half-baked idea: improv classes

Going back to my breast exam running diary, the easiest part of learning  to give a breast exam was actually touching the breast. It's just skin and fat. The hardest part was talking about breast, and watching all the words you use. Don't use inspect, feel, sag, etc. Don't stutter. Don't be nervous talking about breasts. So my half-baked idea is that we should work on our talking skills by taking improv classes. 

that's all, folks

I don't know anything about improv other than the few articles I just read about Stephen Colbert and Tina Fey, but it sounds like a great way for us to become comfortable interacting with patients. 

Here's 3 pieces of advice I just looked up about how to be good at improv:

1) Make a connection to the other player.
2) Never expect a certain answer, just react to what was actually said.
3) It doesn't matter what you're doing on stage as long as you sell it.

You can probably make the connection from these three points to medicine, but I'm going to lay it out for you. 

#1 - Make a connection to the other player. 

This has obvious implications in medicine, where half the battle is gaining the trust of your patient. Getting sensitive information from your patients - whether you need a thorough sexual history from an elderly lady or you're trying to talk to a teenager about alcohol abuse - it can be tricky. Not every patient is going to be a fire hose of information like our standardized patients. Not to mention, if you're going to approach patients about making a serious change like quitting smoking, you need an established relationship. 

#2 - Never expect a certain answer, just react to what was actually said. 

The small group interviews are good practice but it's a pretty straightfoward process. OLDCARTS. You already know exactly what you're asking before you go in, so you're basically rehearsing from a script. The problem is that when you're actually seeing patients you have to do a lot of winging it. Patients aren't going to tell you exactly how pain radiates. Doctors need to practice talking to human patients instead of robot patients.

#3 - It doesn't matter what you're doing on stage as long as you sell it. 

Patients are scared to see their doctors. Waiting for a second opinion on a cancer diagnosis is going to be tense. They don't want to see you nervously fumbling and trying to find the words to explain the situation to them. Patients want doctors to be confident. 

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How expensive would it be to hire twenty local comedians and have them teach an improv class for 2 hours? I can tell you how much it would cost. Here's a local improv class:

Students would totally think it was fun, which would make it unique among required med school activities. It'd be a good group bonding activity, watching everyone screw up and have a good time with it. 

Not to mention, it wouldn't hurt doctors to have a sense of humor. 

See you on the other side,

from ken

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