Delivering your patient involvement activity
Behaviours for effective facilitation
As a facilitator you’re aiming to create a safe environment that enables everyone to participate fully and feel valued. Working on these behaviours will help you become an effective facilitator:
- being warm and welcoming to put people at ease and encourage open conversations
- taking an inclusive approach will ensure everyone has their say and make everyone feel their contribution is valued
- being objective and non-judgmental is important – effective facilitators take a neutral standpoint, stepping back from their own views to appreciate different viewpoints
- strong and active listening skills are key to pick up on group dynamics and really hear what is being said in the room. Find out more
- asking great open questions to explore opinions (questions that start with what, when, where, why, how, tell me etc)
- being able to constructively challenge others will help you effectively facilitate a variety of situations
- feeling comfortable giving feedback will help others understand the impact of their actions
- having the confidence in your own judgement and ability to act – when facilitating you’ll often have to decide what’s needed in the moment
- being alert and perceptive – paying attention to the group dynamics and individual behaviour (e.g. if someone’s body language indicates they have something to say but are too shy, you can invite them to contribute)
- flexing your own style and approach to accommodate different situations and people
- being aware that people work and learn in different ways so will enjoy or be more productive in different activities (e.g. some people prefer group discussions while others may prefer time to think things through by themselves first)
Using facilitation techniques to help manage discussions
You can use these techniques to help keep the conversation on topic, manage dominate characters, and encourage quieter patients to contribute.
Views in turn
Ask everyone to share their views in turn. It’s helpful to use people's names.
If you notice someone is quiet, it’s ok to ask them if they’d like to share their views. Sometimes when other people are dominating the conversation it can be helpful to invite other peoples’ views.
Making direct eye contact with someone is a subtler way of inviting them to share their views.
If people are getting a bit side tracked, it can be helpful to acknowledge and thank them for their contributions and then repeat the question or the session aims to refocus the conversation.
If people have questions or comments that aren’t on topic or you won’t have time to delve into, ask people to write these on a post-it note and add it to the ‘car park’. The car park can be a piece of flip chart paper on the wall. Do follow up on any questions or comments placed here (you can respond in your session summary), so you don’t miss any valuable information and patients don’t feel like they’re being ignored.
Use flip charts
Writing patients’ comments on a flip chart or whiteboard at the front of the room can help you capture key themes but also help patients feel listened to and valued. During small group discussions, ask facilitators or a volunteer scribe to capture comments on their own flip chart paper.
When lots of views are being discussed it can be useful to ask groups to put their responses into themes. It’s easier to do this if they’re capturing their views on post-it notes. You can also group responses in themes if small groups are feeding back to the whole group, or you’re having a whole group discussion.
It’s good to gather a variety of views. If someone is dominating conversation is can be difficult for other people to contribute. A useful technique is to invite other patients to respond to what they’ve said. For example: “It’s important we get a variety of views on this topic and I’m interested to hear what other people think. Does anyone have anything to add to what Mary said?”
Pausing after people speak can encourage other people to respond or add their thoughts.
Follow up questions
Follow up questions can help delve deeper into someone’s responses. These could include questions like:
- “Can you say a bit more about that please?”
- “Could you give me an example”
- “How does that make you feel?”
You can use hypothetical questions to explore views on different scenarios or help put patients in the shoes of other people.
Repeat what you’ve heard and ask if you’ve understood correctly. This can help patients add to or clarify their views. If you didn't understand what they were trying to say, tell them you don't understand and ask them to repeat or clarify.
It can be helpful to ask those who have contributed a lot or dominated conversation to be scribes for their table discussions, or to write things up on the flip chart to give other members a chance to contribute.
If there are breaks planned, make sure everyone knows you’re available to chat so people who find it difficult to express themselves in a group setting can come and talk to you.
Repeat ground rules
If people aren’t following the ground rules it’s helpful to remind the group and highlight the rule that isn’t being followed. For example: “As we agreed as part of today’s ground rules, it’s really important that we stick to the topic, as we’ve got a lot to get through today.” If someone persistently breaks the ground rules you may need to have a quiet word with them. It can be helpful to acknowledge their positive contributions, reflect on what negative behaviours you’ve noticed and give feedback on how this impacts others. You may want to ask if there’s anything going on or that you can do to help them keep to the ground rules.
How to respond if someone gets upset
Cancer can be an emotional subject. Sometimes talking about cancer and people’s experiences of it can be difficult and make people upset. If you notice someone’s looking upset, then:
- quietly check in with them and ask if they’re okay
- be empathetic
- ask them if they’d like to step out for a moment
- take them outside and ask if they’d like you to stay or have a moment to themselves
- reassure them that if at any point they want to stop and leave, they can
- listen to them if they want to talk briefly
- don’t try to console them – signpost them to a support service like the Cancer Research UK nurses
- if they decide to come back to the discussion, try to check in with them throughout the day
- be sure to follow up after and thank them for their contributions