Experiential activities adapted from theatre education and improvisation are a form of Medical Improv. They become a part of this emerging field when used to address goals or outcomes we seek in healthcare.

There are literally hundreds of experiential activities and variations that can be used to teach communication-related skills and improve healthcare outcomes. Critical outcomes such as patient safety, patient experience, workforce health and wellbeing and even cost-effectiveness. That’s because improving theses skills helps us become our best selves which impacts all of our relationships, are ability to work in teams and lead all of which in turn impact outcomes.

Why Status Activities?

One branch of activities developed by improvisation guru, Keith Johnstone refers to status activities. In theatre, these activities help actors make scenes more interesting for audiences. While Johnstone’s legendary book, Impro is directed towards actors, the chapter on ‘Status’ is fascinating for anyone interested in human behavior.

In healthcare, status activities offer great opportunities to discuss dignity and hierarchy. Dignity for our patients, families, colleagues, and selves, healthy vs. toxic hierarchy, and their interrelationship.

These activities, when facilitated properly, provide experiences where participants become more aware about how high/low status and dignity look, sound, and feel.

This awareness then becomes a door to talking about our healthcare hierarchy in constructive ways while coming from a place of dignified interconnectedness!

• When do we need a clear top to bottom decision-making structure for best outcomes?
• When does it get in the way?
• What ideas do we have for improvements?

All in the spirit of mutual respect and co-creative problem-solving!

Dignity Exchange

My favorite activity is called Dignity Exchange, an activity created by Liz Korabek-Emerson, myself and our students. In short, with coaching, people walk around as if they are highly superior to everyone else. This is portrayed with body posture, facial expression, tone of voice, and an internalization of what it ‘feels’ like.

From left to right: Susan Conboy, Robin Masia, Patricia Corso, John Klossner & Jody Fuller – Boynton Improv Education

After they’ve spent a minute or so in high status, I invite them to shake it off. Then, with a similar process, they assume low status personas. This is followed with another invitation to “shake it off”.

From left to right: Patrica Corso, Carolyn Vibbert, John Klossner, Glenna Kimball, Barbara Trimble, & Curran Russell – Boynton Improv Education

It has always surprised me how little modeling or coaching people need to embody these ways of being. As if, somehow in our life experiences we know. Maybe we’ve been treated or treated others in such ways? Maybe both? And shaking it off can feel like a big relief!

The coaching process now turns to language and modeling around self-respect and dignity. What does that look like? Sound like? Feel like? And people know this too! In general, it feels good!

Once they embody a feeling of dignity, they pair up and face each other. One assumes high status while the other, low status. While facing each other and over the course of about a minute they switch status postures. Once that is done they are instructed to find the place where they feel dignity for themselves and each other.

What happens next is incredibly inspiring and affirming for the best of humankind!

Visceral Moments of Dignity

These heartfelt moments between people are a privilege to witness. And as you can see in this pic, they show it in a variety of ways. It is, as if, we are tapping into a human quality that is already there. And in facilitating this activity we are reminded of what some of our best qualities are!

From left to right: Liz Korabek-Emerson, Robin Masia, Beth Boynton, John Klossner, Lori Austin, Robin Masia, John Klossner, Curran Russell, Susan Conboy, Patrica Corso, John Klossner, & Glenna Kimball – Boynton Improv Education

If you’d like to know more, please feel free to reach me: [email protected]. Also, this handout from an event with Human Dignity and Humiliation Studies a few years ago offers more guidance about teaching Dignity Exchange.

And I happily invite you to explore a variety of Medical Improv resouces and the exciting new self-paced 3 Paths into practice!