Perspective: The doctor as performer: a proposal for change based on a performance studies paradigm.

The authors recognize the pressing need for teaching methods that encourage empathy in both undergraduate and postgraduate medical curricula. While the useful application of theatrical acting techniques in medical education has been reported in major medical journals, these reports present an incomplete picture of these techniques and their potential importance to physician competence. The authors propose a broader understanding of performance theories and practices and a more nuanced appreciation of the experience and knowledge acquired through working with standardized patients and acting exercises. The academic discipline of performance studies offers a paradigm not only for teaching doctors how to "act" in a more truly empathetic and compassionate manner but also for analyzing, and thus evaluating and improving, human interactions in the medical environment. A complex understanding of performance is essential to the development of an empathetic imagination, a cognitive faculty that allows physicians to generate unique responses to given situations rather than employing reactions learned by rote in "communications training." The authors recommend the inclusion of a wide range of performance theories and practices alongside the ubiquitous presence, in medical schools and other physician education forums, of actors performing as standardized patients.