Management Adviser, Trainer and Facilitator
Patricia is an HR specialist in general practice. She was the managing partner of a large practice for more than 10 years, and now provides HR and management advice and training. She is also a trained facilitator and a coach. Together with a GP colleague, Patricia has recently set up a specialist recruitment service to help practices select a GP partner or salaried GP
When I worked as a practice manager, I took part in away days with the partners and attended other events that were run by an external facilitator. When I had the opportunity to train as a facilitator, I thought it would be a great skill to learn.
Facilitating is one of those skills that when done well looks effortless and easy, but in reality is far from simple. I realised that a lot of thought and effort goes into planning the right process so that the event runs smoothly and addresses the key issues.
Facilitation is certainly never easy, as a facilitator must be alert at all times to what is going on in order to pick up on the obvious and less obvious cues of the group dynamics and to be able to think on your feet.
What is facilitation?
People are often not clear about what facilitating is. It is not training, which is about imparting information, nor chairing a meeting, where the chairperson is an integral part of the group.
Facilitation is about making it easy for the group to solve problems, gain consensus, mediate conflict or generate new ideas. It is a very important skill for any practice manager when facilitating a strategic planning session or a teambuilding session with the practice staff. It is also extremely helpful in resolving conflict in a group or interpersonal difficulties between team members.
Often the facilitator is the practice manager, but sometimes it is helpful to engage an external facilitator to help the group with new ways of working, to keep objectivity in the process, and to allow the manager to fully participate in the event.
The facilitator's role normally starts by organising the agenda for the event depending on the purpose of the event, the objectives and the desired outcomes. The facilitator will design a suitable process, taking into account the size of the group, the participants, the time available, the venue, the history of previous events, the current issues, and any obstacles that might inhibit achieving the desired outcome.
Once the agenda is agreed, the facilitator's role on the day is to guide the process by providing the right tools and techniques to help the group achieve this agenda.
It is very important that a facilitator stays neutral and only contributes if asked to do so by the group. A facilitator who jumps in with his or her own ideas or tries to influence the group will quickly be discredited. So it is important to realise that if you are going to facilitate, make sure it is a situation in which you can remain truly independent and have no personal stake in the outcome – other than believing it is the right one for the group.
A facilitator will need to make sure that everyone in the group contributes appropriately and that no one person dominates. We all know that some group members are more forceful and vocal than others, and can often sway or influence the group with their opinions. Other group members may be quieter or less confident to voice their views, but will often have legitimate and
Sometimes, group members can be so domineering that their behaviour verges on bullying, for instance deriding other group members or their ideas. The facilitator needs to nip this in the bud at the first sign by being firm and maintaining neutrality.
Another useful role of the good facilitator is to find alternative ways of doing things if the group gets stuck. Groups are often keen to focus an action but this can be at the expense of exploring feelings, concerns and intuitions. While this can take up time, it is nevertheless useful, since it allows the group to avoid making a decision not everyone is onboard with.
If a facilitator is doing the job properly, he or she will be unobtrusive, optimistic and flexible enough to change tack if things are not working out. A good facilitator will talk little but stay alert at all times, listening actively to the content and the dynamics of the discussions, and observing what is happening in the group. A facilitator can never afford to lose concentration.
Questioning and communication
An important facilitation technique is to ask questions, which should always be clear without leading or influencing. Questions need to be honest and relevant, seeking information based on what people know. A facilitator needs to have the confidence to ask challenging questions when appropriate in order to stimulate thoughts or to probe deeper into a problem.
Sometimes, "permission" questions are needed – such as, "May I ask you about finances?" – to acknowledge that there may be a perceived sensitivity around the response.
Let's consider a group contemplating changing their computer system, for example:
Paraphrasing is also helpful to ensure that you and members of the group have a common understanding of the discussion. It can also be helpful to report behaviours back to the group, such as: "I am noticing that …". The facilitator may also need to check perceptions and feelings, such as: "You seem impatient. Are you anxious to move on to the next topic?"
The communication pattern of the group will tell the facilitator a great deal about the dynamics, and provide information about whether to take more or less control. This includes the members' body language, which is often more revealing than their actual words.
It's also worth being aware of: who talks first; who hardly talks at all; who dominates; who supports others; who follows one another; whose opinions are rarely acknowledged, and who
Tools and techniques
Many of the process tools used by a facilitator are simple. The most common is the flipchart, used to record what people say. It is important to use their words or to ask permission to change words or paraphrase them. It is also important to record complete ideas, such as: "Work group to meet Monday at 10.00am for an hour".
Different-coloured flipchart pens add interest and can separate themes or issues. Using the flipchart can be invaluable in taking the heat out of a discussion because it depersonalises statements. It is also a visual tool that allows group members to assimilate information.
Other simple techniques can be used at different times during the event. Icebreakers are often useful at the beginning to relieve tension about the event, eg, a short fun activity involving sharing information with a partner, such as describing a recent success. Icebreakers can also be used to focus participants, eg, discussing with a partner what you would each like to get out of the event.
Dividing a bigger group into small discussion groups or pairs encourages high participation from all members and is useful for groups to investigate issues and come up with answers. In large multidisciplinary meetings, it can be helpful to group or pair colleagues from different functions to achieve a better understanding of each other's issues. The results of small group work can be documented onto flipchart paper by the group scribe and presented back to the bigger group later.
A useful technique to generate contributions is to place flipchart sheets around the room, with a topic or issue on each one, and ask members to record their ideas or opinions on post-its underneath each topic. The facilitator can group these into themes later.
Energising activities, providing fun and lifting the energy, are useful to provide a break and light relief, or to smooth over undercurrents of conflict. Such activities include games or mental challenges either inside the room or outside, if appropriate. Simply taking a break for refreshments or fresh air will have a similar effect, and often provides the group with the energy to continue working effectively.
One of the most useful techniques during a discussion is a "round robin", in which everyone in turn is asked to express their views. This ensures that everyone contributes and themes or commonality can be identified. When creativity is needed, the flipchart can be used to brainstorm the issue. Group members are encouraged to generate uninhibited ideas, no matter how wacky or stupid they may seem. The facilitator records the ideas on the flipchart in no order or priority. Once the ideas have dried up, they can be analysed to see whether they are worthy of further examination or should be dismissed.
A SWOT analysis is a useful tool to establish "where we are now". The issue is clearly identified, such as "the practice premises", and the group will identify Strengths, Weaknesses, Opportunities and Threats. This can be a helpful stage before making decisions about what changes need to be made.
A number of other tools can be used to promote discussion or help decision-making. Eventually, the group will want to make agreements about courses of future action. This can be done by voting (eg, putting a cross besides a choice of several options), multi-voting (eg, allocating 10 points to each person and asking them to allocate points against a list of options) or by consensus.
One way of encouraging consensus decision-making is to get each person to state their case in a few minutes, record the main issues on the flipchart, look for areas of agreement, explore areas of contention, and facilitate a discussion around a win/win outcome.
Many groups experience conflict or differences between group members. Sometimes conflict is like Pandora's box – no one wants to open the lid because of the discomfort of having to deal with the possible aftermath. But it is important not to shy away from conflict and it is helpful to recognise that differences exist and to give members "permission" to have different views.
Pinpoint the differences using the flipchart and explore the potential benefits of allowing different feelings to surface, such as increasing understanding of one another, developing self-awareness and finding novel approaches.
Any facilitated event should end with a brief feedback session, which reviews the outcomes of the day and reinforces successes.