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Changing the rules of engagement is inspirational


Abigail Masterson and Pippa Gough on how to present ideas effectively

We write this having just returned from Lancaster where we have had the privilege of hearing presentations from The Health Foundation’s Leaders for Change award holders. The focus was their personal leadership journeys since securing a place on this challenging programme run on our behalf by Dr Elaine Swan and colleagues of the Lancaster University Management School. The audience included guests from the participants’ organisations and staff from The Health Foundation, which sponsors the programme.

Participants had been asked to report back on what they had learnt on the Leaders for Change programme. The change projects presented ranged from those involving the whole health system in a highly politicised area of care subject to intense media scrutiny, such as children’s services in a relatively remote and rural area of England, to much more focused initiatives, such as improving the quality of care and patient flow through one particular surgical service in one organisation.

Reflecting on these diverse leadership challenges, we were struck by the similarities in the leadership journeys described
and were reminded of one of the key attributes of successful leadership, namely that to be a good leader you must be able to communicate a vision.

‘Next time you find yourself needing to encourage others to change, why not take a risk and experiment with new ways of communicating ideas? Dump the PowerPoint’

Participants used many different media to communicate their ideas for change and how to go about improving the quality of care. They talked about their learning from putting these ideas into practice and weren’t shy about talking about where things had not gone so well. In getting their ideas across, a variety of media was used. Some participants had prepared colourful collages of images, which detailed their personal leadership journey and the change process. Others played video clips they had developed in partnership with patients in which patients told their stories about why the change in the service proposed was so necessary and how it would save lives. Some adopted powerful metaphors such as the Lion from the Wizard of Oz to describe themselves and their leadership challenges, while others used poetry to articulate their feelings about their experience and their future aspirations.

All felt being on the leadership programme required tremendous resilience. The importance of both peer support and challenge in building and sustaining this resilience was emphasised. Each participant was now revelling in their increased confidence and benefiting from greater insight into their personal strengths and weaknesses and how to sustain themselves within a complex and uncertain context.
Participants continually stressed the importance of their teams and the necessity of building alliances in achieving the changes they were presenting. Learning from others’ experiences through developing relationships with mentors was highly prized. Humility and developing the ability to ask for help was a recurrent theme. All described the value of realising that being a leader did not mean that they alone had to be the hero and have all the answers.

Many of the participants described how being on a course forced them to engage with management theory and read things they might not have otherwise read and the importance of this in challenging their perspectives. Similarly, the experience of visiting a range of health and non-healthcare organisations and the opportunities this provided to challenge previously held assumptions had a powerful impact.

Again and again, through the presentations, the importance of having a vision and being able to communicate it in a meaningful way to patients, carers, other staff locally and policymakers was illustrated. In trying to convince a staff team of the need to change their practice, many leaders’ first step would be to prepare a comprehensive PowerPoint presentation describing the problem and outlining evidence based reasons for change. For us, the presentations that had the most impact were those where the participants had - in their words - taken risks and used story telling, visual images, metaphor, poetry and so on. The presentations changed the rules of engagement with us, the audience, and enabled us to be more than passive recipients of a presentation. Instead, the images and stories somehow licensed us to contribute our own stories and interpretations and fully engage with each other.

Perhaps the next time you find yourself needing to encourage others to change, why not take a risk and experiment with new and different ways of communicating your ideas? Dump the PowerPoint and linear description. Try telling a story, using images, dance or poetry instead. Both of us have dear colleagues, one of whom gave his professorial inaugural lecture using the medium of dance - and survived - and the other created a tapestry to illustrate her approach to the care of the dying and submitted this as her MA dissertation - and was awarded a distinction. The level of engagement you achieve and the impact on the way people think could be surprising. We’d be delighted to hear how you got on.

Abigail Masterson and Pippa Gough are assistant directors, clinical quality, The Health Foundation


Readers' comments (2)

  • Roger Rowett

    I have been providing training and organisational development for the past 30 years. Over the past year I have been using an Appreciative Inquiry approach which for me is the most powerful and 'refreshing' approach to stimulating lasting change. See for more details

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  • I attended a training session last year which made a lasting impression on me more so than any other training I have ever been on.

    The topic was Safeguarding Adults and while we all know it is very important it can be a bit dry. It was scheduled for a whole day and we all looked on it as a chore to go but being mandatory there was no choice.

    It was run by a team of professional trainers who used drama to put their point across. When the idea was broached we the audience panicked thinking the dreaded 'role play' but it was not that at all. The team presented their points in small 'plays' acted out to us the audience with a 'narrator' who involved us in feedback and questioning over what was being depicted. It was absolutely brilliant and made such a difference to the overused Power Point and the old OHPs. It cost a bit to do but was well worth it in terms of impact and making us remember it.

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