Facilitation Tips for Medical Educators, July 2015

bored studentsSo my group teaching session didn’t go so well – what do I do now?

When planning a workshop session, there are many things that can cause worry:  “Will anyone come?”, “Will I remember what to say?”, “Will the IT work?”, “Will the room set-up be suitable?”, “Will the group be responsive and engaged?”, “Will they realise how little I actually know about this topic and turn on me?”  (maybe this last one is just relevant to me?) and on the list goes.

While adequate preparation can help minimise mishaps (try to remember the 6 P’s – “Prior Preparation Prevents Piss-Poor Performance”), it is not always enough.

Things can and do go wrong for a variety of reasons, and the longer you’re in this game, the more “failures” you’ll accumulate. I use the term “failure” loosely, not limited to completely disastrous sessions in which lives are lost or spirits are broken, but to include those “sub-optimal” workshops – the sessions which, afterwards, as a facilitator, you don’t experience a mixture of relief, pride and joy, but instead feel disappointed and/or inadequate.

So what can you do with those feelings?  How can you make failure work for you?

I was recently contacted by Dr Rob Park, a Queensland-based medical educator who was co-facilitating a workshop session on social media.  The session was being run twice, on two consecutive days.

He called me on the Saturday night after the first session had he felt there were things that could have been done differently to improve the session. Luckily, I don’t have a social life, so talking to Rob was not an imposition. On the contrary, it was the highlight of my evening (I’m such a ME nerd!).

Rob explained that the group was challenging because of a general lack of engagement and interaction, combined with some adversarial comments and questions towards the end of the session.  Not uncommon problems, especially when speaking on a topic like social media, in which levels of knowledge of interest and experience vary so widely, and on which strong opinions are often held.   Rob and his co-presenters have excellent knowledge, experience and oodles of street cred on this topic, and had presented sessions on this topic before, which is a huge advantage. The trick was going to be in finding effective ways to encourage audience engagement and manage the naysayers.

It is a relatively uncommon, but fantastic learning experience, to have the chance to re-run such a session within a day or so.

In my opinion, Rob approached this learning opportunity in exactly the right way, and, having obtained his permission, I’d like to share what he did with you….

  • He recognised that the approach and/or content hadn’t worked well for the particular group.
  • He considered that it may have just been a really difficult group to engage and inspire (there are “dud” groups with which, no matter how experienced or talented you are, you cannot make a session sparkle) and therefore did not take it too personally.
  • While not over-personalising, he did, however, realise that a different approach/es might have resulted in a more positive outcome, and might be worth trying when he re-ran the session the following day.
  • He actively sought advice as to what these different approaches might be by discussing with an experienced colleague (in this case, by phoning me). We talked through what had happened and brainstormed alternative strategies.
  • He then put thought into how he could integrate some of these different techniques into the session.
  • He put these changes into practice the next day.
  • After the second session went very well, he reflected on why this was so.
  • He acknowledged that it was a different group and so the difference in outcome couldn’t entirely be attributed to the new facilitation techniques, while realising that, chances were, they made a significant difference.
  • He intends to keep this experience in mind when planning future teaching sessions.

Of course, there is no formula which will work every time (and how boring would that be!), and different techniques will lend themselves to different topics, audiences, group sizes etc.

The tips that Rob and I discussed to try manage the kind of challenges he faced are outlined below:

For groups who you are concerned might be quiet/ disengaged:

Get everyone talking at the beginning – either in pairs/ small groups or going around the large group if the groups is not too big/ time permits (“everyone talks once before anyone talks twice”).  Usually best for the discussion to be on something relevant to the topic such as their experiences and/or what they want to get out of the session.

For groups who are likely to have different levels of experience/ learning needs, especially when you have some flexibility in content:

Ask participants the one thing they want to get out of the session at the start, and consider whiteboarding the list.  Address each one either:

1) with an immediate answer (if quick and easy, and not covered later) or,

2) by saying it will be coming up in the workshop or,

3) by acknowledging that it is outside the scope of the session (preferably with information as to where to go to get more information and/or offering to talk to the person at the end of the session about it).

If the list has been whiteboarded, refer to it as you go – I like ticking the items off as they are covered, and checking that each has been covered adequately with the person who brought up the item (if I can remember who said what!).

For topics/ groups in which you expect to get resistance/ challenge/ negativity:

Try to get this out at the start and acknowledge/address head on, rather than wait until participants start making disparaging remarks/ adversarial questions later on.

Try to neutralise with (appropriate) humour when you can (I find self-deprecatory humour works best in such situations)

Recruit other audience members to pull the negative audience members into line if you can – the message is usually much more powerful if it comes from their peers.

For example, if I get a particular negative/ unhelpful question/ anecdote, I’ll often ask the rest of the group – “So what do others think?” or “Have others had experiences like this, or have yours been different?”

While this can work well, you do need to be a bit careful with this approach. I have run into trouble a couple of times. Once, two participants nearly ended up in fisticuffs. Another time, a participant ran off in tears and hid in a supply closet after a response from another participant. Mostly, however, it works well, and when it doesn’t – see it as another valuable lesson to be learned.

In summary:

When a session falls flat, it is natural to feel disheartened. Luckily, unlike in our clinical work, bad outcomes as a facilitator are rarely serious in the scheme of things.  However, just like in our clinical work, when things go wrong, engaging in root cause analysis, debriefing, feedback and formulation of specific actions for improvement, can be incredibly useful strategies.

I’ve learned so much more from my failures than my successes, and I now love nothing more than a “challenging” group so I can pull out a few extra tools from my facilitator’s toolbox.  Failure is never fun, but it can be your educational friend.

Thanks to Rob for approaching me for advice on this in the first place and for encouraging me to share these tips as a blog post.

I would love to hear your thoughts, experiences and tips – please comment below.


6 thoughts on “Facilitation Tips for Medical Educators, July 2015

  1. Great tips Genevieve.
    I think Rob was a bit hard on himself though.
    Other things to think about maybe, venue, seating, prior presentations that day that you could tie it to, and perhaps a vignette and lesson plan. Also annoying assistants who are overly helpful… Rob had one of those on day one 🙂

  2. I was at that particular session and didn’t feel it was flat at all! There were one or two people in the session who are notorious grumps and may have been there just to complain rather than learn.

  3. Thank you both for commenting. You have highlighted another very valuable point – even when, as a facilitator, you thought a session didn’t go so well, your audience members may have thought otherwise. We are our own hardest critics! It also worth remembering that quiet groups who don’t interact much may actually be engaged, learning and enjoying themselves.

    The purpose of this blog post was not to critique any particular session, but to discuss the process of how to manage the subjective feeling of “I wish it had gone better” experienced by every facilitator from time to time, and to turn it into a positive learning experience. Along with sharing a few tips.

  4. Thanks Genevieve, the tips were great. The other point here was we were losing two of our very strong co-presenters for the session the following day. I was worried that without their steadying influence and the eminence that they provided to the topic, that if the same dilemmas presented again it could be difficult to contain and challenge. As it was I think the changes helped prevent any dissent occurring which myself and my co-presenter may have found more difficult to control without their assistance.

    • Of course, Rob’s most important lesson is to always keep a spare Windows laptop, backup power supply, speakers and projector unit in your backpack. Doesn’t matter if the Mac is better; if the venue cords don’t plug in, it doesn’t help you!
      Oh, and avoid jargon. Break a potentially daunting topic down into achievable points easily comprehended by the audience. He does that too 😃

  5. Finally got to this. I thought Rob that the two groups had different needs. This first session we ran was not dissimilar to the session on GP confidential that Tim Senior and I ran at GP14 straight after an AVANT session on medico-legal issues. These are always the first questions that people in Social media Contemplation stage have. I didnt think it was flat. As a facilitation reflection maybe moving through some issues more quickly and taking the one on one discussion about fear out to the broader group. These fears and concerns are very valid and do need to be addressed for some people. Having different stages of readiness amongst the audience was perhaps another issue. Perhaps you like more structure and crossing things off the to do list? 🙂 I thought the addressing concerns around social media feelings stuff and validated reassurance was still a very valuable step. The important question in a workshop is whether you are addressing the concerns of the whole group or just a single outlier while the rest of the natives get restless…..

    From every Educator I’ve spoken to, running workshops is always a bit challenging due to having to respond quite a bit, rather than lead which is very audience dependent.

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