Theater of Medicine: What We, As Physicians, Can Learn from the Theatre

Posted on by Guest Author

Contributors: Courtney Manser, MD, CCFP (PC) and Alexis Milligan, M.IDST 

Take Away Tidbits 

  • There is a direct connect between improvements in quality of care and improvements in patient satisfaction, including actual patient outcomes, and overall physician well-being. 
  • The five modes of communication include: words, numbers, movement, sound and image. As physicians we often focus on what is being said, however, how it is said, as well as how it makes patients feel through our body posture, tone of voice, and spatial awareness are just as important. 
  • Taking a few moments to re-centre ourselves using techniques often used in the theatre space can improve our non-verbal communication when entering a room. 

The Five Modes of Communication 

  1. Words 
  2. Numbers 
  3. Movement 
  4. Sound 
  5. Image 

Take a moment to consider how you are communicating your words through the other modes.  This includes how you are moving your body, the tone of your voice, and being aware of jumping to conclusions or assuming aspects in others that may not be the truth. 

Try to balance being on receive as much as transmit and help activate listening in others. 

Remember that breakdown of communication can often be something as simple as intention vs impact.  Sometimes what we intend does not have the impact we want and vice versa. 

How to Re-Centre Ourselves 

Picture this: You’ve been on your feet all day, running from room to room. You’re behind. You’ve had at least one difficult patient encounter. You’re tired, both physically and emotionally. How do you continue to see patients without allowing your physical presence and non-verbal communication to affect how your patient perceives the interaction? What you are “giving off” is much more than the words you say. Take a deep breath and do the following: 

The 5 points 

  1. Up – thinking of the lift coming up from the soft palette. 
  2. Wide – Open the peripheral vision and work to bring the horizon towards you. 
  3. Space – Let joints of the body feel open with space to move freely and easily. 
  4. Down – Feel the floor (or chair) supporting you as you stand (or sit). 
  5. Back – Feel the balance of your forward and back space. 

If you can, take three deep breaths thinking of these five points and add a gentle secret smile. 

Adaptability, Repetition, & Play 

Playing is not always a reference to fun and games.  It is a useful tool to help us adapt to something new, or work with rapid changes in a more positive way.   

When you need to engage in seeing multiple patients, or feel like you are a broken record, ask yourself to find one thing that is different, unique, or special with each repetition. 

Non-technical Skills 

Bringing equal value to non-technical skills is an essential part of developing a whole-system approach to medical practice.  They not only improve patient satisfaction and outcomes but also improve overall physician health and wellbeing. 

Non-technical skills are easy to learn, and with practice they can become second nature

For more information on ‘Theatre of Medicine” through the Shaw Festival, please visit:

https://www.shawfest.com/theatre-of-medicine

References

  1. Eisenberg, Amy MMH; Rosenthal, Susan MD, MS; Schlussel, Yvette R. PhD. Medicine as a Performing Art:What We Can Learn About Empathic Communication From Theater Arts. Academic Medicine 90(3):p 272-276, March 2015. | DOI: 10.1097/ACM.0000000000000626
  2. Leung J, Som A, McMorrow L, Zickuhr L, Wolbers J, Bain K, Flood J, Baker EA. Rethinking the difficult patient:formative qualitative study using participatory theater to improve physician-patient communication inrheumatology. JMIR Formative Research. 2023 Mar 6;7:e40573.
  3.  Milligan, A. (2022, May 1). Speaking in silence: A concept of whole-person communication.https://unbscholar.lib.unb.ca/items/8a219f3d-1ade-45be-9a03-33e7a3b5f985
  4.  Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, De Boer C, Lingard L. How arethe arts and humanities used in medical education? Results of a scoping review. Academic Medicine. 2021, Aug 1;96(8):1213-22.
  5. Stivers T, Tate A. The role of health care communication in treatment outcomes. Annual Review of Linguistics. 2023 Jan 17;9(1):233-52.
  6. Zulman DM, Haverfield MC, Shaw JG, et al. Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter. JAMA. 2020;323(1):70–81. doi:10.1001/jama.2019.19003