Inteprofessional groups have their own communication dynamics. Is it possible changing things up, and trying new communication patterns, can help groups progress? In Part 4 of our 4-part series on communication in public health, Samantha Cinnick of HRSA tells a story about the power of questions, and silence.
And stay tuned – our next episode has a big announcement!
Is it possible the ways we’re used to communicating with our colleagues can sometimes make it tougher on us when we want to tackle problems together? Listen to Samantha Cinnick from HRSA tell us how breaking common communication habits can break open new ideas.
Hi everybody, this is “10 Minutes to Better Patient Communication” from Health Communication Partners. I’m Dr. Anne Marie Liebel. Our Equitable Communication course has been found to make a statistically significant improvement in people’s communication knowledge, confidence, and skills. What this course has, that no other does, is a one hour, live, group meeting for the course participants after the videos have been watched. So we can get started applying what you’ve learned in your specific workplace. Learn more at healthcommunicationpartners.com.
Anne Marie: I’m live via zoom with Samantha Cinnick from the Health Resources and Services Administration. Sam, welcome back to the show!
Samantha: Thanks Anne Marie, glad to be be back.
AM: This is the fourth installment of our four-part miniseries on public health communication and it’s been a great pleasure to sit down with you Sam.
Sam: So many communication issues! Ok, well for this first one, or for this one, I want to talk a little bit about what I first worked on when I started my public health career.
Ok.
I helped to coordinate webinars and asynchronous courses where we have one subject matter expert share their research findings for their recommendations on how to fix a health problem. And although I saw the value in disseminating those research and policy recommendations from researchers and practitioners who studied them all day long, I thought that the lecture-based delivery of the information might be preventing our training participants from seeing themselves as the subject matter experts, or being able to take action on the problem.
That’s definitely a shortcoming of webinars. And I mean we’ve all been to a million of them. They do kind of put us in a passive spot. Which is unfortunate because we need experts, and we need experts to tell us things. So the webinars do have their drawbacks. We need more than just that kind of passive setup.
Absolutely. I 100% agree. And it made me realize that I wanted to design more educational experiences where the teams were coming together, right? Groups of people are coming together to build their capacity, their knowledge, by listening and learning from the wisdom of the group they were working with.
So I like this issue that you’ve brought to us because it’s about communication and it’s about education.Because that– the webinar set up, going back to that, one of the limitations is that you’re usually not engaged. You’re usually not doing something, you’re just receiving what’s getting delivered to you. So how are you facing this issue of needing to have different kinds of education that have different kinds of modalities, different ways of working together?
Sure. I think in an effort to build my own skills and how I could develop team-based learning, I started experimenting with different types of teaching which included coaching. And I had the privilege of coaching a group of non-profit professionals who came from different organizations, using a framework called action learning. And in action learning, participants only need to follow two rules in order to take action on a problem and learn from each other. The two rules are: statements should only be made in response to questions. And the second is that the action learning coach has the power to intervene when they see an opportunity to improve performance and learning of the group. So,
Okay, wait a minute I’ll pause you there. Because that’s a lot! So there are two rules. The first one, “statements should only be made in response to questions.” So what that says to me is that there’s a lot of question asking, and I already like that because it’s close to inquiry, and giving questions pride of place. I think it’s also pretty interesting that it breaks us of, potentially breaks us of the habit of just going right to statements that maybe do or don’t have something to do with what was just talked about.
That’s totally right Anne Marie. To make this more concrete let me give you a public health example.
Okay
Let’s say an action learning team is working together to implement an obesity prevention program. And they want to figure out how to increase outreach to community members. They might be asking themselves questions like, “How will we develop relationships within the community to increase uptake?” A natural next question could be, “Who has the connections with leaders who are doing activism on school lunches, community gardens, youth education, etc.?” And you’re going to start to recognize people around the room. They might not be doing that work, but they know someone who does, or they’re connected to a network that does that.
Thanks for giving us that kind of glimpse into this kind of work. What did you learn from using this educational approach that has some pretty strict communication rules?
It was a learning process. At the beginning of our sessions when I was working with this team, I noticed some pretty uneasy body language. Things like squirming, people crossing their arms, leaning away from the other participants.
I bet!
Yeah I mean it’s such a steep learning curve to put into practice this new communication style that’s focused on intense listening. But eventually, the team began to fall into a rhythm, right. Where a participant would ask a question and the other team members would take notes. They would carefully craft their responses before answering. They were, they were really putting their all into listening. And my favorite moment was when a participant asked a question that was so out of the box that it stopped everybody in their tracks. And there was a moment of intense silence for about 10 seconds.
Oooh. When people hear that they might think “oh gosh that was awkward” but I think what you’re talking about here is a different kind of a question. A question that like, stops things. That breaks things open. Because a good question can do that!
Yes. And I think only making statements to questions, as we’re talking about it, it probably sounds unnatural to our audience. But what I witnessed was that, when you have that purposeful inquiry with the measured and focused responses from the team, it’s a pathway for teaching others how to gain new perspectives about a problem. And it helps them feel like they have the knowledge to handle it. They are the subject matter experts. And it felt like a way to expand my training participants’ ability to listen to and appreciate their own internal wisdom.
There’s a couple of things that I love about this. And one is that you know it’s it’s centering questions. And the other is that it’s about listening. And I have to admit, Sam, this is kind of embarrassing for me, because here I am, 150-something episodes into a podcast series about communication, and I don’t talk about listening that much!
You’re gonna have to invite me back so we’ll just talk about listening.
We’ll talk about listening absolutely! Did you learn anything about you in this process?
Absolutely. I as a coach, I had to engage in some pretty intense listening myself and trusting my own internal wisdom.
So for example during that coaching experience, I noticed that there was one person out of the group that was asking the most number of questions. Now did that have something to do about power imbalances, group dynamics, politics? I wasn’t sure!
Right
But I had to figure out, you know, when’s the right time to bring this up to the group, so they can reflect on it and determine whether they want to do anything about those behaviors.
So usually at this point it’s when I ask people, you know, what are the next steps for you? But this is the fourth and last installment of this mini-series on communication in Public Health with you Sam. So I thought I wanted to kind of look back across all four of them, and tell you something that I have noticed just observing. You know that, not everybody knows, that some of my expertise is in professional learning across the career span. So it’s been a real treat to be able to learn from you as an early career professional. And so some of the things that I’ve noticed, if you’ll indulge me for a moment, is that across the series, you have been looking at taken for granted practices and arrangements in public health. And you’re pulling them up and you’re asking some questions about them. And that takes bravery by itself, to question the status quo. Across the examples that you’re giving us, I hear you also resisting what must be significant pressure to show your value by showing how quickly you can rush to a solution. And like have the answer, which is the opposite from what you’re, you know–you’re telling us the story today about that 10-15 seconds of silence, and resisting the pressure to jump into that silence. You get the collaboration is the way forward, and that there are many layers and nuances to the work of bringing different people together. You also clearly get that this is long-term work. You have that long-term sense of field. And I think that’s also, that’s admirable in any professional. And you’re daring to claim that as an early career professional you have knowledge worth sharing.
Thanks Anne Marie, you’re making me blush over here! No, I have been extremely lucky to have mentors like you in my life who allow me to grow and have a place to safely explore and learn. Ultimately, Anne Marie, I hope that I’m able to continue to use these frameworks and you know continue to be able to look for the questions that I want to answer. Like, how can I create a culture where public health professionals see themselves engaged in lifelong learning? And then like what does what does the organization that’s dedicated to learning look like? But I’m sure it’ll take a lifetime and I’m sure it’ll take a whole smorgasbord of these frameworks to actually make it work.
Samantha Cinnick from the Health Resources and Services Administration, thank you so much. Thank you for sitting down with me these four times, bringing stories from your experience, and being vulnerable with us, and reflecting on your practice, and letting us learn from you.
Thank you so much I really appreciate it.
This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering by Joe Liebel. Music by Joe Liebel and Alexis Rounds.