Two students taught a quarter-long elective for Year 1 medical students with three themes: portraying ourselves; perception of others, and interpersonal interactions. The elective focused on exercises derived from improvisational theatre (improv). Practising improv teaches quick thinking, a valuable skill in the practice of medicine. Students actively participated in weekly improv exercises that coached specific skill sets: portraying varied social status; improving and directing attention; telling stories, and working as a team. The exercises themselves were not related to clinical scenarios. Instead, the tenets and vocabulary drawn from improv provided a structure for applying lessons learned in the communication exercises to the doctor–patient relationship. Each session included ample time for students to comment on what they saw and experienced in their ‘performances’, as well as how they could utilise their new skills in the clinical realm. A subset of sessions were led by improv experts as well as doctors who provided personal experience and clinical scenarios in which the students engaged in more traditional role play.