From Invisible to Visible - Positive Deviance Initiative

wanted to know the difference between improv
and skills competency training. She suspected
skills training wasn’t consistent with PD.
“It was an important turning point,” Ms. Everett
said. “The core team had really grasped the essential
difference, and was struggling with how to
implement the new way.”
The idea of introducing
Improvisation Theater was
born.
Acting One’s
Way…. xxi
“H
ow do I tell patients
that they have
MRSA accurately and with
empathy?”, asked a less
experienced nurse.
“I like to tell them they are
infected with a Staph germ
that has become resistant to
a common class of antibiotics.
I also emphasize the fact that now that we
have a culture result, we now know what is causing
the infection so we can treat it.” another nurse
said.
“Education is not the
piling on of learning,
information, data,
facts, skills, or abilities
– that’s training or
instruction—but is
rather making visible
what is hidden as a
seed.”
–Thomas More,
sixteenth century
Renaissance scholar
Lights, Camera, Action:
Rehearsing for Change
Ms. Iversen, who served as Mr. McCandless’
co-conspirator, explained: “We know
knowledge alone does not change behavior. We
wanted to create experiences where people learn
for themselves, discover solutions, and have a
safe place to practice.”
Improvisational (Improv)
theater provides a space for
rehearsal, especially for
those who wish to experiment
with new ways of
addressing intractable problems.
Improv’s intellectual
roots go back to the Theater
for the Oppressed (TO)
movement started by
Brazilian theater-activist,
Augusto Boal, who, accidentally,
hit upon the idea of
theater as a space for
rehearsing action. One
afternoon in the early
1960s, when Boal and his troop were presenting
the struggle of Brazilian peasants using fake guns
as props, the peasants in the audience surrounded
Boal after the performance and said:
That snatch of back-and-forth dialogue was one
of thousands of new conversations that occurred
at Billings Clinic as front-line health workers
from various units got together to share insights
on how thwart MRSA infections. Remarkably,
these deadly serious conversations about simultaneously
managing infections and patient’s feelings
occurred in playful, theater-like settings.
“Improvisational play takes the edge away from
difficult conversations, creating a safe space to
discover possibilities that may not be initially
obvious” noted Coach McCandless, the brains
behind this guerilla theater exercise.
“That was a great idea! Where are the rifles?! Let’s
go and take over!” xxi The peasants thought Boal
was serious about starting a revolution. Reflecting
on this incident, Boal realized that theater was not
only a portrayal of revolution, but also represented
a rehearsal for revolution. That is, the theatrical
act by itself is a conscious intervention, a
rehearsal for social action based on a collective
analysis of shared problems. xxii
Chris Nightingale, RN, CIC, quality specialist,
infection control, summarized the collective wisdom
that emerged from the MRSA improv.
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