Freedom’s just another word for nothing to present









Your USB key is corrupted, and by the way the handouts weren’t printed


Bad deam? Worst nightmare? Or maybe the best and most productive 90 minutes possible. I’ve read that the Chinese character for crisis represents danger + opportunity, and nothing could be truer. This unwelcome scenario happened to me today when presenting to a small group of Medical Residents on the topic of Motivational Interviewing.

The moment I realized that “Plan B” (the handouts) was not an option, I decided to use (and trust!) the principles of Motivational Interviewing (captured by the acronym “A-C-E”, Autonomy, Collaboration and Evocation) as the foundation spirit for my approach. In other words, it’s all about relationships, and my primary goal was establishing a relationship with the group to help facilitate meaningful practice and learning.

So…what did we actually do? I demonstrated Motivational Interviewing skills with a volunteer who agreed to talk about physical activity and exercise as a hypothetical change goal  (a “real play” versus a “role play”). Frequent pauses, critical reflection and discussion allowed key points and clinical skills to emerge organically. In the second half of the session, the whole group participated in another activity focused on practicing – and again critically interrogating – reflective listening skills. We closed with each person articulating a specific practice goal based on their learning.

It’s all too easy to fall into the trap and habit of teaching as performing. In Motivational Interviewing I often talk about a “red flag” being when the practitioner is working harder than his or her patient; and today I was reminded that it’s energizing and affirming when the learners work harder than the instructor.

Maybe next time “Plan C” gets promoted to “Plan A”. That 90 minutes felt like freedom.

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