Publication Date


Document Type


First Advisor

Patterson, Julie Ann

Degree Name

M.S. (Master of Science)

Legacy Department

School of Health Studies


Introduction: Medical improvisation is the use of theatrical-based games to develop interpersonal communication skills (ICS), including those applicable to telehealth communication, among health care professionals.

Purpose: The purpose of this study was to determine if implementing a medical improvisation-based workshop via a virtual classroom within an upper-level undergraduate nutrition and dietetics counseling course improved students’ self-assessed perceived capability of the following characteristics required as ICS for telehealth communication: becoming a better listener, becoming more observant of nonverbal communication, responding in the moment, increasing self-confidence in presenting, and becoming a better team member/collaborator. This study also considered the feasibility of using a virtual platform to deliver medical improv for the purpose of increasing ICS as a part of telehealth training. This study was justified by a body of scientific research indicating the efficacy of using improvisation-based exercises within similar face-to-face courses for other health science fields. The aim of this study was to contribute to the body of literature examining novel methods and teaching techniques to better prepare undergraduate nutrition and dietetics students for careers as Registered Dietitian Nutritionists.

Method: A mixed-methods study design was followed utilizing posttest/retrospective pretest surveys and themes identified from participants’ written responses. Using paired t tests, changes between the posttest and the retrospective pretest were compared within a nonrandom experimental group (n=31). A 100-point self-efficacy scale based off of Berk’s Improvisation Evaluation Scale was designed and used to evaluate participants’ self-assessed perceived capabilities related to five characteristics required in effective ICS for telehealth: (a) active listening, (b) perception of nonverbal communication, (c) responding in the moment, (d) self-confidence in presenting, and (e) effective collaboration, as well as the combination of all five characteristic measurements as an overall result. Participants received an interactive 3-hour medical improv-based workshop that was delivered via Blackboard Collaborate as part of their dietetics coursework. Participants responded to open-ended prompts and submitted feedback to the researchers. The prompts were analyzed by conventional content analysis protocol, utilizing an inductive approach. Additionally, demographic data was collected.

Results: Self-efficacy measurements related to becoming a better listener, becoming more observant to nonverbal communication, responding in the moment, and becoming a better team member/collaborator significantly increased (p < 0.005). Measurements related to the characteristic of self-confidence in presenting within the construct of self-efficacy increased but were not statistically significant. Emergent themes mentioned by participants in written responses indicated a positive experience participating in the online training, increased development of ICS skills for telehealth, and application of ICS skills beyond of the classroom setting.

Conclusion: These findings support the use of medical improvisation exercises as a way to increase self-efficacy beliefs regarding skills related to effective counseling developed within an undergraduate nutrition and dietetics counseling course and demonstrate feasibility of administering medical improvisations via a virtual classroom.


140 pages




Northern Illinois University

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