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Concentric Conversations

Concentric Conversations

Modelling Reflection


Like most people doing this kind of work, I have discovered that the best way to start any piece of team development is by having an extended conversation with the original inquirer. This involves asking questions like these: What is your concern? What is the nature of your own responsibility? Who else is involved? What are your relationships like with these people? Who is likely to be helpful? Who might feel upset or threatened by any action? This one-to-one dialogue is a vital part of any project, and the first of the 'concentric conversations' that I hope to hold over the next few days or weeks. The aim of this initial talk is not just to map out the difficulties. It is also to model the way I plan to continue, by slowing things down, applying analysis and reflection, and not jumping to instant diagnoses or magical solutions. The same applies to the every stage of the process. Working in the National Health Service (NHS) it is also essential to discover from the outset if there is any perceived risk of harm to patients, and who will need to be informed if that is the case. If the problem is one where other stakeholders have an interest, including senior management or regulators, their views need to be sought as well.

Frequently, the person expressing concern about a workplace problem can list many individuals who feel apathetic, upset or angry about it, but the most helpful way forward is to set up an initial meeting with one or two other people within the system who have some motivation, and hopefully enough goodwill, to try and change this state of affairs. To give an example, if the first person phoning me up is a senior educator in a hospital who has heard persistent complaints about junior staff being undermined on a unit, I will aim to meet next with the educator and a couple of consultants who do not appear to be implicated in the complaints, but who know about these and want to address them. Stage two of 'concentric conversations' is to get this small group of people together in a room, find out their views about the problem, and look at possible ways forward. This depends on taking the same stance as before: accepting that the problem is significant and possibly serious, but without making hasty judgements, and by promoting dialogue. Interestingly, people are often familiar with this painstaking kind of fact-finding exercise in their clinical work, but find it surprising that the same precise and unprejudiced inquiry might work in the area of human relationships as well. They may be less familiar with the idea that this style of inquiry can itself free up a discussion of difficult topics and reduce strong emotion—and well as emboldening them to start having some of the challenging conversations that they have avoided.

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