Addressing the Entire Spectrum of Human Conflict

Building ​Respectful​ and ​Safer​ Environments

VISION:​ Through a collaborative partnership, Vistelar and Blackstone Consulting, Inc. will
design, develop, train to, implement, evaluate, and validate an effective comprehensive
Conflict Management for Healthcare training program for Kaiser Permanente.

Scenario Practice Instructions

Scenarios are the bridge for trainees to become proficient in skills before needing to perform them
back on the job.

Scenarios must be as real-world as possible for the participants in the class and all scenarios
should be practiced from the beginning to the end (whole task).

Scenario Practice Steps

1. Demonstrate both the role play and debrief steps of the scenario with the primary instructor as
practitioner and others as role-player and coach. If the primary instructor thinks it’s necessary,
demonstrate a second round of the scenario. The goal of this step is to get a clear picture in the
participant’s mind of what the “classroom model” looks like.

2. Provide an explanation to the class of what they just saw, read through the scenario description,
answer questions, and moderate a class discussion to ensure everyone completely understands
the scenario.

3. Provide clear instructions as to what each three-person group is expected to do during the
scenario, as follows:

● Decide who will be in which role (practitioner, role-player, coach) for the first round of the
scenario

● Practitioner and role-player do the role-play

● During role-play, if needed, Coach provides guided instruction:

a. Level 1: Interrupted refinement​ - During the scenario, the instructor/coach will

provide guided instruction in the form of brief suggestions for improvement and
modifications. This will occur as seamlessly as possible without stopping to
formally “teach” a concept. This interrupted refinement is intended to allow the
participants to continue to “be in the moment” and continue with the scenario as
seamlessly as possible

b. Level 2: Teachable moment​ -​ During the scenario if/when the instructor/coach

sees that a method/tactic is incorrect, the instructor/coach will stop the scenario
and review the method/tactic. The group will then continue with the scenario.

1
 Addressing the Entire Spectrum of Human Conflict
Building ​Respectful​ and ​Safer​ Environments
VISION:​ Through a collaborative partnership, Vistelar and Blackstone Consulting, Inc. will
design, develop, train to, implement, evaluate, and validate an effective comprehensive
Conflict Management for Healthcare training program for Kaiser Permanente.

c. Level 3: Reteach​ - During the scenario, if/when the instructor/coach realizes that a
method/tactic is entirely incorrect and further training is needed, the
instructor/coach will stop the scenario and reteach the method/tactic to the entire
group. This reteach is intended to allow the participants to see the difference
between the initial incorrect delivery and the correct method/tactic. This level of
guided instruction may take considerable time.

● Coach asks the practitioner to “provide a step-by-step narration of doing this perfectly
when back on the job.”

● Practitioner provides the narration.

Note: this narration should not be about what the practitioner thought they did wrong.
Instead, it should be a positive description of them doing it flawlessly when back on the job

● Coach provides practitioner a three-step evaluation:

1. Promote: Encourage by describing specifics about what you thought the

practitioner did well.

Example: “Your ​Universal Greeting​ and stance were spot on. In fact, I learned a
couple of things about how I could do these better.”

2. Identify: If the coach identifies any need for improvement, describe how they see
the practitioner doing the skill perfectly next time (describe the future in present
tense).

Example: “I see you doing this next time, like this ... (description of improved
behavior)”

3. Coach: Reinforces a specific plan for how to improve.

Example: “Think ​10-5-2​ when approaching someone and remember to communicate

at 5 feet.”

Note: Negative feedback creates stress and blocks learning; positive feedback
promotes learning.

The overall goal of the debrief is to get the practitioner to view themselves as who
they can be (instead of as who their current beliefs suggest they are). Therefore,

2
 Addressing the Entire Spectrum of Human Conflict
Building ​Respectful​ and ​Safer​ Environments
VISION:​ Through a collaborative partnership, Vistelar and Blackstone Consulting, Inc. will
design, develop, train to, implement, evaluate, and validate an effective comprehensive
Conflict Management for Healthcare training program for Kaiser Permanente.

care should be taken to ensure the debrief doesn’t damage the practitioner’s ego.
All evaluations – by both the practitioner and the coach – should be structured as a
description of the practitioner’s positive future, rather than a description of their
current weaknesses.

● If the role-player identifies any need for improvement, they share their comments and the
coach provides their evaluation of the role-player’s comment (again, by describing the
future in present tense).

● Rotate roles (coach to practitioner, practitioner to role player, role player to coach) and do
another round

● Do sufficient rounds until each person is proficient with the skill (as the practitioner) and
with debriefing (as the coach)

● Once sufficient rounds have been completed, get all participants back together for a group
debrief (see group debrief questions below)

Scenario Practice Variability

The goal of practice time should be to get in as many repetitions of each whole task as possible
given the amount of class time available and the skill competency the participants bring to class

During training, scenarios should vary in two ways:

● Scene and situation

● Speed, circumstances, intensity

Practice sessions should take the participants slightly outside of their comfort zone (should not be
too easy or too hard). The greatest amount of learning occurs when participants are encouraged
and supported to stretch their thinking and learning, which may include a degree of supported
failure. The “danger zone” of learning must be avoided, so practice should not include unnecessary
surprises, tricks, traps, roadblock, or obstacles.

Scenario Practice Goals

Practitioner completing role-play and individual debrief:

3
 Addressing the Entire Spectrum of Human Conflict
Building ​Respectful​ and ​Safer​ Environments
VISION:​ Through a collaborative partnership, Vistelar and Blackstone Consulting, Inc. will
design, develop, train to, implement, evaluate, and validate an effective comprehensive
Conflict Management for Healthcare training program for Kaiser Permanente.

● Gain practice with the skill and the debrief process

Practitioner answering coach’s question following each role-play (debrief process):

● Stimulate the practitioner to move their proficiency in the desired direction (e.g., “I see
myself next time … -- with a positive description of each step). Note that the answer to this
question should not be about what the practitioner did wrong. Instead, it should be a
positive narration of the practitioner handling a similar situation when back on the job.

● Improve in their skill of effectively debriefing their own skills when on the job and in their
personal life

Coach asking debrief questions, listening to answers, providing an appropriate level of guided
instruction (if needed), and delivering three-step evaluation

● Improve in their skill of effectively debriefing others skills when on the job and in their
personal life

=============================

Group Debrief Questions:

● Are the methods and tactics taken as a result of this scenario justified within the Kaiser
Permanente system?

● Why is this scenario practice important and relevant to creating a respectful and safer
environment at Kaiser Permanente?

● What skills and abilities are developed using this scenario?

● How will you specifically train using this scenario?

● How will you know the participants are developing the expected skills and abilities?

● How will you gauge the transfer of learning into the workplace?