Enhancing medical improvisation training: a mixed-methods approach to curriculum modification

Introduction: Medical improvisation (improv) is gaining recognition as an effective method for enhancing communication skills among healthcare professionals. Successful implementation of medical improv training relies on dynamic refinement of curricula. In this project, we articulate a theoretically grounded framework for modifying a medical improv program that puts the focus on the crucial yet often overlooked process of curriculum refinement in this growing field. Methods: We used the Collaborative Improvement Model [1] as a guiding framework for the curriculum revision. Our analytic approach involved a sub-analysis of quantitative and qualitative data collected as a part of the Alda Healthcare Experience (AHE) mixed-methods process evaluation including surveys, in-depth interviews, and observations. Quantitative and qualitative data were collected from key stakeholders of the AHE program including clinical co-facilitators, improv co-facilitators, and participants. Our analysis was guided by interpretive descriptive design, drawing on inductive and deductive approaches as well as quantitative and qualitative mixed-methods triangulation. Results: Inductive analysis of co-facilitator interviews revealed four dimensions for interpreting the identified areas of revision: desirability (of the revision), feasibility (of the revision), triangulation (whether different sources of data are divergent or corroborated), and evaluability (whether the revision would confound the program evaluation). We illustrate how this framework is implemented through specific examples from our curriculum revision. Conclusion: Our manuscript articulates a theoretically grounded framework for revising medical improv curriculum. This structured yet adaptable framework could be useful for curricular modification in other medical improv and experiential learning curricula.