Improv to improve medical student communication.

Background: Effective patient provider communication skills can be difficult and time-consuming to teach. Deliberate practice of communication skills through improvisational theatre exercises, with structured debriefing, can provide a solution for teaching patient-centred communication skills in time-limited settings. The objective of this study was to determine if improvisational theatre exercises improved the ratings of patient satisfaction and empathetic communication by standardised patients.

Methods: This was a randomised controlled trial looking at the effect of improvisational theatre exercises on ratings of patient satisfaction and empathetic communication. Third-year medical students (n = 188) participated in a formative team-based standardised patient (SP) experience. Prior to the SP experience, teams of students were randomly assigned to receive a 45-minute communication-focused improvisation intervention (immediately before the SP experience) or to a control arm without intervention. All teams then participated in the SP experience; the SPs (blinded to team randomisation assignment) then assessed each team's empathetic communication and completed patient satisfaction questions focused on physician behaviours derived from Press Ganey and the Hospital Consumer Assessment of Healthcare Providers and System Surveys . Fifty teams of three or four students participated; 20 teams in the intervention arm and 30 teams in the control arm.

Results: Student teams in the improvisation intervention group had increased measures of empathetic communication (p = 0.04) compared to the control group. The intervention group had increased patient satisfaction survey ratings of 'ability to listen carefully' (p = 0.001) and of 'physician skills' compared to control groups (p = 0.03).

Discussion: Improv exercises with students increased students' empathetic communication and patient satisfaction as assessed by standardised patients.