Can I Get a Suggestion? Medical Improv as a Tool for Empathy Training in Obstetrics and Gynecology Residents

Abstract

Background Physician empathy is associated with improved patient outcomes. No studies have examined the outcomes of medical improvisational (improv) training on empathy. Objective Our aims were to determine whether an improv workshop is an effective tool to deliver empathy training for obstetrics and gynecology (OB-GYN) residents, and whether that effect is sustained over time. Methods We conducted a prospective cohort study of OB-GYN residents undergoing empathy training through 4 improv games in a 1-hour session. Empathy surveys (score range 20–140) with validity evidence were administered 2 weeks prior to empathy training, immediately after, and 1, 3, and 6 months later. Fisher's exact test, Student's t test, and Wilcoxon rank sum test were used to compare statistical differences at each post-intervention assessment. Results All 22 invited residents participated in empathy training. Empathy scores improved immediately after (120.0 ± 9.8 versus 113.1 ± 10.6, P = .026), though they regressed toward baseline through 6 months (116.3 ± 11.0 versus 113.1 ± 10.6, P = .43). When asked on a scale of 1–5 how much the workshop would impact their work, there was an increase in scores both immediately after (mean 3.5 versus 4.6, P < .001) and 1 month later (mean 3.5 versus 4.1, P = .039), but this difference disappeared at 6 months. Conclusions Using improv comedy to deliver empathy training is associated with a minor improvement in empathy scores in OB-GYN residents, which decreased at 6 months. Residents found the activity to be acceptable and reported the training would impact their clinical practice.

A systematic scoping review of approaches to teaching and assessing empathy in medicine

“…• Improvement in self-rated empathy scores using validated scales [ 1 , 4 , 8 , 9 , 11 , 16 , 19 , 47 – 49 , 52 , 60 , 61 , 65 , 68 , 71 – 73 , 75 , 78 , 79 , 82 , 87 , 90 , 94 – 96 , 100 , 104 , 106 , 108 , 110 , 114 , 121 , 123 , 124 , 127 , 132 , 137 , 141 ]…”

Improvising through a pandemic: adapting a medical improv elective over Zoom

“…The benefits of improv are immense, and its application in medical education has shown promise in improving student communication, empathy, and teamwork. 4,5 We have seen this firsthand at our institution, with many students thoroughly enjoying their experience and confirming personal benefit gained from participation. The challenges faced due to COVID-19 provided a unique environment to practice the principles of improv and attune, adapt, and commit to the situation at hand.…”

“…2,3 These courses have shown great promise in enhancing students' communication skills as well as providing an enjoyable environment for learners. 4,5 Our institution launched its inaugural medical improv elective in 2019, inspired by Katie Watson's work. 6 Our elective was crafted after training with Watson and adopting many aspects of her curriculum for medical students.…”

Exploring a brief medical improvisational performing arts intervention for genetic counseling graduate students

“…For example, an activity where students are placed in non‐medical, light‐hearted scenes in which one character has to give another one bad news helped students break down the conceptual components of breaking bad news, practice these scenarios, and critically assess themselves in a safe environment (Kukora et al., 2020 ). Other activities that have been used include taking outside suggestions and building scenes out of them, and then breaking down the scenes to assess whether participants made any logical jumps or assumptions, to reveal how biases may unconsciously color decision‐making (Cai et al., 2019 ). Following participation in such training, improvements in students’ performance in clinical situations, their expression of empathy, and their ability to interpret non‐verbal cues have been documented (Boesen et al., 2009 ; Cai et al., 2019 ; Sawyer et al., 2017 ; Watson, 2011 ).…”

“…Other activities that have been used include taking outside suggestions and building scenes out of them, and then breaking down the scenes to assess whether participants made any logical jumps or assumptions, to reveal how biases may unconsciously color decision‐making (Cai et al., 2019 ). Following participation in such training, improvements in students’ performance in clinical situations, their expression of empathy, and their ability to interpret non‐verbal cues have been documented (Boesen et al., 2009 ; Cai et al., 2019 ; Sawyer et al., 2017 ; Watson, 2011 ).…”