How Improv Exercises Can Help Nursing and Medical Students

May 11, 2021 

Students in nursing and medical school may be familiar with standardized patient simulations, where an improvisational actor portrays a patient with a particular condition. But they may not know that practicing improvisation themselves can actually make them better providers. 

Beth Boynton, RN, believes that improv activities can build clinical nursing skills, including confidence, empathy and clear communication. A nurse by training, Boynton leads improv workshops for healthcare teams and published a medical improv workbook for nurses and health educators. She says that by creating space outside the health setting, providers can practice these soft skills in a low-risk environment—and then apply them to interactions with patients and the healthcare team.  

“It’s like a sports game,” Boynton said. “We get out of the clinical environment and play with the skills so that when we’re back in the field, we’ve had the practice that helps us be more successful.”  

Keep reading to learn more about improv activities for nursing students in clinical rotations, as well as health professionals in any field or setting. 

Tips for Medical Improv Workshop Facilitators

  • For beginners, start with “low-risk” improv activities. These are exercises that allow participants to consider their part ahead of time or read from a script. For example, in the Two-Minute Rant activity, the ranting participant could come up with their topic and several key points ahead of time. 
  • Create emotional safety for participants by reminding them it is okay to make mistakes and by offering options for how to engage. For example, in the Overload activity, consider letting participants choose which role they play or choose to observe.
  • Debrief and ask application questions after finishing the activities to make the most of the benefits of improv. Boynton suggests asking:
    • Which part of the improv activities was most comfortable for you?
    • Which part of the improv activities was most challenging for you?
    • How do we make these improv activities relevant to our work and daily lives?

The following improv activities for small groups are adapted for students but can also be used by health teams. Boynton suggests integrating these improv games for nursing students into staff meetings for 10 minutes on a monthly basis to work on communication skills in nursing and other health professions. 

Improv Activities for Small Groups 

Activity One: Overload

This medical improv activity adapted by Boynton illuminates how, when added up, even simple tasks can overwhelm an individual’s attention. When providers are overwhelmed, mistakes may become more likely. When healthcare students understand the limits of their attention, they can develop a better sense of when to ask for help and when to support others. 

Number of Participants: 4 

Skills Developed:

  • Awareness of personal limits
  • Ability to identify stress in others
  • Awareness of triggers in the environment 

Instructions:

  1. Participant 1 stands in the center, surrounded by three other participants, one in front and one on either side.
  2. Participant 1 (in center) has four tasks: Count aloud from 0 to 100 in multiples of four, respond to simple personal questions, answer simple math problems and physically mirror the person in front of them.
  3. Participant 2 (on side) asks the simple personal questions. For example: “Where were you born?” “What was the name of your first car?”
  4. Participant 3 (on side) asks the simple math problems. For example: “What is 2 + 4?” “What is 9 – 7?”
  5. Participant 4 (in front) makes slow gestures with their arms and head.  
  6. End the activity before participants become distressed.  

Source: How Medical Improv Training Sparks Better Communication, Teamwork

Activity Two: Yes, And

In this activity, participants practice adding knowledge to the conversation without negating the speaker’s contribution. This skill can prepare them to share their health expertise while appreciating what the patient is experiencing. 

Number of Participants: 2–8 (in pairs)

Skills Developed:

  • Accepting others’ ideas
  • Cooperation to build a shared understanding
  • Sharing expertise with respect and humility

Instructions:

  1. Participant 1 makes a simple statement. 

“The hospital has 14 floors.”

  1. Participant 2 adds onto the statement, saying “yes, and.”

“Yes, and the pediatric ward is on the fourth floor.”  

  1. Participant 1 responds in kind, building the story. 

“Yes, and one family brought their pet monkey.” 

  1. Keep the statements moving quickly so that the story builds in excitement. The next statements could be:

“Yes, and the monkey wore a pink sweater.”

“Yes, and a thread from the sweater got caught in the elevator.”

“Yes, and a nurse rushed to cut the thread.”

“Yes, and the monkey was saved.”

  1. End on a high note with a funny or interesting moment. 

Source: No Joke: The Serious Role of Improv in Medicine

Activity Three: Time Travelers

This improv exercise can help prepare students to care for individuals with low technological literacy, which is the ability to use and understand technology. By explaining medical innovations in an accessible way, providers can gain patients’ trust and support them in following through on their recommendations.   

Number of Participants: 2–6

Skills Developed:

  • Having compassion for those with low technological literacy
  • Tailoring communication to specific audiences

Instructions:

  1. The group selects a time period to travel back to, such as the 1500s, and designates one participant as translator.
  2. Participants choose a modern innovation, and the translator attempts to explain what it is to people from that era. 
  3. Participants rotate playing the translator.
  4. End the activity once each participant has had the opportunity to play the translator. 

Source: How Medical Improv Training Sparks Better Communication, Teamwork

Activity Four: Two-Minute Rant

With this improv activity, participants gain experience sorting through a person’s speech and identifying the values beneath their statements. Being able to quickly understand a patient’s needs, desires and fears will be critical as they become providers, and practicing with non-clinical topics can help. 

Number of Participants: 2–8 (in pairs)

Skills Developed:

  • Listening for underlying values and needs
  • Tailoring communication to specific audiences
  • Discerning patients’ concerns quickly
  • Expressing that the speaker is heard and understood

Instructions:

  1. Participant 1 chooses a topic and rants about it for two minutes.

“I can never find a parking spot downtown. Every time I meet my family for lunch, I am 20 minutes late because there are no spots available for half a mile…”

  1. Participant 2 translates the rant with a focus on the needs and values of the speaker. 

“That makes sense. It sounds like the inconvenience is annoying and even more frustrating that it takes away from your family time. You’re looking for a better solution that honors your time and commitment to your family.”

  1. Have participants switch roles.
  2. End the activity once each participant has played both roles.  

Source: How Medical Improv Training Sparks Better Communication, Teamwork

For those interested in how to improve nursing skills, improv exercises can be a helpful tool because they help providers learn to see their patients and themselves holistically. When providers have opportunities to practice communicating with compassion and curiosity, they—and their patients—can benefit. 

To find out more about medical improv, consider the following resources:

Please note that this article is for informational purposes only. Individuals should consult their healthcare provider before following any of the information provided.

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