Facilitation Skills Research Articles

Lived Experience of Disability Equality Training Facilitators: Narratives of Disabled People From Ulaanbaatar, Mongolia

This study explores the lived experiences of becoming and continuing as facilitators of Disability Equality Training (DET). This study was conducted in Ulaanbaatar, Mongolia, one of the countries where DET has been strategically implemented. Nine facilitators were selected by purposive sampling for semistructured interviews. Thematic analysis was applied to the narrative data for exploring themes with consideration to chronological sequence, namely, before, during, and after DET training of facilitators (DET–TOF). The narratives indicated that DET facilitators had varied personal backgrounds, including experiences of discrimination. Their stories also indicated that some interviewees not only obtained views on the social model of disability and facilitation skills but also reframed their past life experiences both during and after the DET–TOF. While this study considers the potential criticism of the social model, which is the foundation of the DET, these findings can provide helpful insights for future agents of change who engage in a society.

P83 Formative Evaluation of a Culturally Adapted Spanish Nutrition Education and Obesity Prevention Curriculum for Low-Income Hispanic Adults

<h3>Objective</h3> To conduct an exploratory formative evaluation of a culturally adapted nutrition education program for SNAP-eligible Hispanic/Latino adult Georgians <h3>Use of Theory or Research</h3> Nutrition education programs for low-income Hispanics/Latinos must be culturally tailored to be effective. <h3>Target Audience</h3> Spanish-speaking SNAP-eligible adult Georgians <h3>Program Description</h3> "Hablemos de Comida: Comida: "Por SU Salud!" (HCPSS) is a cultural adaptation of "Food Talk: Better U," an evidence-based program focusing on healthy weight management by University of Georgia SNAP-Ed. A comprehensive needs assessment informed systematic translation and cultural tailoring. The program consists of four 90-minute didactic lessons taught by bilingual paraprofessionals focusing on portion control, limiting added sugar, and making small healthy changes. The program content is interactive and features physical activity using culturally appropriate music and 6 Hispanic/Latino-inspired, low sodium recipes. <h3>Evaluation Methods</h3> A mixed-method formative evaluation was conducted using self-administered participant surveys (n = 15), program administrative data, key informant interviews with program developers and providers (n = 6), program participant focus groups (n = 3), and in-class observations (n = 10) in 1 pilot county in 2019. <h3>Results</h3> Focus group and key informant interview findings suggested acceptability and cultural appropriateness of HCPSS. Major themes from development and implementation phases emphasized the importance of attending to diversity and cultural appropriateness for target audiences and language, translation, and other interpersonal facilitator skills such as cultural competence and humility. A team-based approach was recommended to address cultural diversity, recruitment barriers, ongoing staff training needs, and other population-specific barriers regarding language, literacy, and mistrust. Administrative data and class observation data suggested high fidelity but the importance of fully bilingual paraprofessionals and additional training for physical activity. <h3>Conclusion and Implications</h3> This study found that the culturally adapted nutrition education and obesity prevention programming targeted to low-income Hispanics/Latinos and strategies to strengthen ongoing development and implementation efforts was feasible.

Empowering Pakistani Woman: Impact of Education, Technology and Training Skills Development

Purpose: It is known fact that Currently Pakistani woman are facing several problems e.g., domestic violence, gender dominancy, gender discrimination and unequal distribution of power, rights and work, due the inadequacy of education. In this contemporary era of gender inequality woman empowerment is an essential area of study to be focused on. This study, therefore, aims to investigate the impact of education, technology and Skills development adopted for empowerment of women.&#x0D; Design/Methodology/Approach: Data was collected from private and government girls’ colleges of Hyderabad district Sindh. A survey technique was used to collect data using convenience non random sampling technique. Smart PLS responses analyzed with the sample size of 1184.&#x0D; Findings: Results of Structural equation modeling through Smart PLS supported the structural model. It was found that appropriate educational facilities, technology facilitation and training and skills development positively related to Pakistani woman empowerment.&#x0D; Implications/Originality/Value:&#x0D; Education is the milestone in empowering woman and the main factor in woman’s prosperity and development. In this scenario, education is a turning point in playing vital role in empowering woman because it enables the woman to face the challenges of contemporary time and make a significant change in their traditional roles and in their lives. Academician, policy makers and leaders of organizations must note this fact.

Sustaining implementation facilitation: a model for facilitator resilience

BackgroundImplementation facilitators enable healthcare staff to effectively implement change, yet little is known about their affective (e.g., emotional, mental, physical) experiences of facilitation. We propose an expansion to the Integrated Promoting Action on Research in Health Services (i-PARIHS) framework that introduces facilitation intensity and facilitator resilience to better assess facilitators’ affective experiences.MethodsWe used an instrumental case study and facilitator data (logged reflections and debrief session notes) from the Coordination Toolkit and Coaching initiative to conceptualize facilitation intensity and facilitator resilience and to better understand the psychological impact of the facilitation process on facilitator effectiveness and implementation success.ResultsWe define facilitation intensity as both the quantitative and/or qualitative measure of the volume of tasks and activities needed to engage and motivate recipients in implementation, and the psychological impact on the facilitator of conducting facilitation tasks and activities. We define facilitator resilience as the ability to cope with and adapt to the complexities of facilitation in order to effectively engage and motivate staff, while nurturing and sustaining hope, self-efficacy, and adaptive coping behaviors in oneself.ConclusionsFacilitators’ affective experience may help to identify potential relationships between the facilitation factors we propose (facilitation intensity and facilitator resilience). Future studies should test ways of reliably measuring facilitation intensity and facilitator resilience and specify their relationships in greater detail. By supporting facilitator resilience, healthcare delivery systems may help sustain the skilled facilitator workforce necessary for continued practice improvement.Trial registrationThe project was registered with ClinicalTrials.gov (NCT03063294) on February 24, 2017.

Wow, woo, win"- Healthcare students’ and facilitators’ experiences of interprofessional simulation in three-dimensional virtual world: A qualitative evaluation study

BackgroundIn an age disrupted by COVID-19 pandemic, three-dimensional virtual world (3DVW) offers an opportunity for healthcare students from different higher education institutions to participate in interprofessional education. Despite its growing evidence, there is a need to unravel the complex learning process in order to ensure high quality of interprofessional education delivery. AimThis study aimed to explore the experiences of healthcare students and facilitators on the use of 3DVW for interprofessional team-based virtual simulation. MethodsInterprofessional teams, each comprising six different healthcare students (Medicine, Nursing, Pharmacy, Physiotherapy, Occupational Therapy, and Medical Social Work) and two clinicians who acted as facilitators, logged into the 3DVW from their own remote locations to participate in team-based care delivery that included an interprofessional bedside round and a family conference. A qualitative descriptive study was conducted on a purposive sample of 30 healthcare students and 12 facilitators using focus group discussions and individual interviews. ResultsFour themes emerged from their experiences: the “wow experience”, authentic experience on collaborative care, ease of learning, and preeminent role of the facilitator. The simulation provided the “wow” experiences through contextual, collaborative and experiential learning approaches. Despite technical challenges, the participants were wooed by the comforts of learning from home and the psychological safety in virtual environment. The facilitators played a critical role in optimizing learning engagement to win learners over. ConclusionOur study explicates how attention to the “wow, woo and win” trilateral factors can transform the interprofessional learning experiences offered by 3DVW simulation. Future developments in the use of this learning technology should include developing the clinicians' facilitation skills and the provision of technical support to make this 3DVW a success calls in winning students' learning engagement.

Development and evaluation of a parent advisory group to inform a research program for knowledge translation in child health

BackgroundIn response to a growing movement to involve patients and community stakeholders in health research, we established a parent advisory group in 2016. The group meets regularly to act as advisors and partners for our research program. The purpose of this paper is to describe our experiences establishing the group, and results from parent evaluations.MethodsWe contacted 191 organizations to recruit parents and caregivers of children who wanted to contribute to child health research. Our initial goal was to recruit 8 to 10 parents who would meet regularly (approximately 8 times per year). We conducted an online baseline survey of members after the first two meetings to understand motivations for participating and early experiences. Sixteen months later we conducted another online survey to identify what was going well and areas for improvement.ResultsTwelve parents initially joined the group. The baseline survey (n = 9 complete) identified motivations for participation: wanting a patient/family voice in health research; personal experience accessing health system for child’s care; wanting to improve healthcare communications. Concerns about participation included: having sufficient time to attend meetings; whether contributions would be worthwhile; and uncertainty about how the group’s input would be used in practice. Parents identified aspects that were working well: opportunity to provide constructive feedback; diversity among parents involved; well-run and organized meetings (agenda and materials sent prior to meeting, skilled facilitation, adequate time for discussion). Items parents identified as not working well were: fluctuating attendance; not knowing others in the group; challenges if attending remotely. At follow-up, there were seven active members. The follow-up survey (n = 5 complete) identified positive feedback related to group dynamics (e.g., collegial, everyone participates) and organization of meetings. Suggestions for improvement included increasing membership, regular attendance, and providing adequate information/context to allow meaningful input.ConclusionsOur experience establishing a parent advisory group and evaluation of the group by parent members have yielded tremendous insights around involving parents and patient proxies in health research. The parent advisory group is a dynamic entity requiring ongoing communication between researchers and members. Effective means of evaluating engagement is essential to ensure it is meaningful. Dedicated time, funding and resources are required for success.

HOW TO DO A STRATEGIC PIVOT TO ADDRESS EXTERNAL DISRUPTORS

AbstractThe author writes of his experience advising organizations in the wake of COVID‐19. He explains that a “strategic pivot entails changing major or minor aspects of an organization’s goals. It allows leaders to closely examine pain points in order to guide teams through uncharted territory and back to productivity.” He outlines a process for a pivot, starting with: “Simply get someone with facilitation skills and no direct stake in the eventual strategies pursued by the company: it can be a peer executive, a member of the Board, a business coach, a mentor…” “The initial step,” he writes, “involves reevaluating assumptions about the organization’s business model (or operational model for a nonbusiness organization).” He explains six steps for a strategy session, in his words: (1) Scope and strategic goals. (2) Anticipate the future. (3) Potential internal problems. (4) Potential external problems. (5) Potential opportunities, internal and external. (6) Consider unknown unknowns (black swans). He further describes operations day, next steps, and follow‐up. Part of his conclusion includes the following: “Make sure to check if the next steps are being taken through weekly leadership team meetings. After a month, hold a half‐day event to evaluate the progress of the strategy pivot.”

Editorial for JCBE

Editorial for JCBE

High Impact Learning for Facilitator Training and Development

Research shows that cascade training models are common approaches to improving teaching in many developing countries. Cascade models are popular for reaching large cohorts of teachers in a short time and often at a low cost. However, they have been criticized because training efforts can get diluted and transmission modes of instruction tend to prevail across all tiers of the cascade. In this essay, we discuss the development and implementation of the Facilitator Training Program (FTP) at a university in Pakistan. The FTP supports high impact learning for new facilitators to develop pedagogical knowledge and instructional and facilitation skills needed to sustain an experiential faculty development program. We define high impact learning as experiential, reflective, emphasizing feedback, and involving learning with and from others. We believe the FTP design can be useful for facilitator training in other institutions outside of Pakistan where cascade training models may also be prevalent.

Building online facilitating skills in the new normal

The sudden shift to remote teaching caused by COVID-19 pandemic has created a stressful and demanding context for teachers, specifically on the aspect of delivering remote instruction. This ascertained the challenges and opportunities encountered by 311 public basic education teachers attending different online training platforms and utilized the mixed method design in analyzing the data of the teachers’ online facilitation skills and used the scanning method in the data collection process. The challenges and opportunities they encountered was conducted through an unstructured interview via Zoom. The researcher-made questionnaires were sent to the teachers via email. Results revealed that teachers already had prerequisite ICT skills so the use of technology during the online training was not so much a threat in the enhancement of their ICT knowledge and skills except of the issues regarding very slow internet access and the lack of necessary and proper equipment and gadgets. In conclusion, teachers easily adopted to the shift from in-person to remote teaching; enhanced their ICT skills; and became prepared for remote teaching. Despite the sudden shift, these teachers remained positive in pursuing the direction for digital literacy to build an effective and efficient skills in remote teaching in the new normal.

Contemporary Challenges of Nursing CPD: Time to change the model to meet citizens' needs.

The purpose of this paper is to present the evidence shared with a citizen Consensus panel detailing key issues associated with how nursing CPD can best influence the quality of health and social care experienced by citizens and communities. It presents a summary of contemporary theory, research and evidence of the effectiveness of nursing CPD and outlines four key challenges: (i) how to strengthen the focus on patient experience as the starting point for CPD; (ii) the lack of evidence of CPD effectiveness and accountability in its transfer to practice; (iii) evaluation of CPD effectiveness; and (iv) involving citizens in targeting CPD where it is most needed. It briefly describes the methods used to facilitate public consultation through a citizen Consensus panel as part of a collaborative project with the RCN Strategic Research Alliance in 2020 and outlines 7 themes identified as important by the public for future development. The main challenge for nursing is capitalizing on the workplace as a learning resource that can integrate learning with development, improvement, knowledge translation, inquiry and innovation. This requires skilled facilitators, particularly at meso‐ levels, and systems leaders with the full skillset to develop system‐wide cultures of learning that enable everyone to flourish and create good places to work. The paper concludes that the development of CPD process measures would indicate how CPD investment contributes to person‐centred, safe and effective care and system transformation and enable commissioners and education providers to optimize CPD’s full potential.

Strengthening decision-making on sustainable agricultural intensification through multi-stakeholder social learning in sub-Saharan Africa

ABSTRACT Increasing and competing demands on agriculture in sub-Saharan Africa mean that policy and investment decisions become more complex. Despite growing consensus on the need for sustainable agricultural intensification, there is limited agreement on how to achieve this in practice. Governments and societies face uncertainty and complex choices. This paper explores the potential of Multi-Stakeholder, Social Learning (MSL) approaches, facilitated by National Learning Alliances (NLAs), to improve policy and investment decisions. Comparative evidence from a donor-supported research and learning programme in Ethiopia, Ghana, Malawi, Tanzania and Zambia is used in a theory-based evaluation approach to assess the contribution of the NLAs to capacity and practice change amongst individuals, networks and senior decision-makers. Ten outcome cases are explored, including their contribution to systemic changes in the governance of evidence. Key lessons included: the value to decision-makers of engaging with informal networks; importance of combining dialogue, deliberation and experiential learning; the need to create safe spaces in national level MSL processes; the demanding combination of facilitation skills and commitment; and appropriately flexible support. This suggests a need not only for the production of quality research, but crucially support for MSL as a means of contributing to the good governance of evidence and sustainable change.

A health and wellbeing programme for preadolescents in underserved Australian communities: child and stakeholder perspectives.

Social inequities in childhood affect children's health and development. Active In-Betweens is a weekly, healthy lifestyle and outdoor activity after-school programme, tailor-made for preadolescent children (9-12 year olds), incorporating a strengths-based, trauma-informed, co-designed and place-based approach. This study evaluated the extent to which the programme strategies and activities met the anticipated short- to medium-term programme outcomes during its first year of operation in two socio-economically disadvantaged housing communities in New South Wales, Australia. A qualitative case study used data from semi-structured interviews with child participants (n = 11) and key stakeholders (n = 10). A broad range of positive outcomes were described. Children's feedback indicated they had experienced opportunities which facilitated the development of new physical activity skills; new healthy eating experiences and knowledge; positive relationships with peers and facilitators and new connections with neighbourhood programmes and outdoor environments. Stakeholders valued the programme for the positive outcomes they observed among the children and the strong organizational partnerships which resulted. The importance of skilled facilitators to deliver the programme, the engagement of local stakeholders and a long-term commitment to programme delivery, with secure funding to ensure continuity, were clearly identified as integral for effective, sustainable outcomes.

Professional development for facilitators of interprofessional education: Participation and outcomes of a pilot program

Clinician-educators often have limited opportunities to acquire the knowledge, skills and values to facilitate Interprofessional Education and Care (IPEC) in clinical settings. An interprofessional team of educators created a 4-part “lunch and learn” program to address this gap in professional development. Program activities included reading articles, didactic teaching, reflective practice, peer learning, and deliberate practice of facilitation skills with students between sessions. Twenty-three participants from a variety of health professions participated in the pilot program at an academic medical center. Program evaluation used a mix-methods design with pre- and post-program surveys. Participants reported statistically significant changes in theirs values and confidence in their ability to facilitate IPEC as a result of the program. Thematic analysis identified the most valuable program content and instructional activities as well as the importance of the opportunity to engage in and advance IPEC within the institution. This professional development program can serve as a model to advance effective interprofessional education in clinical settings and prepare collaboration-ready graduates. The educational content of this program is open access and available online at the institution's website: https://duke.box.com/v/IPEfacilitation .

Double trouble: Therapists with low facilitative interpersonal skills and without training have low in-session experiential processes

ABSTRACT Objectives: This study examined the combined effect of therapist Facilitative Interpersonal Skills (FIS) and Training Status on experiential processes within therapy sessions. In this randomized trial of FIS and Training Status, we predicted that in-session experiential processes would be highest for the high FIS and trained therapist group and lowest for the low FIS and untrained therapists. Methods: Forty-five clients were selected from 2,713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists were selected for their level of FIS (high vs. low) and Training (trainee vs. untrained) and each were assigned two clients for seven sessions each. Two different coder teams independently rated experiencing and narrative process from the third therapy session and computer analysis identified affect words from transcripts. Results: FIS×Training Status significantly interacted on the set of experiential process measures. Relative to all others, therapists who were in the low FIS / no training group had lower experiencing and reflexive content, but higher external content. Conclusions: The findings highlight the importance of therapist characteristics within therapy sessions. Therapists without training and with low interpersonal skills have sessions that are nearly devoid of content that focuses on client experiential processes and emotion.

Modes of Facilitator Skills for Group Learning Among Design and Technology Teachers in Secondary Schools

The purpose of this study was to verify the constructs of facilitator skill for a group learning in Design and Technology subjects in secondary schools. The method used descriptive quantitative method. This study covers several tests such as content validity, construct validity, pilot studies and internal reliability test. Sample value that involved in this study was 273. The instrument is based on Heron’s Model (2006) which involves constructs and elements in facilitator skills. The results show that the high mode of facilitation is the hierarchical mode with mean value 4.32. Followed by cooperative (4.14) and autonomous mode (3.96). This is because the facilitator still determines the objectives, learning process, interprets and gives meaning, provide structure and take full responsibility for the decisions making in learning process.

Can a clinical skills facilitator improve staff retention in a children's hospital?

Clinical skills facilitators are experienced nurses responsible for staff education and support in a clinical area, where they are employed supernumerary to the team. This article discusses the implementation and evaluation of a pilot clinical skills facilitator role on a medical ward in a children's hospital in an NHS trust in England, aimed at improving the retention of nursing staff. A baseline survey was conducted at the start of the pilot and a follow-up survey was conducted at the end, nine months later. The surveys contained ten statements about three factors important for staff retention: clinical skills, job satisfaction and well-being at work. Improvements were seen in all ten statements and a review of staff retention data showed that no member of staff had left the ward in the year of pilot implementation, compared with four the year before. The development of clinical skills facilitator roles on children's wards is therefore of potential benefit for staff retention.

Complexifying Facilitation by Immersing in Lived Experiences of on-the-fly Facilitation

Background: Describing the role of a facilitator often results in to-do lists resembling a recipe or a laundry list to follow. Such lists fail to grasp the inherent complexity of facilitation and are not very useful in guiding facilitators when, why and if they should intervene in the unfolding live performance of that day. Aim: To develop a deeper understanding of on-the-fly facilitation by analyzing rich empirical accounts of in-situ facilitation episodes. Intervention: Six facilitation episodes were through purposeful sampling selected from a body of hundreds of interventions in forty-seven performed crisis management training exercises in Swedish municipalities. Each full-day crisis management simulation-game had between fifteen and fifty participants involving politicians, administrative managers and crisis management staff. Method: An auto-hermeneutical phenomenological analysis of six lived experiences of facilitation episodes was conducted to understand what the facilitator observed and how a facilitation intervention was applied. Results: On-the-fly-facilitation is instantaneous, but draws simultaneously on awareness of the past, present and future. Facilitation needs are foreseen during design and they influence current attentiveness and coaching. Unfolding game-play needs to be grasped quickly. Potential future consequences of intervening or not intervening are evaluated within a limited window of opportunity. Due to these circumstances, facilitation is multi-skilled, arbitrary and fallible. Such muddiness of on-the-fly facilitation requires courage from the facilitator. Conclusions: In order to better understand how facilitation skills and roles actually are performed, the facilitation literature desperately needs a larger number of rich empirical accounts of interesting in-situ facilitation. Elaborate analysis of such lived experiences could develop understanding as to how available skills, situational circumstances as well as the unfolding interaction between players and facilitators actually develop into a facilitation intervention. This could generate more complex theoretical understanding of how to apply facilitation skills, in addition to theories that list what skills a facilitator should master.

From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery

BackgroundThere is substantial evidence that facilitation can address the challenges of implementing evidence-based innovations. However, facilitators need a wide variety of complex skills; lack of these can have a negative effect on implementation outcomes. Literature suggests that novice and less experienced facilitators need ongoing support from experts to develop these skills. Yet, no studies have investigated the transfer process. During a test of a facilitation strategy applied at 8 VA primary care clinics, we explored the techniques and processes an expert external facilitator utilized to transfer her skills to two initially novice internal facilitators who became experts.MethodsIn this qualitative descriptive study, we conducted monthly debriefings with three facilitators over a 30-month period and documented these in detailed notes. Debriefings with the expert facilitator focused on how she trained and mentored facilitation trainees. We also conducted, recorded, and transcribed two semi-structured qualitative interviews with each facilitator and queried them about training content and process. We used a mix of inductive and deductive approaches to analyze data; our analysis was informed by a review of mentoring, coaching, and cognitive apprenticeship literature. We also used a case comparison approach to explore how the expert tailored her efforts.ResultsThe expert utilized 21 techniques to transfer implementation facilitation skills. Techniques included both active (providing information, modeling, and coaching) and participatory ones. She also used techniques to support learning, i.e., cognitive supports (making thinking visible, using heuristics, sharing experiences), psychosocial supports, strategies to promote self-learning, and structural supports. Additionally, she transferred responsibility for facilitation through a dynamic process of interaction with trainees and site stakeholders. Finally, the expert varied the level of focus on particular skills to tailor her efforts to trainee and local context.ConclusionsThis study viewed the journey from novice to expert facilitator through the lens of the expert who transferred facilitation skills to support implementation of an evidence-based program. It identified techniques and processes that may foster transfer of these skills and build organizational capacity for future implementation efforts. As the first study to document the implementation facilitation skills transfer process, findings have research and practical implications.

Psychometric analysis of the Dutch language Facilitative Interpersonal Skills (FIS) video clips.

With the motivation of investigating the replicability and transferability of the findings employing the Facilitative Interpersonal Skills (FIS) performance task beyond Anglophone countries, a set of Dutch FIS clips have been scripted and recorded. In this study the psychometric properties of the Dutch clips was tested. Furthermore, an additional set of FIS clips portraying a non-challenging client-therapist interaction was tested. 369 psychology students rated the interpersonal impact (IMI-C) and the affect (positive and negative affect schedule) displayed by the hypothetical client. Thirteen out of sixteen FIS clips were located in the same IMI-C quadrant as the US clips, indicating good content validity for all sets of FIS clips. Inter-rater reliability was reasonable for one set of Dutch language FIS clips (k=0.416). Visual inspection of quadrants showed the different character of the non-challenging set of FIS clips. The Dutch FIS clips are directly applicable for educational and research purposes.