IMPROVing Communication in Emergency Medicine: Leveraging Medical Improvisation in the Emergency Department

Applied improvisation, or “medical improv,” is a dynamic, group-based approach that improves communication, empathy, and wellness among medical trainees and clinicians. Emergency medicine, with its unique demands—immediate responses, creativity in resource management, task-switching, and communication—requires skills often not addressed in traditional education. Medical improv offers a low-stakes, psychologically safe space to practice these essential skills, including comfort with uncertainty. In this interactive session, participants will be introduced to the role of medical improv in emergency medicine, practice key skills through improv games, and engage in a discussion on how improv can enhance inclusivity, well-being, and interprofessional collaboration. This session is led by experienced emergency medicine physicians integrating arts-based pedagogy into education.

Learning Objectives:

Upon completion of this session, participants should be able to:
  • Gain familiarity with the existing literature around medical improv and the role of medical improv across the continuum of medical education
  • Discuss the importance of “deliberate practice” as it applies to medical improv games
  • Experience improvisation games alongside other session participants followed by an all-session debrief regarding applications to emergency medicine
  • Identify key populations who would benefit most from these interventions and outline structures for integrating these techniques into clinical teaching and practice

Presenters:

  • Christina Seto, MD
  • Kamna S. Balhara, MD, MA, FACEP
  • Nathan Irvin, MD, MSHPR
  • Kirlos N. Haroun, MD
  • Elizabeth Weinstein, MD
Authors

  • Christina Seto, MD

    Johns Hopkins University

    Christina Seto is an Emergency Medicine physician and the inaugural Health Humanities fellow at Johns Hopkins University. She graduated from medical school from the University of Central Florida in 2021 and completed her Emergency Medicine residency at Kaweah Health where she also served as chief resident. With a degree in both English Literature as well as Neuroscience & Behavior from Barnard College of Columbia University, Dr Seto has always been driven by both storytelling and science. Her personal blog “Brunch with Bear” detailing a life with food allergies sparked her interest in illness narratives and the healing power of writing, which led her to pursue a career in medicine dedicated to understanding each patient’s story. She has a background in performing arts, narrative medicine, and creative writing, as well as a love of textiles and crafts.

  • Kamna S. Balhara, MD, MA, FACEP

    Associate Professor of Emergency Medicine

    Johns Hopkins University

    Dr. Kamna Balhara is an associate professor of emergency medicine (EM) at the Johns Hopkins University School of Medicine, and holds a dual appointment as associate professor in Medicine, Science, and the Humanities at the Johns Hopkins Zanvyl Krieger School of Arts and Sciences. After obtaining a master’s degree in French Cultural Studies from Columbia University, she completed medical school and residency at Johns Hopkins, serving as chief resident. She served in residency program leadership at the University of Texas San Antonio and subsequently at Johns Hopkins.

    Dr. Balhara is an innovator in the health humanities and has experience with implementing humanities curricula for medical students, residents, and faculty from across specialties. She is a founder and co-director of the Health Humanities at Hopkins EM initiative, which offers equity-focused and humanities-based programming to institution, community, and national audiences. She also directs a unique longitudinal interdisciplinary institution-wide health equity and humanities track for residents and fellows across Johns Hopkins, and directs the Health Humanities Fellowship. She has been invited to speak to international audiences on the humanities in medicine and was selected as a Harvard Macy Institute Art Museum-Based Health Professions Education Fellow.

    Her scholarly interests revolve around equity and inclusion in clinical and learning environments. She has authored multiple publications on graduate medical education, humanities, social determinants of health, and disparities in health care access, and has developed tools and resources for other educators seeking to apply the humanities towards equity in health care and health professions education. Her work has been funded by the Association of American Medical Colleges (AAMC), the Josiah Macy Foundation, the National Endowment for the Humanities, and the Emergency Medicine Foundation. She serves on the steering committee for the National Health Humanities Consortium, and is a member of the editorial board of the SAEM journal Academic Emergency Medicine.

     

  • Nathan Irvin, MD, MSHPR

    Johns Hopkins

    Dr. Irvin is an assistant professor in the Department of Emergency Medicine. He earned a medical degree at Harvard in 2003. Following medical school, he completed a residency in emergency medicine at Alameda Health System’s Highland Hospital in Oakland, California, where he was a chief resident, prior to graduating in 2011.

    Upon completion of residency, Dr. Irvin entered into the Robert Wood Johnson Foundation’s Clinical Scholars Program at the University of Pennsylvania, graduating in 2013 with a master's degree in health policy research.

    Dr. Irvin holds interests in social emergency medicine and addressing many of the health and behavioral problems that affect people living in urban communities. Two such threats are HIV/AIDs and violence. He is currently the clinical director of the Johns Hopkins Bayview Medical Center Emergency Department HIV/HCV screening program, working to identify and get people with new diagnoses of HIV linked into care. Additionally, he is engaged in work related to youth violence prevention and endeavors to develop a trauma-informed, hospital-based violence intervention program.

  • Kirlos N. Haroun, MD

    Johns Hopkins University

    I was born in Egypt to an incredibly supportive farming family before moving to Miami, Florida with my parents and my three siblings, where I grew up. I completed my undergraduate studies at the University of Miami, attended medical school at the University of Pennsylvania, and finished my residency at the University of Chicago. Currently, I am learning and growing as a Clinical Instructor and Medical Education Fellow at Johns Hopkins, focusing on the development of wellness-minded medical professionals. This upcoming July, 2025 I will be gratefully stepping in as the Assistant Program Director of the Johns Hopkins Emergency Medicine Residency!

  • Elizabeth Weinstein, MD

    Indiana University School of Medicine

    Dr. Elizabeth Weinstein is a Professor of Clinical Emergency Medicine and Pediatrics at the Indiana University School of Medicine with over 20 years of clinical experience and healthcare leadership. Elizabeth is triple board certified in Emergency Medicine, Pediatrics, and Emergency Medical Services. She is an educator, coalition builder, and healthcare communicator with a passion for making tough concepts accessible and relatable. Her research has centered on healthcare communication, pediatric emergency care, and EMS. She served as the Program Director for Indiana’s Emergency Medical Services for Children program from 2009-2023 and continues to be an advocate for pediatric readiness in emergencies. Her grant funded scholarship in healthcare communication has coupled applied improvisation with various themes in emergency medicine and public health including advocacy, vaccine hesitancy, patient experience and provider wellness.

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