The Answer is YES!
Learning how to say “No” requires self-awareness and confidence. These are emotional intelligence competencies that help us to set limits, compromise, delegate tasks, and at times, say “No”. They are super important for healthcare professionals as well as patients and families to have to ensure the safest, most compassionate, and patient-centered care.
Surprisingly, a “YES AND” mindset adapted from the world of applied improvisation, theatre education, and medical improv can be used to develop and practice such competencies.
Consider two conversations:
Person 1: There is a cow in my kitchen.
Person 2: Yes, there is a cow in your kitchen.
Or
Person 1: There is a cow in my kitchen.
Person 2: Yes, and that cow is speaking French.
In the first conversation, Person 2 is validating Person 1 and following a say ‘YES’ philosophy. Such listening is one-way Medical Improv can help healthcare professionals, leaders, and teams.
The second conversation reveals how valuable the learning potential of the ‘AND’ is. To appreciate this, ask yourself what you might say using “YES AND”. Also, consider how you might feel to add to this or some other unexpected statement on the spot!

Image by Leopictures from Pixabay
The "AND" of "YES AND"
Truthfully, I can feel a little anxious when called upon to add something to an improv story. A little bit of a fight, flight, or freeze response is going on. Yet, practicing improv has helped me to trust my ability to move through the stress response, access creativity, and share an idea.
- YES, AND that cow is making pancakes!
- YES, AND this is a great way to make sure we have fresh milk!
- YES, AND there is an old farmer looking at it through your window!
In an improv scene, this is much more interesting and fun to watch than me saying, “I don’t see any cow.”
More importantly from a learning process, when I add an idea, I’m developing and practicing essential expressive skills and competencies like self-awareness, confidence, and speaking up.
What might you say as Person 2 in the second conversation?
"YES AND" & "NO"!
One of the biggest myths Medical Improv, is that we are teaching people to agree on everything. It certainly can look that way when we are accepting ideas that aren’t true. However, adding to stories (the AND) nudges us to develop self-awareness, confidence, and assertiveness. It is in this space where we grow the skills and competencies necessary for developing healthy boundaries, setting limits, delegating tasks, and when necessary, saying “No”!