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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.

Personal creative writing is increasingly used in medical schools to foster self-reflection. This article looks particularly at poetry as a vehicle for expressing personal experiences of professional development. The authors present a series of poems written by students at their medical school. In them, the students reflect on embryology, gross anatomy, telling (or not telling) bad news to trusting patients (and family members), encountering death, and encountering their own anger and frustration with the demands of medicine. These poems not only capture individual students' feelings and imaginations but also demonstrate the students' constant struggle to sustain their idealism about medicine throughout the four years of their education.