Improv: A new tool for boosting empathy in health care

When health care workers have higher levels of empathy and compassion, it improves the quality of patient care and decreases the likelihood of practitioner burnout.

New research has shown how improv performance can help.

The study, conducted by Rocky Vista University, Edith Cowan University (ECU), and Midwestern University, involved 165 students studying health care professions. They participated in an improv session and were tasked with several improv activities. Their self-reported empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester).

The findings showed that a single one or two-hour improv session can promote substantial increases in health care students' empathy for one another.

The paper, "Substantial Increases in Health care Students' State Empathy Scores Owing to Participation in a Single Improvisation Session," was published in the International Journal of Environmental Research and Public Health.

Improv boosts listening skills, connection, and shared experience

Improvisational skills are known to be central to the success of actors fostering empathy for one another. This study measured whether improv could benefit health care students in a similar way.

The exercises in the study required students to pay attention to the words and actions of their classmates and to participate actively in simple activities, which may make them feel vulnerable and nervous, but doing so in a team and collegial atmosphere, foster support and a sense of teamwork.

Lead author of the study, Dr. Brian D Schwartz from Rocky Vista University, said being placed in this situation caused students to focus on their classmates, to evaluate both verbal and non-verbal communication methods, and created an environment where they actively worked together to ensure any measure of success or completion.

"We believe that empathy is developed and deepened in this circumstance through a heightened requirement to truly listen, actively and presently, and forge a connection with classmates and teammates based on a sense of shared experience," he said.

A tool to complement more traditional ways of developing empathy

ECU psychology researcher Dr. Shane Rogers said health care practitioners used affective empathy, i.e., sympathy to sense patients' feelings, and cognitive empathy to understand the kind and quality of patients' experiences.

"Health practitioners should 'feel patients' pain' but not in a way that impairs 'understanding their suffering,'" he said.

He recommended the incorporation of regular improv sessions throughout the course of health care students' training.

"Greater health care professional empathy and compassion foster better health care team cooperation and patient outcomes, so health care professionals and their students should engage in empathy-enhancing activities at regular intervals throughout their training and careers," he said.

"Improv is one tool to complement other more direct methods of fostering empathy, such as asking students to write critical reflections from patients' perspectives."

The authors of the study recommended further research to understand how improv activities can be best incorporated into health care provider education, and the best practices for improvisation techniques regarding the content, duration, and frequency of sessions.