Graphic Facilitation Research Articles

“A rollercoaster of drawing and using digital tools!”:

Responding to the Covid pandemic, educators worldwide were forced to reconsider ways of delivering content and engaging students. Graphic Facilitation offers opportunities for educators to rethink ways of delivering text heavy content. This paper charts the journey of developing a Graphic Facilitation Digital Badge for staff in a Higher Education institution. The paper describes the process from the perspective of three educators (two instructional designers and a lecturer) exploring the use of Graphic Facilitation as a tool for teaching and learning across a range of subjects and discipline areas to enhance communication and sustain participation across a diverse cohort of students. The paper focuses on how we applied Graphic Facilitation through planning, teaching, assessing, providing feedback and reflection on learning. Following the module participants were required to complete an evaluation form. Feedback from participants is presented. The findings highlight the value of graphic facilitation in supporting learners to develop graphic skillsets, engage with new technologies, enhance communication, and, develop a sense of community amongst staff at a Higher Education institution through engagement in an online classroom.

From training to practice: long-term perspectives of graphic facilitation used in organisations

ABSTRACT Graphic facilitation is a growing international practice and is often used to describe what professionals do when visually facilitating group processes. Although the professional arena has grown, there is a lack of empirical research in the field, especially regarding long-term perspectives on applying the practice in organisations. This paper aims at investigating employees’ experiences and competence development over time within graphic facilitation. The study followed three employees, first in a 2-day basic graphic facilitation course, then in follow-up interviews, eight months, and two years after completing the course. The empirical data were analysed based on a literature review conducted on long-term perspectives, focusing on three themes: 1. The graphic facilitation practice at individual, group, and organisational level; 2. Contextual knowledge and knowing about the participants; 3. Relation between objects, processes and competencies needed. The findings show that all three employees from different organisations continued to use graphic facilitation and found it valuable for giving new insights and overviews of processes and tasks. The methods aided in creating common ground and goals. The employees activated their contextual organisational knowledge to aid the process and found that being sensitive to various groups’ needs and personal preferences were effective when applying the methods.

BUILDING AN AGE-FRIENDLY ECOSYSTEM THROUGH NEIGHBORHOODS, HEALTH SYSTEMS, AND CAMPUSES

Abstract The age-friendly movement grew from an idea into a social movement recognizing the importance of adapting multiple facets of society to meet the needs of older adults. The movement integrates multidisciplinary work in research, policy, planning and design to build age-friendly ecosystems. Age-friendly ecosystems comprised of communities, health systems and campuses can become platforms for equity, health, and wellness for older adults. We designed a virtual symposium to examine age friendliness from a place-based approach by examining neighborhoods, campuses and health environments as sites uniquely positioned to catalyze equity in aging. The symposium was convened by national experts and regional aging stakeholders to consider how age friendly environments can address urgent social, environmental and health challenges, and create measurable outcomes that promote aging well for all. Knowledge was generated through lectures, panel discussions, a world café, focus group discussions, and a student-ideas competition. There were 113 attendees, including 27 health professions students; 78% of attendees indicated their work focused on aging/older adults and 52% reported specialized training in geriatrics/gerontology. Attendees reported increased familiarity with age-friendly concepts post-symposium. Key findings indicated the benefits of shared language and metrics across place-types that can collectively transform the social, physical, and economic landscape of aging. Symposium outcomes include a website, graphic facilitation, a collaboration resource guide, and a forthcoming book. Outcomes are serving as a foundation to radically re-imagine cross-sector collaborations between communities, health systems and campuses to create an ecosystem that embraces longevity as an asset and advances equity in aging.

Combining graphic facilitation and animation-based sketching in higher education

This paper explores how non-design students can benefit from using visual methods as part of collaborative group processes in higher education. Based on an exploratory study, the paper analyses how analogue hand drawing in graphic facilitation combined with animation-based sketching can support humanities students in higher education to take on the role of designer. The empirical data is based on a course in a bachelor’s degree in communication and digital media in which students were tasked with designing an event for a museum. The students were not especially trained in using graphic facilitation or animation-based sketching methods as academic tools prior to this course. Thus, the educational approach incorporated two workshops in which the students were introduced to these visual methods and design approaches. Through visual examples, the students’ experiences are analysed in relation to their view on how these methods benefited or challenged their ways of working throughout the course. The paper ends by summarizing how visual methods can be considered relevant to academic practices beyond design courses.

The Use of Graphic Facilitation to Support Adherence to OCAP® Principles in Research With Indigenous Communities

Graphic facilitation is a creative, robust visual communication process and tool that can be used by researchers for several benefits including improving data integrity; mitigating barriers between researchers and participants; promoting participants’ ownership of data, decision-making, and creativity; and, co-creating knowledge, which is of particular interest among certain cultures and in some contexts. For Indigenous Peoples who traditionally use visual, oral, and narrative modalities as primary forms of communication, graphic facilitation is a methodology that aligns well with these modes of communicating. In this article, we describe our use of graphic facilitation in a community-led project exploring Indigenous parents’ perceptions of community strengths, needs and priorities related to healthy early childhood development and optimal parenting. In collaboration with the Indigenous Friendship Centre in Hamilton, Canada, we held a Community Gathering that was facilitated by a graphic artist experienced in working with the Indigenous community; the findings resulting from the Gathering are presented. We discuss how researchers can use graphic facilitation as a tool to ensure adherence to the OCAP® principles of data ownership, control, access, and possession for the Indigenous community and describe the potential for mitigating power imbalances. Finally, considerations for researchers contemplating using graphic facilitation as a tool for research projects with Indigenous people and communities are presented.

DETECT: DEveloping and testing a model to identify preventive vision loss among older paTients in gEneral praCTice – protocol for a complex intervention in Denmark

IntroductionThe number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people...

Solution Circles: What do we know about the use of Solution Circles in Educational Psychology (EP) practice and do they work in the context of online collaborative problem solving?

Aims:This paper sets out to find out more about the use of Solution Circles (SCs) in EP practice and to consider the benefits and impact associated with this process.Method:The literature search provides information about SCs being used by EPs. The role of graphic facilitation is also considered. Practice-based evidence is shared alongside the summary of a literature review which focuses on the use of SCs within education settings.Findings:SCs are used in a variety of ways such as in collaborative problem solving and supervision. Reported benefits and limitations are similar. For example, staff particularly value the structured process, having dedicated time to think and reflect whilst being supported by skilled process and graphic facilitators.Limitations:There are several versions of the process as well as different delivery models being used for a variety of purposes. However, as the review question was exploratory in nature, the different versions may be considered and provide useful information to reflect upon when considering the use of SCs in EP practice.Conclusions:We conclude that SCs are effective in the context of online collaborative problem solving. Information shared in this paper supports next steps for the use SCs as a multiagency online consultation/problem solving in the principal author’s Local Authority.

Graphic Facilitation in the Engineering Workflow: Adoption Framework, Barriers, and Future Roadmap

Engineering processes involve multiple interrelated activities comprehended through workflows. An increase in remote working accelerated by Covid-19 has pushed an immediate shift to technology-enabled processes, fundamentally shifting workflow dynamics causing information overload. Graphic facilitation as a high-artifact representation methodology for processes, concepts, or ideations, employing an organized cluster of images, arrows, diagrams, sketches, doodles, and text elements, offers a unique application for information management in an engineering context. The article further investigates the adoption framework focusing on the stakeholders. This study applies a systematic literature review approach to present essential literature across multiple databases and provides an adoption framework systematically exploring six years of popular peer-reviewed journal bibliographic and global patent grants data. The study reveals that the discussions are still emerging, and the domain is not thoroughly explored in the engineering context. The patent dataset showcases insignificant development; however, emerging approaches are summarized, and newer tools are presented along with an adoption framework as a roadmap to further exploration. Graphic facilitation demonstrates the potential capacity to support individuals and groups in different, creative, and innovative ways to address information overload. The presented outline will serve as a template for engineering leaders toward reviewing, experimenting with, and incorporating across the engineering workflows. The approach addresses information overload and presents its use cases along with entry-level barriers to graphic facilitation and suggests an exploratory future research scope, including enhanced patent data analytics that synergizes with the latest technologies mitigating barriers.

Undertaking graphic facilitation to enable participation in health promotion interventions in disadvantaged neighbourhoods in Denmark.

Summary This study reports on a health promotion intervention (HPI), where graphic facilitation (GF) was used as an innovative method to enable participation in a co-design process in a multi-ethnic and disadvantaged neighbourhood in Denmark. The aim was to enable middle-aged and older residents to participate in the research process of planning and evaluating the HPI, as well as in the activities it constituted. GF was used to document statements and inputs from residents through visual meeting minutes and resident experiences with coronavirus disease 2019 (COVID-19) lockdown were drawn by a graphic facilitator. We use the ladder of participation as a framework to unfold the participation enabled by GF. During the HPI, data were produced through ethnographic field studies in and outside the neighbourhood and in design workshops with residents. The study finds that GF helped in reaching a target group difficult to engage in research and that the engagement of a graphic facilitator shifted the power-balance between the researchers and the residents, redistributing expertise. Carrying out GF in a HPI is a collaborative endeavour and in addition to research competences, it requires the artistic and relational skills of a graphic facilitator. The co-created process of the visual minutes and COVID-19 experiences created a sense of ownership and encouraged the residents to reflect on their interaction with the researchers. The redistribution of expertise was conditioned by the power dynamics present and GF helped unfold these dynamics. This is especially important in an HPI engaging socio-economically vulnerable populations.

Affective Facilitation: A Framework for Surfacing Lived Experiences and Harnessing Creativity in Focus Group Research

In this article, we introduce the framework of Affective Facilitation to the practice of focus group research. In this context, Affective Facilitation is defined as a framework that helps researchers (1) surface and deeply understand participants’ lived experiences, bearing in mind their individual differences, (2) make space for exploring common ground across their diverse backgrounds, and (3) connect with participants through empathy and compassion using active and reflective listening skills. Conceptually, the framework draws on the theoretical and philosophical strands of phenomenology, existential dialogue, holism, and Gestalt therapy. In practice, it employs graphic facilitation as a technique for fostering group learning and connection while creating a visual memory of the dialogue. We explain the implementation of this actionable framework through a case study of facilitated conversations with parents who share their lived experiences, providing insight into their perceptions, beliefs, and concerns regarding childhood vaccination. This study contributes to a growing body of work on creative, participatory, and arts-based research methods.

Human behaviours: new paradigms of energy efficiency. Communication tools to deliver a technical message to non-experts

In the application of new technologies and incentive model, the complexity of the decision-making process requires new attention. Human behaviour increasingly influences the success of the implementation of technologies for energy saving and comfort, from the decision-making phase to the use of the building, including operation and maintenance activities. A new approach can help people understand, participate, be involved, and maximize the results of a complex operation that directly involves them. Communication and the development of behaviour change programs have many advantages: they are savings measures with an excellent cost-benefit ratio, which can trigger virtuous behaviours thanks to access to emotions that move the limbic part of the human brain, such as fear failure, the desire to excel or immediate success, the promise of a reward, etc. This paper provides an overview of the concepts and behavioural change initiatives that can be most effective in saving energy. A brief on effective communication will be provided, then the project of an awareness campaign in condominiums will be described, followed by a focus on the tool of graphic recording and graphic facilitation that can be used effectively to arise people awareness and conduct an audience to take decision. The paper itself will be presented as an application of this and will use the graphic recording technique to help conference participants to follow and remember the concepts. In a liquid society, soft skills and technical skills are both fundamental and this awareness is only the beginning of a new approach to conduct complex projects with satisfying results for all stakeholders.

Engaging nurses in research awareness using a new style of hospital journal club - a descriptive evaluation

BackgroundNurses, especially nurses in Africa, face barriers when trying to access and apply literature. These challenges include paywalls; complex academic language; and journal content which is hard to translate to local realities. ObjectivesTo investigate nurses' self-reported experiences of participating in a monthly hospital wide journal club at the Red Cross War Memorial Children's Hospital (RCWMCH). DesignThis descriptive study used a researcher-designed quantitative questionnaire design. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guideline were used. SettingRed Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa. ParticipantsAll cadres of nurses working at the Red Cross War Memorial Children's Hospital (RCWMCH) who had attended six or more hospital journal club sessions at RCWMCH over the previous two years. MethodsA descriptive study using a researcher-designed quantitative questionnaire. Results155 participants completed the survey (96.87% response rate). Participants self-reported an improved knowledge of the main sections of a journal article (p < 0.001) and a significant increase in talking to colleagues about evidence-based nursing practice after attending journal club (p < 0.001). ConclusionsAttendance at a journal club appears to contribute to increased access to scientific literature, personal and organisational habits of reading, and collaborative exploration of clinical practice for nurses of all cadres. Innovative facilitation methods (including large-scale graphic facilitation) may contribute to efficacy and popularity of sessions.

Exploring health coaching and mindfulness as levers for transformation in health: stakeholder perspectives.

Health coaching (HC) and mindfulness (MFN) are proven interventions for mobilizing patients' inner resources and are slowly being integrated into public primary care. Since 2015 the medical community in Gibsons BC has integrated physician-led HC and MFN-based programs into team-based care. This exploratory study aimed to understand the mechanisms by which these rural programs helped both patients and clinicians, and to elicit priorities for future study in these fields. Using a qualitative participant-engaged constructivist approach in focus groups and large-group graphic facilitation, we elicited perspectives from patients and their physicians during a 1-day event held in September 2018. Thematic analysis of transcripts using Nvivo identified emergent themes that were regularly reviewed with coresearchers, and member checked with participants via online videoconferences held at 6 weeks and 4 months postevent. We identified six main themes relating to the successful implementation of these programs: (i) accessibility and affordability, (ii) offering a toolbox of practical skills, (iii) providing attuned and openhearted care, (iv) generating hope and self-efficacy, (v) experiencing a shared humanity and connection, and (vi) addressing the health of the whole person. These themes highlight critical qualities of HC and MFN programs when implemented in a Medicare system. Key features include reducing stigma around mental health through making programs physician-led and a natural part of primary care, enriching accessibility through public funding, and enhancing patient agency through cultivating embodied awareness, self-compassion, and interpersonal skills. These themes inform the next steps to support upscaling these programs to other communities.

Multiple outcome interactions in healthcare systems: a participatory outcome mapping approach

Outcomes, which are the result state or condition from a process or intervention, are essential elements of healthcare system design and an important indicator of performance. They are included in well-known system analysis frameworks such as the Systems Engineering Initiative for Patient Safety (SEIPS) and Cognitive Work Analysis (CWA). However, fewer practical approaches exist for understanding and communicating interactions among healthcare outcomes. This study applies a novel mapping method as a practical approach to collect, aggregate and visualise interrelations among multiple healthcare outcomes. Graphic facilitation mapping sessions with eleven healthcare providers and ten patients with chronic conditions were conducted. Participants created outcome interrelationship maps following a six-step process. Two outcome-based network visualisations were synthesised using network analysis. This outcome-based approach advances how we frame healthcare systems, focussing on accommodating multiple stakeholders’ visions, understanding interrelations, and defining trade-offs. This practical approach may complement frameworks such as SEIPS and CWA. Practitioner summary: The presented outcome-based mapping approach can facilitate the understanding of outcomes as part of the interrelated healthcare system. The approach allows the discussion and integration of different stakeholders’ outcome priorities to identify critical elements and better inform the development or adaptation of healthcare systems. Abbreviations: SEIPS: engineering initiative for patient safety; CWA: cognitive work analysis; HFE: human factors and ergonomics; AH: abstraction hierarchy; POTS: postural orthostatic tachycardia syndrome; DRM: design research methodology; FA2: forceAtlas2; HbA1c: glycated haemoglobin; NHS: National Health Service; UK: United Kingdom

A Scarlet A-Line Skirt, Independent and Critical Visual Practice, and the Brit(ish)line: Representing Women’s Leadership in Education Through Values-Based Cartooning

Cartooning and graphic facilitation (the latter of which includes developing visuals in real time with groups) offer increasingly popular yet highly subjective approaches to public engagement, organizational development, communication, research, and research dissemination. Values-based cartooning can provide an ethical framework for those undertaking and commissioning these kinds of practices, and it has been employed by the author as a method for accessing and representing diverse perspectives and experiences for more than two decades. This article is situated within the author’s experience as a practitioner undertaking a range of commissions and partnerships relating to education in the United Kingdom. What follows is a critical examination of three contexts where values-based cartooning has been used to represent women’s leadership within education: within research into women’s experiences of working and studying in a higher education institution, within grassroots movements led by teachers and school leaders, and within broader campaigns that have educational value. This involves negotiation of complex social issues while developing visuals, including how to treat gender, race, and intersectional identities within word/image combinations. Questions are raised about the purposes of visual practice, the roles and responsibilities of practitioners, and the conditions of production, audience, and social media. What are the benefits, limitations, and risks of values-based cartooning in relation to the visual representation of women’s leadership in education? What is the value of portraying the kinds of leadership that exist at different levels, including outside of formal, professional roles and beyond classroom practice and systems leadership? And finally, how should visual practitioners respond to conflicting values, risk, failure, and nuance in relation to women’s leadership, where there is strong desire and need for positive, strengths-based depictions? The author considers her positionality in relation to the type of work undertaken and asks whether this kind of visual practice may in fact represent a particular form of leadership that warrants further inquiry. This article will be of interest to educators, researchers, facilitators, artists, cartoonists, campaigners, graphic and visual facilitators, practice-based researchers, and those who commission and evaluate visual methods.

Experiences and challenges in collecting survey data in an ethnically diverse social housing area

Abstract Socio-economically disadvantaged groups are characterised by a higher burden of disease than the background population. Paradoxically, they are often underrepresented in health research. Failing to include socio-economically disadvantaged groups in research impairs the ability to address the social mechanisms creating health disparities. The study describes how we have tried to accommodate identified challenges from the literature in conducting a questionnaire survey in a socio-economically deprived and ethnically diverse social housing area, and which new challenges we identified. The survey is planned before, during and after the structural changes take place. Through innovative approaches, we sought to accommodate identified barriers to reaching participants. The questionnaire was translated from Danish to the seven most prevalent languages in the area, based on data from the national register. A survey corps of native speaking interviewers went door-to-door to perform face-to-face interviews. To encourage participation, we used a recruitment strategy inspired by ethnographic data collection traditions, such as local presence, participation in local activities, and graphic facilitation on invitation letters. Wave 1 and 2 had a response rate of 35% (N = 209) and 22% (N = 132), respectively. 79 respondents participated in both waves. Despite our efforts to accommodate identified challenges such as language, illiteracy, and mistrust, the response rates are low. We identified new challenges in recruiting participants including participation fatigue, frustration with the restructure process, and a feeling of limited individual gain from participation. Many challenges are associated with conducting research among socio-economically disadvantaged groups. Documenting processes and learning from experiences are important steps in including groups with lower socio-economic status in health research in order to address the underlying social mechanisms creating health disparities.

What possibilities and barriers for community engagement does graphical facilitation establish?

Abstract Participatory approaches are appropriate to apply in interventions aiming at improving health and wellbeing in the everyday life of people living in deprived areas. However, more research is needed on how participation is staged, what negotiations of power are possible and to what extent the applied methods for engagement are accessible to a less affluent spectrum of residents. We apply an interdisciplinary approach to allow theoretical reflections on the applied strategy of participation. The intervention employs the use of physical materials through the performance of drawing to make participation less dependent of language and writing skills and hereby more equal. With this participatory intervention study, we aim to empower residents to increase their ability to act on their own health, i.e. social relations and life quality. We apply graphical facilitation by using physical drawing materials to explore how this method can give voice to the residents by providing them the opportunity to tell their story - from where they came to where they hope to go. The main component in the study is four participatory workshops in spring 2020: a) two focusing on teaching of basic drawing skills; b) one where the residents individually draw their own life story; c) one where the residents draw their shared vision of their community. This intervention study aims to contribute to health promotion by exploring generic methods to engage residents in deprived areas. The intended outcome is to empower residents by giving them a means of communication transferable to other settings in everyday life.

Health, well-being and social relations in a changing neighbourhood

Abstract The main purpose of the study is to examine the development in health, wellbeing and social relations among middle-aged and older residents during a four-year period from 2018-2021 in a Danish multi-ethnic social housing area undergoing large structural changes in the built environment. In addition, to develop two interventions with a focus on ensuring social cohesion in the area during the study period. This presentation will provide an overview of the study outline. The presentation will include a description of the study area, the political decisions that have led to the structural changes, the study population and a short overview of the aims and planned sub-studies. To prepare for the workshop discussion of the challenges, advantages and possibilities with the multi-methods approach this is followed by a short introduction to the different methods applied (a three-wave survey and qualitative data as well as two co-created interventions). The study is furthermore including a 'natural experiment' (N∼6.000) with a neighbouring non-profit social housing area not undergoing structural changes as the control area based on register data. The user-engagement in the design of study will be shortly described for example by their involvement in intervention development and by the involvement of citizen representatives and representatives from the Municipality and local non-governmental organizations in the design and execution of the study. Finally, the inclusion of graphical facilitation as a communication tool will be introduced.

A qualitative study on resident engagement in a community-based health promotion intervention

Abstract Emerging evidence points towards lower quality of life, more fragile social relations and suboptimal health behaviour and health status of residents living in social housing areas characterized by ethnic diversity and socioeconomic disadvantage. Residents from social housing areas are less likely to engage in health promotion interventions compared to the rest of society. Community-based health promotion interventions developed in collaboration with the target group and adjusted to local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in social housing areas. This study explores resident perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. Engagement was the key foundation for the designing and implementation of the intervention by the use of graphic facilitation. The intervention consisted of social outings to different sights and historical landmarks in Denmark. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analysed with a focus on participation in an everyday life context and by concepts of othering and territorial stigmatization. Engagement in the intervention was motivated by a need for establishing and enhancing social relations, and exploring the world outside the housing area. However, barriers including cultural and language differences among residents and competing contextual factors challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in social housing areas. Nevertheless, it is necessary to understand the motives and barriers to ensure feasible and relevant health promotion interventions and future engagement among residents living in social housing areas.

ЕФЕКТИВНІСТЬ МЕТОДУ ГРАФІЧНОЇ ФАСИЛІТАЦІЇ ПІД ЧАС ВДОСКОНАЛЕННЯ КОМУНІКАТИВНИХ УМІНЬ МАЙБУТНІХ МЕНЕДЖЕРІВ

the publication highlights the role of communication skills of managers in their future professional activities. An analysis of modern teaching methods used by teachers in the United States, Ukraine and other European countries. The expediency of using methods of information visualization in the educational process, in particular the method of graphic facilitation, was substantiated. The expediency and efficiency of using the method of graphic facilitation in the conditions of the 2020 pandemic in order to increase the efficiency of distance learning was analyzed.