes. And one of the great things about it is that we often don't know who does what, what, what their real-life world is, is like.

So, we're all just playing Zip Zap Zap and Whoosh Bang Pow and making up scenes. And then we'll go out for drinks after the last class and be like, "Oh, you're a doctor?" "Oh, you're a stay-at-home parent?" "Oh, you're, you just moved to town?" "You're unemployed?" We, you have no idea. You know, one of my favorite quotes about, I think it's about improv, from Plato, this, you know, classic Greek philosopher is, "You can know a man better in an hour of play than a year of conversation." Playing with people is just a really different way of connecting and it kind of presses fast forward on that relationship building and that connection.

So yeah, you can come, uh, nobody needs to know you're a doctor or you can tell everybody you're a doctor, um, and come to an improv class and you will see the connections with the work you're doing every day in every class. You'll see the connections. It's so clear and obvious because it's such fundamental skills to what you're doing. Additionally, I do come to organizations. So TMLT will often bring me to their customer's organization and teach workshop on improv for medicine and improv for better communication and help people learn how to communicate better as a method of risk management, right?

Because oftentimes the people are unhappy, not because of the, like I said, not because of something that went wrong, but because of the way they were treated. So, we can learn to treat people better, build better, uh, relationships that way. So, um, yeah, that's tricky to, learn improv from a book or from a YouTube or on your own.

It's great to listen to this podcast and we'll do some exercises that you can try, but I definitely think it's an experiential learning. So as much as you can take what you hear, take what you read and see, try it out or get with a group of people and practice it, the more impactful it will be.

 

Tony Passalacqua:
Thank you, Shana, and thank you for listening to our podcast. Coming up this season on TrendsMD, we will continue to explore medical communication improv with Shana Merlin, including how to deal with difficult patients, improve patient interactions, and how to more effectively communicate with other health care professionals. I invite you to keep listening!

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