Healing Relationships for Healthcare Improvement Part III: What is Neuroplasticity and How Can it Help?

By Beth BoyntonHot TopicsLeave a Comment


Healing relationships and promoting healthy respectful interactions are crucial to improving healthcare. In Part I, we addressed the importance of good relationships in healthcare. We followed with discussion in Part II  about the neuroscience and the effect it has on relationships. There’s one simple practice that can enhance neuroplasticity and help heal our relationships.

What is Neuroplasticity?

Many of you may already be familiar with Dr. Daniel Siegel’s pioneering work in Interpersonal Neurobiology (IPNB). IPNB is defined as “…a consilient field that embraces all branches of science as it seeks the common, universal findings across independent ways of knowing in order to expand our understanding of the mind and well-being. Sometimes abbreviated as IPNB, this field explores the way that relationships and the brain interact to shape our mental lives. IPNB is meant to convey the embracing of everything in life from society (interpersonal) to synapses (neurobiology).”1

In his book, The Pocket Guide to Interpersonal Neurobiology, Dr. Siegel explains neuroplasticity as a process of neurological changes that take place in our brain in response to our experiences. Way more complex than we’ll go into here, but he provides a detailed scientific explanation for how our experiences change the physical structure of our brain, and our attention is “…the driving force of growth and health.”1 This means that where and how we focus our attention is integral to what our experiences are or can be, and in turn influences our brain structure or neuroplasticity.

Following this logic is important, because according to Siegel, there are seven—possibly eight—aspects of our lives that support neuroplasticity:

  • Aerobic exercise;
  • Good sleep;
  • Good nutrition;
  • Relationships;
  • Novelty;
  • The close paying of attention;
  • Time-in (reflection); and
  • Possibly humor.

Remember I said that one simple practice can enhance neuroplasticity and improve relationships? Take a look at the four bolded aspects above. They are in bold because one simple practice—medical improv—can help build essential interpersonal skills in ways that promote each of these aspects of our lives.

Medical Improv for Healthy Neuroplasticity and Relationships

Medical improv—although fun—is distinct from improv comedy in that the emphasis is on the learning process rather than entertainment or performance. Once basic principles of “play” are taught, there are hundreds of activities that can be adapted from improv to build a variety of relationship skills such as trust, flexibility, listening, speaking up, collaboration and much more. Not only is medical improv a novelty as a practice, but each time participants engage in an activity, they have to pay close attention to each other. What emerges is always new and different. And even though participants are not trying to entertain each other, the process is incredibly engaging and fun.

For example, one activity called “Dr. Know-it-All” requires three people to answer open-ended questions from other participants by contributing one word at a time. They don’t have to be factual, but they do have to make sense and work together quickly and collaboratively. In one recent workshop, there was a surgeon sitting in the middle of two nurses while they answered the question, “Why is the sky blue?” One of the nurses hesitated to add to the answer and when she did, the surgeon took a breath as he adapted from what he thought the answer was going to be to a different one.

In these moments of hesitation, the nurse learns to speak up, the doctor learns to listen, they build their relationship, collaborate, and have fun. The relationship part of our complex adaptive system is healing!

Participating in medical improv activities is a wonderful way to develop and practice positive relationship skills and promote healthy neuroplasticity. As we heal our relationships outside the stressful clinical environments, we can return to our stressful clinical environments better prepared to function as collaborative partners. Our work will be safer and more rewarding.


  1. Siegel DJ. Pocket Guide to Interpersonal Neurobiology. 3rd New York, NY: W. W. Norton & Company; 2012.
About the Author
Beth Boynton

Beth Boynton

Beth Boynton, RN, MS specializes in communication, collaboration, and workplace culture. She is a Medical Improv Practitioner and author of Medial Improv: A New Way to Improve Communication (CreateSpace 2017), Successful Nurse Communication (F.A. Davis 2015), and Confident Voices (CreateSpace 2009). Find more of her stories at Confident Voices in Healthcare.

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