Prepare to Be Spontaneous! 

The night before an exam, I went to the Brixton Academy in South London to see a popular singer perform. I made it to the front of the stage, and in the middle of his set, the singer walked over to me with a microphone, inviting me to say or sing something profound. Instead, I said “we love you, Dwele!” The exam the next morning was easy to pass, but the charisma malfunction at the concert haunts me to this day.  

Concerts notwithstanding, spontaneous communication has become a daily reality for me as a medical educator. Whether answering tough questions in a lecture, responding to families at the bedside, or introducing an invited professor at Grand Rounds, the ability to think fast and talk smart has become essential for effective teaching and inspiring confidence. Indeed, effective impromptu communication fosters better engagement, empathy, and trust with learners and with patients.   

In his book “Think Faster, Talk Smarter,” Matt Abrahams shares six core principles for mastering impromptu speaking skills. 

1. Remain calm to manage anxiety  

I have learned to acknowledge the anxiety I experience in the context of spontaneous speaking. Instead of resisting it, I have learned to greet it and reframe the situation as an opportunity rather than a threat. Abrahams suggests using both physical and mental exercises to regain composure. Physical exercises can include engaging in activities like deep belly breathing, progressive muscle relaxation, or enacting power poses to ground yourself. Mental exercises can include using tongue twisters or counting backward by challenging numbers to focus your mind and stay present. 

 2. Unlock to get out of your own way 

When I speak, I recognize that I am pre-judging my speech's content. Abrahams suggests that instead, we let go of self-criticism and allow ourselves to be "mediocre" to reduce pressure and enhance authenticity. Dare to be dull, and just get it done. 

3. Redefine to shift your mindset 

In adopting a growth mindset, I have learned to view mistakes as learning opportunities. Replacing the fear of failure with the curiosity of exploration has released me to fully experience the moment and be of use to my audience rather than getting caught up in self-deprecation. 

Improvisation exercises lend themselves to building confidence in an unscripted conversation. Consider the "Give a Gift, Receive a Gift" game. This back-and-forth exercise strengthens your ability to think on your feet, listen actively, and embrace the unexpected. By imagining and accepting outlandish “gifts,” participants practice the art of accepting and building upon others' ideas to foster collaboration and creativity by saying “yes, and”— a key mindset for effective, in-the-moment communication. This is a simple, energizing way to boost your impromptu game while having fun. 

4. Listen actively and engage with empathy 

In conversation, I find myself crafting the next sentence. Instead, Abrahams suggests focusing entirely on the speaker, aiming to understand their message fully before formulating a response. Use techniques like paraphrasing to show understanding and build rapport. 

5. Structure your response 

Heuristics are mental shortcuts that can help ease cognitive load, enabling you to focus on your audience and message rather than getting stuck on what to say next. Consider using simple frameworks to organize your thoughts using structures like: 

Finally, Abrahams emphasizes the importance of focusing on your message and your audience. Be precise, be relevant, be accessible and be concise. Ask yourself: 

Contrary to popular belief, spontaneity can be practiced and indeed enjoyed. It has been over twenty years, but my friends still answer my calls with “we love you Dwele!” And, although I do still love Dwele, I often reflect on my learning from that moment. I have matured and learned to be more intellectually present, and that girl at the front of the stage now represents my learners. Residents and students may be tongue-tied during rounds or say the “wrong” thing in front of patients. Rather than making them feel ashamed, I am learning to support their speaking habits, emphasizing reflecting on the event with a growth mindset, offering tools like “yes, and” and modeling active listening.  

How might you prepare to think fast and talk smart? Importantly, how might you support your learners to do so?  

#MedEdPearls are developed monthly by the health professions educator developers on educational affairs. Previous #MedEdPearls explored embracing failure, cultivating a growth mindset, and finding your strengths.