Example projects, techniques and exercises…

When I started my Wellcome Trust Fellowship, I wanted to try out as many different facilitation approaches as possible. My background is performance, but I hoped to learn from other practitioners, and experience new, arts based facilitation techniques. Ultimately, I wanted to see how creative techniques might support meaningful conversations about health and research.

I originally planned to create an arts based facilitation toolkit that health researchers, and others, could draw on.  However, my thoughts on that changed over the course of my fellowship. Rather than develop a ‘how to’ guide, I focused on:

  • Building meaningful collaborations between researchers and creative practitioners – There’s no substitute for working with a skilled practitioner, and it is unfair to expect health researchers to run arts based sessions when it’s outside of their expertise.
  • Helping researchers to think through the pros and cons of different approaches and consider when a partner is needed – Research is a collaborative endeavor. Experienced facilitators and artists have a role to play within that.
  • Developing an understanding of basic facilitation principles with early career researchers – Appreciating what goes in to good facilitation both helps you to run your own sessions, and to know when it’s time to bring in a different facilitator, with a new perspective / practice.
  • Promoting facilitation as an important, valued research skill – I believe facilitation is currently under-valued within academia.

Having said all that, I do still think that example projects / techniques can be helpful. Examples can help people to see what’s possible, and reflect on the risks / benefits of different approaches. There are various examples dotted throughout this blog; I thought it might be helpful to pull things together in one place.

I’m going to use this page to list interesting approaches that I’ve come across or used. It’s a mix of standalone exercises and project links. I’ll keep adding to it when I can. Please feel free to add your own suggestions in the comments!

For some tips on how to select an appropriate facilitation technique, see this blog post.

I’d like this to be a space for ideas and inspiration, rather than an exhaustive list, or a ‘how to’ guide.

Please note, wherever possible I have credited the people who created different exercises and techniques. However, sometimes it’s hard to find an original source, as things change and develop over time. Please let me know if you think I need to credit someone.   

Applied Performance

Image Credit: Freshcut

Applied performance has a long-standing history of health related projects, and there’s lots of useful literature out there. A few examples:

Games – I wrote a little about drama games in a previous blog post. ‘I believe’ is a good example of a drama improvisation game, which I have used in public involvement workshops. It’s a versatile game that can be used as a warm up, to stimulate discussion, or as an evaluation exercise. One person stands in the centre of the room and makes a statement starting with the phrase ‘I believe’. For example, ‘I believe that this has been a good workshop’, ‘I believe that I have had a chance to contribute meaningfully today’. If the other participants agree then they stand close to the speaker. If they disagree then they stand further away. People’s position in the room gives an indication of how strongly they agree or disagree. 

This exercise can be run in many different ways. For example, a facilitator can read out pre-prepared statements on a particular topic, or you can invite participants to take it in turns to stand in the centre. You can also invite people to share why they have chosen their particular position in the room, or to chat to people with a different viewpoint. You can ask people to focus their statements on the workshop topic, or ask people to say anything they believe to be true. I’ve found this more open, informal version works well as an warm up exercise with children.

Lost in Memories – A participatory theatre project with people who have personal experience of dementia.

Invincible – A great theatre project by Kilter Theatre and the University of Bristol, starting public discussions about synthetic biology.

Simulation (specialist role play) – More info in a previous post

People are Messy – A play and workshop about public involvement in health research, by Theatre of Debate.

Visual techniques

Photo Voice is a participatory photography technique which uses photos as a tool for ‘self-advocacy and communication’. There are example projects on the Photo Voice website. I’s been used quite a lot as a research method, particularly in mental health e.g. https://journals.sagepub.com/doi/10.1177/1363459314567790.

Digital Storytelling is another technique which uses images to aid reflection and expression. The Patient Voices Programme use digital storytelling to help people express their personal narratives. Digital stories can also be shown to groups to stimulate discussion and debate.

Participatory Video is another visual technique with a rich history. Video can be used to help people capture, reflect on and share their experiences. It’s not something I have used personally, but I recently heard Jackie Shaw talk about her video work, and would recommend her participatory video handbook (co-authored with Clive Robertson).

Mapping exercises can help to uncover connections and relationships at different levels. For example mapping personal experiences at an individual level (see river example below); mapping connections within a group / community; or large scale systems mapping. Danny Burns has written a lot participatory systems mapping.

There’s a different example of how mapping has been used within public involvement here: https://www.invo.org.uk/posttypeconference/mapping-participation-picturing-your-involvement/  

Rivers of Life is another example of a visual, mapping exercise, which I was introduced to during a course at Oblong Community Centre in Leeds. I was asked to draw a river which represented my journey to this point in my career. Different elements on the river symbolised different aspects of my life. For example, a whirl pool may be an unsettling experience, a fork in the river could be an important decision, stepping stones may represent someone who helped me. We were then asked to present it to the rest of the group. Essentially the idea is to reflect on and present a personal journey in a visual way. I liked the river exercise as it allowed me to reflect individulay and consider which aspects of my story I felt comfortable sharing.

The STEPS centre website, has a really detailed example of where Rivers of Life was used as part of participatory data generation. https://steps-centre.org/pathways-methods-vignettes/methods-vignettes-rivers-life/

Animation – Creating and viewing animation can be a great way to stimulate discussion, aid expression, and bring complex concepts to life. I love the Animated Minds series, which is about people’s experiences of mental health. I’ve used the animations as a starting point for discussions about metal health with young people.

Visual data analysis – I was part of some really interesting workshops with Vicky Ward, using drawing and collage to facilitate qualitative data analysis, based on a technique developed by Brendan McCormack and colleagues. More info on Vicky’s blog.

The problem tree exercise – This is one of my favourite exercises. I’ve read / heard about many versions of it, but I’m not sure of the original source. It’s another one that I was introduced to by Oblong Community Centre. This is my version…

  • The facilitator draws a problem tree on a whiteboard / flip chart etc. (see image below).
  • Somebody poses a problem to the group and asks people to consider barriers in relation to that problem. E.g. ‘What are the barriers to effective communication between patients and health professionals?’
  • Each person considers the barriers and writes them on post it notes (one barrier per post it). This is done individually.
  • The facilitator then asks each person to stick their post it note on the appropriate section of the problem tree, and say why they think it belongs there.
  • Each part of the tree represents something different. The roots represent individual / personal barriers, the trunk is institutional barriers (e.g. problems within an individual GP practice) and the branches are wider political barriers (e.g. NHS / government policy).
  • The facilitator and the group can challenge why people choose to put things on different parts of the tree, and ask people to think about the interplay between the different levels. 
  • Once people have added their barriers, you can move on to considering solutions together. These are added to the tree as apples or leaves.
A Problem Tree

Again this can be adapted as needed. For example, if people feel self-conscious about standing at the front of a big group, you can draw / print smaller trees and ask people to work in pairs or smaller teams. There are a number of reasons that I like this exercise. Firstly, as a participant, you have time to think about your opinion individually, before a big, group discussion. Also the different parts of the tree can help people to think about why problems may exist. It can help you to unpick and puzzle complex issues before jumping to solutions.

Building and Making

Lego Serious Play – I think there’s something powerful about asking people to do a practical task, with their hands. I talk more about this in a previous post about training to be a Lego facilitator. There’s more info about the specific Lego methodology on their website.

Child Cosmos Sculpture Project – Working with young children and their families in Bradford.

Case Studies / vignettes

I’ve found that case studies can be a great way to get people talking and provide a common focus for people from different backgrounds. They can also encourage people to gradually open up about their own personal experiences. For some people, it may be easier to project personal experiences on to a case study, rather than explicitly talking about things which have happened to them. There are many different ways to present case studies e.g. writing, videos, theatre etc.

For example, we used videos and simulation to bring case studies to life during the Severe Pressure Ulcer Project (short film about the project here). For an example which includes written vignettes, see this paper about co-research with people who have a learning disability (Tuffrey-Wine and Butler, 2009)

Ice Breakers

I often get asked for ice-breaker / warm up exercises. There are hundreds out there and I think it’s really important to find one that works for your group. For example, there is a big difference between the dynamics within a group of strangers, and a group who know each other well. The tone of a session will also differ depending on the topic, setting etc. As with all facilitation planning, you need to think about the purpose of each exercise and the group you are working with. Here are a couple of examples that have worked well for me in the past…

Person Bingo – Everyone gets a ‘bingo’ card. Instead of numbers, the card contains information about different types of people. For example…

Example Bingo Card

The categories on the card can be developed by the group / facilitator to make it relevant. I find it works quite well if you have a mix of categories related to the workshop topic, and some more general, light hearted ones.

Players move around the room, talking to different people in order to find someone who fulfils each category. When they find someone, they write their name on the card. The first person to fill the card shouts bingo, and then introduces the people named on their card.

Blob Tree – This works well in small groups, but can also be done as an individual exercise. Each group has a ‘blob tree’ diagram (see examples here). They are asked to pick one of the people on the diagram, which best reflects how they feel about a particular topic, or about being at an event etc. The exact question can be tweaked. They mark where they are on the tree and discuss / reflect. You can repeat the exercise at the end of a session to see if / how people have shifted.

You can purchase a variety of different ‘blob’ exercises here

Social Media and online engagement

I’m aware that this page currently focuses on face to face activities. I’ll try to address that as I develop this resource. Social media is one way to get public input when it’s not possible / appropriate to bring people together. Social media isn’t really my area of expertise, but I can certainly see some advantages, e.g. the ability to remain anonymous, bigger reach, lower costs etc. Involve, a UK public participation charity, have some good social media resources on their website.

The National Coordinating Centre for Public Engagement have also developed some useful guidance about running online events. Like most people, I’ve started to dip my toe into online engagement due to the COVID-19 lockdown. Some more thoughts on that in my latest blog post.

I’d love to hear from anyone with experience of using social media to facilitate meaningful conversations.

Large Groups

Many of these techniques can be adapted for different size groups. In a previous post, I wrote about World Cafe and Open Space events, which both lend themselves well to big groups of people.

Other Resources

Websites

Books

  • ‘Games for Actors and Non-Actors’, Augusto Boal – A brilliant starting point for Applied Theatre approaches.
  • ‘Applied Theatre Facilitation. Pedagogies, Practices, Resilience’ Sheila Preston.
  • ‘Creative Research Methods in the Social Sciences: A Practical Guide’ Helen Kara.
  • ‘Participatory Workshops’ Robert Chambers – loads of example activities and facilitation tips.

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