Impact of Medical Improvisation on Therapeutic Use of Self: A Randomized Controlled Waitlist Study

Importance: The application of interpersonal skills is considered therapeutic use of self, a pillar of occupational therapy practice, and a required competency for occupational therapy education (American Occupational Therapy Association [AOTA], 2020). Medical improvisation (medical improv) uses the principles of improvisational theater to enhance professional competencies and shows promising results in health professions education (Gao et al., 2019).

Objective: To understand the effect of medical improv on occupational therapy students' therapeutic use of self.

Design: A 6-wk randomized controlled waitlist trial.

Setting: Occupational therapy education.

Participants: A cohort of 36 occupational therapy students.

Intervention: Two 2-hr sessions of medical improvisation.

Outcomes and measures: Standardized patients rated students' therapeutic use of self with the Empathy and Clarity Rating Scale (Terregino et al., 2019), and students completed the Self-Efficacy for Therapeutic Use of Self (SETUS; Yazdani et al., 2021). Data were analyzed using independent samples t tests and multivariate mixed-methods models.

Results: There was a significant difference between the intervention and waitlist control group in three SETUS subtests (modes, p = .004; traits, p = .04; total score, p = .03) and a significant interaction effect in SETUS modes (p = .03). The waitlist control group responded with comparable increases, and all participants demonstrated a significant increase in self-efficacy of therapeutic use of self after the medical improv intervention (p < .001).

Conclusions and relevance: These findings provide the first evidence for the positive effects of medical improv in building self-efficacy of therapeutic use of self in occupational therapy students. Plain-Language Summary: Medical improvisation (medical improv) in health professions education uses the principles of theatrical improvisation to build the interpersonal skills of students. This study's application of medical improv to occupational therapy education found significant change in students' self-efficacy of therapeutic use of self. The inclusion of medical improv in occupational therapy education can better prepare students to build and maintain therapeutic relationships.