Slides from keynote address 2014 Annual Stanford Center for Immersive and Simulation Based Learning Symposium

1. Power Up
Your Teaching of ACGME Communication
Techniques from Business and Performing arts
Richard Snyder MD
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2. 2
Pa#ent Care
Medical Knowledge
Prac#ce-Based Learning
Interpersonal Communica#on
Professionalism
System Based Prac#ce
Communication Skills Are Critical
to Achieving ACGME Milestones

3. 3
How Most People
View Communication
Workshops

4. THE FOUR HABITS MODEL
HABIT SKILLS TECHNIQUES AND EXAMPLES BENEFITS
INVEST
IN THE
BEGINNING
Create
rapport
quickly
accuracy
ELICIT THE
PATIENT’S
PERSPECTIVE
DEMONSTRATE
EMPATHY
INVEST IN
THE END
Copyright © 2011 (Revised) by The Permanente Medical Group, Physician Education and Development. All rights reserved.
THE FOUR HABITS MODEL
HABIT SKILLS TECHNIQUES AND EXAMPLES BENEFITS
INVEST
IN THE
BEGINNING
Create
rapport
quickly
accuracy
ELICIT THE
PATIENT’S
PERSPECTIVE
DEMONSTRATE
EMPATHY
INVEST IN
THE END
Copyright © 2011 (Revised) by The Permanente Medical Group, Physician Education and Development. All rights reserved.
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Why do people Resist Communication training?
Reason #1 : Cognitive Overload
4

5. Reason #2: Habit change, e.g. dieting is much less fun
than learning something new, e.g. suturing
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6. Reason #3:
Communication work
is personal work
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7. “Training for communication skills has not
produced uniformly positive results.”
Van Nuland M, et al., Educational interventions for improving the
communication skills of general practice trainees in the clinical consultation.
Cochrane Database of Systematic Reviews 2005(4)
Habit
Change
Defense
of Self
Cognitive
overload
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8. 8
Actors Receive Effective Communication Training

9. 9
Business Staff Receive Effective Communication Training

10. 10
The 3 Techniques We Can Use

11. All Communication
Curricula Are A
Combination of These
Four Teaching Methods Performance
Role Play/
Simulation
Scripting
Didactic
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12. Something of Self
Something in Small Talk
Something They Know
Something They Want
REVEALS
Engaging Openings Part I: Establish Psychological Safety
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13. Engaging Openings Part I: Establish Psychological Safety
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Something in Small Talk
Safest: How you got here today
Bit Riskier: Something weird and quirky about yourself
Something in Small Talk
Safest: Your Favorite Flavor if Ice-cream
Bit Riskier: Type of air you most love to breath
Something they know
Talk about what they already know about subject
Something they want
What is one thing I want to get out of this class today?

14. Engaging Openings Part II: Expand What is Possible
Cognitively Physically Emotionally Vocally
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15. Engaging Openings Part II: Expand What is Possible
Cognitively Physically Emotionally Vocally
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Level 1: “Big and Small” Physical Stretches
Level 2: “You’re the King!” Walk Around
Room to Game of Thrones Theme Music

16. Using Engaging Openings
1. Reveal Families
• Something of Self
• Something in Small Talk
• Something they Know
• Something they Want
2. Expanders
• Reference texts
• Apps
• Collaborate
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17. Medical Improv
Acad Med. 2011: 86: 1260-1265

18. What is Improvisational Theater?
Courtesy Professor Ka#e Watson
ComedyImprovisation
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19. Make Your Partner Look Good
Fail good naturedly.
Accept. Everything you get is a gift.
Listen. Let Your Partner Change you.
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Improv Principles

20. Partner A: Remember Mexico?
Round 1: Partner B “No”
Round 2: Partner B “Yes”
Round 3: Partner B “Yes And...” then A: “Yes And...”
etc.
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Improv Yes And Exercise

21. Medical Improv = Cross Training for Communication
Listening
Talking
Reading Emotions
Positive Attitude
Team Work
Leadership
Resiliency
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22. v.s. Selected Exercises
Targeted Discussions
Medical Improv
Theatre Improv
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23. Medical Improv Assessment
No. (%) students
who agree or
strongly agree
Students rated agreement
1 strongly disagree
5 strongly agree
This class helped me become a
better team member/collaborator 80(92) 4.47
Studying Improv could make me a
better doctor 83(95.4) 4.49
I would recommend this class to
other medical students 87(100) 4.97
Watson, K., Perspective: Serious Play: Teaching
Medical Skills With Improvisational
Theater Techniques, Acad Med. 2011;86:1260–1265.
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24. Professor Watson’s Train-the-Trainer Course
Katie Watson JD Belinda Fu, MD
Rich Cox William Hall Dan Klein Rebecca Stockley
Local Improv Professionals
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25. Impactful Closing Technique #1:
The Focus Point
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26. Keep your hands in front
Focus Point
“What is one thing
you want to
take from today?”

27. Impactful Closing Technique #2:
Set Up A Practice
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28. Diffusion
Self
Directed
Tiny Habits
Set Up
a Practice
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29. Richard’s 20,000 View
Tiny Habits
tinyhabits.com
1. Tiny-fy
2. Trigger
3. Train

30. 30
Impactful Closing Technique #3: The Good Finish

31. Good Finish #1: Appreciations
“Tell Your Partner One Thing You Appreciated About The Work You Did
Together”
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32. Good Finish #2: Final Activity
“On The Count of Three, Let’s All Do A Single Simultaneous Hand Clap”
Repeat Up To Three Times
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33. Thank You For Viewing !
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