Crucial Conversations Duke University School of Medicine Office

Crucial Conversations Duke University School of Medicine Office

Crucial Conversations Duke University School of Medicine Office for Faculty Development June 9, 2017 8AM-12N Ann Brown MD MHS Vice Dean for Faculty Cathie Siders PhD Psychologist, Executive Coach Crucial Conversations

Conflict of Interest None Goals of Session Define crucial conversations And to acknowledge that, skillfully done, they are a normal part of healthy human interaction Introduce Crucial Conversations concepts Demonstrate Invite observations on what worked and what did not Discuss common situations and neutral rejoinders Practice Crucial Conversation, SOM Office for Faculty, 6/9/17

3 Pre-work: worksheet on your own crucial conversation (sent by email prior to workshop) 1. Describe a recent (or pending) situation where you had (or need to have) a crucial confrontation or conversation. Describe the facts of the situation, your story of why it happened, and your emotions. 2. What do you want to happen based on your pending conversation? (Chapter 2, Crucial Conversations) 3. What do you NOT want to happen? 4. Do you see any safety concerns?

Crucial Conversation, SOM Office for Faculty, 6/9/17 4 Three Good Resources 5 Crucial Conversation, SOM Office for Faculty, 6/9/17 Crucial Conversations: Tools for Talking When the Stakes are High. Patterson, Grenny, McMillan, Switzer 6 Crucial Conversation, SOM Office for Faculty, 6/9/17

Why this topic Professionalism Support a culture of trust, respect, empowerment Diversity Make it possible to talk about differences and explore assumptions Patient care and safety Encourage dialogue to support effective information exchange about patient care Research integrity Normalize discussions about ethical conduct of research Learning Community Support an environment where personal growth can happen Personal belief Sweeping conflict under the rug creates a toxic environment

Crucial Conversation, SOM Office for Faculty, 6/9/17 7 Examples of Crucial Conversations Addressing disruptive behavior Giving a negative performance review to a junior colleague or student Giving boss feedback about her performance Talking with a co-worker about a terrible hygiene problem Asking in-laws to stop interfering Crucial Conversation, SOM Office for Faculty, 6/9/17

8 All people and organizations have problems The difference between the good and the best is not how many problems we have It is how rapidly and respectfully the problems are solved. Crucial Conversation, SOM Office for Faculty, 6/9/17 9 Role Play (Demonstration)

Watch for language that moves the conversation forward, stalls conversation Debrief What worked well? What could have been done differently? Crucial Conversation, SOM Office for Faculty, 6/9/17 10 What Makes a Conversation Crucial? Law of Crucial Conversations: Anytime you find yourself stuck,

there are either crucial conversations you are not holding, or not holding well that are keeping you there. -Deborah Marshall, Crucial Conversations consultant Source: http://workthink.org/having-adifficult-conversation-at-work/ Crucial Conversation, SOM Office for Faculty, 6/9/17 11 Crucial Conversations: Tools for Talking When the Stakes are High.

Patterson, Grenny, McMillan, Switzer 12 Crucial Conversation, SOM Office for Faculty, 6/9/17 Recognize a Crucial Conversation Stuck Conversation having same one over and over Stuck issue- despite attempts, no change Feelings of Anxiety Fear Judgment Anger Crucial Conversation, SOM Office for Faculty, 6/9/17

13 Watch for your own (and others) reaction to tough situations Silence Masking, Avoiding, Disengaging Violence Controlling/coercing, Labeling, Attacking, Belittling Open, Honest and Effective Communication Crucial Conversation Skills

The mistake most of us make in our crucial conversations is we believe we have to choose between telling the truth and keeping a friendbetween candor and kindness.. -Kerry Patterson 14 Contribute to the pool of shared meaning Crucial Conversation, SOM Office for Faculty, 6/9/17 15

Get more legos on the table Crucial Conversation, SOM Office for Faculty, 6/9/17 16 Core Principles of Crucial Conversations Start with Heart: Focus on what you really want Learn to Look: How to Notice When Safety is at risk Make it safe Master [your own] stories Learn how to effectively share your own views

STATE your path Encourage others when they are emotional to share their own views and get back to the facts: AMPP skills Move to Action 17 Start with Heart Stay Focused on What You Want What do I really want for myself? for others? the relationship? How would I behave if I really wanted these results?

What do I NOT want to happen? REFUSE THE SUCKERS CHOICE Crucial Conversation, SOM Office for Faculty, 6/9/17 18 Learn to Look When Safety is at Risk In the midst of a conversation, learn to recognize when things are not going well Step out of the content conversation and observe how the conversation is going

The conversation turns crucial when the interpretation of the content assumes mal-intent. Crucial Conversation, SOM Office for Faculty, 6/9/17 19 Make It Safe Conditions of Safety Mutual Respect Mutual Purpose If you recognize that either mutual purpose or mutual respect are at risk, step out of the content of the

conversation and re-establish safety. Crucial Conversation, SOM Office for Faculty, 6/9/17 20 Make it Safe Re-establish Mutual Respect and Mutual Purpose Apologize Contrast to repair misunderstanding Use CRIB as a tool to find mutual purpose

Commit to seek mutual purpose (shared goal) Recognize the purpose behind the strategy Invent a mutual purpose Brainstorm new strategies Crucial Conversation, SOM Office for Faculty, 6/9/17 21 Master [your own] stories Silence or Violence

Path to Action Facts Interpretation Tell a See and Hear Story Emotion Feel

Behavior Act Dialogue VillianHuman VictimEmpowered HelplessAble Crucial Conversation, SOM Office for Faculty, 6/9/17 22

Learn how to effectively share your views Confidence Humility Skill Crucial Conversation, SOM Office for Faculty, 6/9/17 23 Effective communication: What vs. How Skills S

Share Your Facts: Start with what has been said or done T Tell Your Story: Talk about your conclusion. Consider adding contrasting. A Ask for Others Path: Encourage others to express their facts and stories.

T Talk tentatively: Perhaps you were unaware In my opinion Im beginning to wonder if E What Skills How Skills Encourage testing: Invite opposing views

and mean it. Does anyone see it differently? Id like to hear the other side of the story Hold to your belief but soften your Play devils advocate. approach Kerry Patterson et al Explore Others Path by Inviting to Share their Path to Action Facts Interpretation Emotion

Behavior See and Hear A M P P Tell a Story Feel Act

Ask to Get Things Rolling: Whats going on? Id like to hear your opinion Mirror to Confirm Feelings: Suggest that a persons tone of voice or gestures are inconsistent with their words. Paraphrase to Acknowledge the Story: State back the message that you have gotten in your own words. Prime when you are getting nowhere: If the person is still not talking take a guess about what they

might be thinking. 25 Explore others path using ABC Agree agree where you can! Build build on that! Compare Crucial Conversation, SOM Office for Faculty, 6/9/17 26 Move to action

Decide how youll decide Document decisions and follow up Crucial Conversation, SOM Office for Faculty, 6/9/17 27 28 Situations. Drive-by feedback and others 29

Table Exercise 1. Review neutral rejoinders handout 2. Identify one verbal response from any of the five behavioral categories that you might find helpful 3. Discuss with your table group your selection and why you find it useful Role Play- Groups of three Identify initial roles A Dr. Young, Junior Faculty B Dr. Smart, slightly more senior colleague C Observer and time keeper Review roles (2 min)

Role Play Dr. Young initiates conversation with Dr. Smart (10 min) Debrief (5 min) Rotate roles, repeat, rotate roles, repeat Crucial Conversation, SOM Office for Faculty, 6/9/17 31 Key points The ability to have difficult conversations is a key to building a healthy environment and healthy relationships Strive to keep in dialogue Add to the pool of shared meaning

Check yourself if you are leaping to conclusions without enough information Crucial Conversation, SOM Office for Faculty, 6/9/17 32 Next Steps Revisit your scenario and add ideas from this workshop. Read the book Talk to your group about these concepts Teach a concept to your group Rehearse

Crucial Conversation, SOM Office for Faculty, 6/9/17 33 Thank You! Please fill out evaluations Crucial Conversation, SOM Office for Faculty, 6/9/17 34

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