Every One of Us Counts – Successful communication and cooperation in clinic teams

RealityCheck

Dr. Andreas Abt

 

Overview
In my courses and programs, I work primarily with action-oriented methods, as they bring the generally subconscious communication and behavioral patterns in groups and teams to the surface, thereby enabling further development work. To foster comprehensibility and manageability as understood by the Salutogenic “sense of coherence” concept, I use action-oriented activities to allow participants to experience certain aspects of knowledge (such as from communication theory and/or group dynamics) and in this way to enable holistic understanding.
The aim of a one-day workshop I held with a 20-member team from a dental clinic was to develop their cooperation and communication skills. The focus was primarily on how team meetings were conducted and structured. The clinic team was het­erogeneous in terms of age and professional experience. In addition to experienced employees who had been with the clinic for many years, there were many young team members from different profession­al backgrounds. The clinic team had already done team activities on a regular basis in the past. During the meeting that I conducted prior to the seminar to clarify expectations, communication within the team was identified as one of the key topics.

 

Topic
The use of action-oriented methods often brings a variety of team-related issues and tensions to light. In addition to aspects I have planned for, unforeseen aspects often also emerge. I also use these methods to make reflection and action models, such as those relating to communication, a holistic experience that is in keeping with the participants’ objectives and prior knowledge, and to derive and test the consequences for successful discussion management in everyday team life.
Furthermore, I find it beneficial for the group members to become aware of the process of task accomplishment and to (re)recognize the individual and collective patterns and dynamics inherent in everyday team life. Do they take a structured ­approach or is the process rather chaotic? Are agreements made in advance that will then be implemented during the activity? What roles are there in the team? How are they accepted by the team and lived by the members? What participation in the solution process is evident and how are decisions made?

 

Staging
a. Preparation
Since we repeatedly find that people intentionally or unintentionally look at the pictures of the people next to them, I sorted the picture cards in such a way that people sitting next to each other had completely different sections of the picture sequence. After introducing the activity and stating the rules of the game, I gave each team member a picture card. After we clarified any questions they had, the activity began and I switched to the role of observer.

 

b. Performance
We humans are by our very nature limited and have a very narrow perception of reality. Through processes of sharing, which should be supported by an appreciative mindset, we are able to broaden our inner maps and expand our frames of reference. Accordingly, the team’s “truth” is formed by the majority and/or all of its members. In RealityCheck, each member of the team possesses a part of the overall story or “truth” in the form of a section of a picture. The task is to discover the “greater truth” through collaborative interaction.
I invited the group to engage in the activity by using the following words: “Imagine that each of you has a part of the truth of a whole picture. It is quite common for each of you to perceive the facts of your daily working lives in quite different ways and to focus on quite different aspects.
These picture cards are connected. Your task now is, by using words and without showing each other the picture cards I am about to hand out, to find the shared truth, the overall picture, what connects the pictures. When you think you have found the solution, place the cards face down on the floor according to what you believe the solution is. If there are no further questions, I wish you every success in finding the solution.”

 

c. Progression
If there is no clear communication structure, typ­ically the more dominant team members dictate how things proceed and the more reserved, quiet members accept this. In this specific case, the group initially agreed on a procedure in which one member after the other was to present his or her picture. However, it is not uncommon that, after they describe the first picture cards, the previously agreed upon procedure is discarded without consultation and a rather chaotic solution-finding process be­comes noticeable. It is worth mentioning, however, that this path can also lead to success.
In this particular team process, the unbalanced level of participation in the conversation resulted in the group members with the “cityscapes” not being able to find a connection to those with the “jungle pictures.” As is not uncommon in action-oriented activities, and as was indeed the case here, the calm, quiet team members, who were ignored by the “game leaders” and also did not have the courage to speak up, were the ones with the key images that were crucial to finding the solution. In other words, they had the knowledge or the information that – to paraphrase Gregory Bateson – made the decisive difference in finding the solution.
Due to the lack of information, the team leaders continually tried to find the “right” solution by shar­ing (only partially complete) information with each other. Since this did not bear fruit and neither the dominant nor the silent team members made any effort to abandon the path they had taken, I inter­vened. I asked one of the silent team members whose picture I could see to participate in the process: “I have the impression that it would be helpful to find­ing the solution if you describe your picture to the group.” With the help of the description, many had an “Aha!” moment and the group then quickly fig­ured out the solution to the learning project. In other words, the participants’ inner maps changed and together they were able to find and place the correct zoom sequence of the overall picture sequence.

 

Reflection
In the reflection following the activity, I drew on the experience they gain to focus on the topic of meeting structure. It became clear to the team members that it was important for the success and satisfaction of the group for everyone to have the opportunity to contribute their perspective and that it was helpful to establish appropriate structures in the team meetings. The dominant team members became aware of how important it was to offer all team members space for discussion in order to leverage their perspectives and experiences for the benefit of the team. The quiet and silent participants realized that their perspective was important for team success.
Through the experience and evaluation of the activity, somatic markers could be triggered in the silent team members, which were pivotal to their personal development, are important and profound impulses for more self-confidence, and key to overcoming their passivity and misconstrued reticence over the long term. Furthermore, the clinic man­agement was given the necessary input with which they could purposefully structure the clinic team meetings and establish strategies and rituals.

 

Transfer to the real World

Elements in the learning projectElements in the real world
Overall setting of the activityTeam meeting setting
Individual picture cardsSnippet or item of information (individual view of reality)
Entire sequence of imagesOverall picture that emerges from the different items of information (common, shared view of reality)
Solution-finding processMeeting culture of the team
(importance of each individual)

 

Conclusion
Our ability as human beings to converse is both a blessing and a curse. Our relationship to groups is also quite ambivalent: we can achieve more through group cooperation, but we also find group work very challenging. Structuring successful meetings and discussions is key to self-efficacy, to achieving job satisfaction, and to staying healthy. Though not always the case, very often the successful use and professional design of action-oriented methods, as in this case, results in profound insights and impulses for sustainable development not only for the individuals, but also for the whole team and the management.