Medical Science Educator Article Review by Alice Fornari

A Review from Medical Science Educator
from Dr. Alice Fornari

This month the IAMSE Publications Committee review is taken from the article titled Medical Improvisation Training for all Medical Students: 3-year experience, published online in Medical Science Educator, (December 2019), by David Fessell, Erin McKean, Heather Wagenschutz, Michael Cole, Sally A. Santen, Robert Cermak, Katie Zurales, Stephanie Kukora, Valeri Lantz-Gefroh, Evonne Kaplan-Liss & Alan Alda 

I have been intimately involved in the development, implementation and evaluation of our Zucker SOM at Hofstra/Northwell SOM since we planned to open and now have a 8 year history. This short communication is has a strong author line from diverse medical schools, with one being a new school. The senior author is the famous Alan Alda who has dedicated his professional focus to communication skills of physicians and scientists to assure patients can understand the scientific and healthcare messages delivered by the medical community. I am very excited to share the reported study aligning a medical improvisation as a pedagogy to help our young medical students practice communication skills and learn skills that can be transferred to patient care settings. This is a win-win!

The background of the article confirms the importance of communications curriculum for our students that focuses on acquiring knowledge, skills and of course transforming attitudes to assure they value the concepts. The transfer of a theater training modality, specifically improvisational training, to support communication education is exciting and fun! This pedagogy is linked to education theory we should all value: Kolb’s experiential learning and Bandura social learning theory. These two theories assure learners are actively engaged in the learning paradigm and learning with peers.

The activity was initiated in 2015, 2016, and 2017 with 150, 177 and 167 students respectively in a workshop format with the students.  In 2015 it was a three-hour workshop for all third-year medical students led by the Alda Center trainers and in 2016 and 2017 trained facilitators held a 2.5-hour workshop for or 3rd year medical students. There were 5 improvisation exercise per workshop.

Post workshop data collection from students included satisfaction with the workshop, perceived impact on teamwork skills, and insight into their role as a physician. Only for the 2016 class was there a 3-month follow-up survey on the improvisation skills they used in clinical rotations.

Results were positive for verbal and nonverbal communication skills and transfer to the clinical setting.

As educators we know from experience and the literature patients highly value outstanding communication skills from physicians who provide care in clinical settings. Teaching these skills is often seen as a soft science and the curriculum is not taken as seriously by medical students despite this strong desire of patients to have physicians listen to their story and gather data about who they are as a person and have a relationship beyond a management plan to treat a disease. To engage students in their learning of new skills, especially in their clinical years of their education, is challenging and if a pedagogy can be experiential, social and fun it seems like a win/win to brand our students with enhanced skills that transfer to the patient care setting. Yes, this requires trained facilitators who are willing to learn new skills themselves and take a risk with their learners to move from traditional learning to a shared approach of humanities-based education to support creative learning modalities. Medical educators who can leave their comfort zone will enjoy the experiences and be role models for their students.

Alice Fornari, EdD, RDN
Professor, Science Education, Occupational Health, Family Medicine
Associate Dean, Educational Skills Development,
Zucker SOM at Hofstra/Northwell
Vice President, Faculty Development, Northwell Health
Director, MSED and Advanced Certificate in Health Professions Education,Hofstra University
Member IAMSE Publications Committee