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From the Road: Just What the Doctor Ordered

Steve Willis is a master trainer and vice president of professional services at VitalSmarts.Steve Willis is a master trainer and vice president of professional services at VitalSmarts.

From the Road

I recently delivered an extended speech to a group of doctors. But this was no ordinary group of doctors—it was a group of emergency room doctors who absolutely, positively would not tolerate any fluff-laden presentation. The organizers told me up front that this group wouldn’t tolerate any pair and share exercises, videos that were not 100 percent healthcare related, and without exception—at the peril of mass walk-outs—this group would not tolerate role plays or ANYTHING that even resembles practice.

Over the years, I’ve learned to distinguish the difference between a presentation that really resonates with a group and one that falls flat. And while it might seem counterintuitive, I’ve noticed that when I cut out the fluff (i.e., the practice-related activities), the group usually indicates that the presentation was lacking.

With this in mind, I worked with the organizers to create some space for practice, which they eventually (and reluctantly) consented to. And even though they had given me “permission” to do some practice exercises, I saw them wince at the mere hint of the word during the session.

The wincing soon ceased as the organizers saw the doctors really engage in the practice. They even willingly worked through practice sessions for longer than two and a half minutes—which was apparently a new record for them. By the end, the session organizers were convinced. In fact, one leader even said, “Wow, I guess we were wrong. We should have trusted you a little more. Who would have known that it even works with doctors?”

So, next time someone tells you practice isn’t necessary, ask them if they’d prefer a presentation that falls short or one that can engage even the most skeptical audience.

10 thoughts on “From the Road: Just What the Doctor Ordered”

  1. Nhung Hurst

    Steve, thank you for sharing this story. I don’t know that I’ve ever been told in such a forthright manner that I would be presenting to an openly hostile/challenging group. Your resposne to their request and needs was very effective. What I liked is that you didn’t “give in” to their demands to cut out all practice-related activities. I know that I have tried too hard at times to “please” the target audience at the cost of the training and material. Your experience reminds me that while my audience has their areas of expertise, trainers have their own and that there are many situations in which the “trainer knows best.” I wonder if I could market a show with that title to any of the major networks. It’s a thought. Thanks again for sharing this.

  2. Judith

    Good for you and kudos to your skills.
    What I would like to know is how the organizer managed to get more than 2 doctors there at the same time?

  3. Christine R. Carver

    That physicians have short attention spans and intolerance to “fluff” seems to be a widespread “story” that is told in healthcare. But I have had the same experience when I have tried to pare down a presentation to a physician group and made theit so spare that it was inevitably dull. I have also omitted communication to physicians on the advice of others, only to find they become annoyed because they were not kept informed. The real issue is that they want their time and attention to be treated as valuable. Doesn’t everyone?

  4. James Campbell

    Having facilitated an array of groups, I concur that there is an amazing amount of ‘baggage’ to the words role play or practice.

    With perhaps an even more hardened group of participants (ex-offenders) and after getting similar reactive feedback to saying ‘role play’ or exercise or practice, we knew we needed a different approach.

    We settled on a combination of motivational interviewing techniques and choice of words and went with, “what do we need to do to ‘make it real’?”

    ‘Making it real’ provides an entry point to use those real life scenarios, which is what the role play would have done anyway. This way we avoid the connotations that accompany ‘role plays’ and still engage the group. The MI approach allows us to continually ask if the way those in the ‘role play’ acted was true to life or were they blowing smoke…would they really use the approaches. This allows us to engage in elements of the crucial confrontations.

  5. Darrell Harmon

    Great experience to share with the training community, Steve. And I think it’s also a great example to share with others (I’m thinking of the organizers here) who tell a “fluff story” about training. This is a great example of how our approach to training is both spot on and unique. I’m afraid that too many organizers and doctors (and executives, engineers, accountants, etc.) have a “fluff story” about training, because that’s exactly what they’ve received way too many times over the years.

    So my take-aways are: 1) discussion, structured rehearsals and other engagement activities are VITAL to effective presentations and training classes; and 2) we need not shy away from insisting on including these when we present to any group. Kudos!

  6. MJ

    I used to design courses in a previous job. According to adult learning theory, adults absolutely need to practice what they learn during training or instructional presentations. A veteran course designer also shared with me that adults who take training need to be “doing something” every 15 minutes or so. This is very true – I have seen so many people squirm and yawn after 20 or more minutes of straight lecture. We like to complain about kids’ attention spans, but in my experience adults can be even worse…just try telling them that they have to turn off their cell phones, Blackberries, or iGadgets!

  7. Loren Quintin

    Although I am not a doctor, I am an RN. I have always despised role play. Get to the point, and just tell me what to do. I took Crucial Conversations through work and under threat of physical violence from the HR rep (she was kidding, I think) I had to role play. Much to my surprise it was extremely helpful in integrating what I learned into real life. I took the class a second time and role play was even better because I could help my partner achieve better results. I have since become an educator and I include role play in my trainings, which I never would have done before! This old dog learned a new trick, arf.

  8. AH

    Steve, I have had the same experience ( substitute Emergency Doctors for Surgeons and their teams) and I was told it was possible that the physicians would not stay for the session. One doctor did get up and walk out but three others stayed. Before the course,I asked for “case studies” ( a familiar way we teach in healthcare) and typed up these scenarios. After teaching the concepts, I asked the participants, who were skeptical and hostile, if they wanted to “test” out the concepts by applying them to their own “worst case studies” ( the idea was…don’t take my word that Crucial Conversation Skills work…try it yourself! Disprove my theory!) Soon, the staff was challenging the doctors to get up and show me how their environment was different from other areas of the hospital. One physician agreed to show me and I role-played using the CC skills.Guess what,dialogue worked! Then I asked them to try with each other and soon the whole room was acting out real scenarios and trying on new skills. I was invited back to facilitate more “case studies” and this group is looking at incorporating small case-based sessions into their monthly staff meetings, studying one skill and then applying it to a real example. I will say I was very nervous to take on this asignment, but I knew that I could not simply lecture without providing application exercises. My thoughts are to be brave and know that we, as educators, do have expertise and we can and should instruct in ways that are proven to engage professionals. I was happy to have done what I knew was right. It all worked out. Using cases showed the learners that Crucial Conversations was relevant to them and to their work. Another principle of adult learning. PS The staff asked the physican who left the room to attend the next session because “she would really benefit from it” and her boss insisted she attend as she was “a yeller” in the operating room. The staff felt more confident to hold her accountable to professional communication skills after she had learned the same concepts.

  9. Diana

    Steve, your article really hit home for me. Although I did not have to work with a group of doctors, I did have to convince a group of executives, including a skeptical CEO, that developing Crucial Conversation and Confrontation skills would improve the effectiveness of our organization. I also wanted the executive team to recognize that without commitment at the top, it was unlikely that the cultural change they were looking for would take hold. I was very nervous about the executives in CC training and did not believe that they would appreciate the value of practice in the form of role play, so I planned for a reduced program assuming that we would cut out much of the role play. I was astonished to discover that not only did these executives willingly participate in the role play, but they actually asked for more. Certainly a testament to sticking with a proven program – it works!

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