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Medical hierarchies are detrimental to medical student education, making it vital to consider alternative ways to support students in diffusing power dynamics. Improv has been linked to power-hierarchy disruption, and has been used to support a variety of interpersonal skills for medical students. However, little work has examined how medical improv can achieve similar results in a virtual environment. This study uses a secondary analysis of data collected for a larger randomized control trial to interrogate medical students’ discursive constructions of power-hierarchies. We use these discourses to provide recommendations on how virtual medical improv can best be leveraged to prepare medical students for successfully interrupting hierarchy during their future careers.