Health and Literacy
It may appear unnecessary to state that delivering health related information is about as crucial a communications cycle as one is likely to deal with. Relying on text alone to deliver key pieces of health information has the problem of ensuring that it can be read and understood. In western societies where there is at least a 25% population base who have a serious difficulty with reading we know or ought to know that this mode of delivery cannot be relied upon. Yet many countries continue to depend on heavily texted documents to ensure delivery. Perhaps in a legal sense they feel they have to, because to otherwise depend on heavily imaged documents has the possibility of miscommunication. In any event it was through this discourse that I found myself collaborating with representatives of the local Western Health Board (Health Services Executive) when they were considering publishing a manual for facilitators who were promoting health. Many of the tips and suggestions mentioned here were included as part of that publication. 1
The Problem: working with Mixed Ability Groups in a Workshop Environment
The Solution:The solution is deceptively simple…
if you want them to HEAR it, YOU talk; if you want them to LEARN it, THEY talk!
This is so, because we remember…
10% of what we read;
20% of what we hear;
30% of what we see;
50% of what we hear and see;
80% of what we see; and
90% of what we say and do.
Knowing this piece of information is not enough though. It is what you do with this information that is really important. Delivering a spirited workshop should strive towards a sense of partnership, with the participants and the facilitator becoming connected. Doing this during the cut and thrust of delivering a workshop is not so simple, as facilitators delivering workshops will tell you. Working with mixed ability adult groups on health related topics makes it even more difficult still. So the following are a few helpful suggestions should you come to be involved in presenting or being part of a learning workshop environment. If applied, these suggestions, will lead to more positive results in the area of recruitment and retention of participants on any training programme.
As givers and receivers of ‘key’ pieces of information, there may be a temptation to talk and to explain complex subject matter for longer than say 10 -15 minutes. Resist this temptation if at all possible as it is likely to be too long. If you talk for 15 minutes and you get your participants to talk for 5 minutes and you talk again for another 15 minutes… you are doing the talking and the learning – not the participants.
Try instead to have plenty of ‘pair share’ breaks. Involve participants in conversational exchanges. Have them speculate why you’ve made a note of this or that, or why you’ve underlined this or that word in a passage or on the white board or flip-chart. Try to cultivate an air of experimentation; as though two scientists might conspire to build a new and unique method of learning. It is this sense of freedom in particular which moves the training session away from some of the more grisly connotations of probable earlier poor school experiences. There is the possibility of a free exchange of ideas. Try also to break up the material and deliver it in meaningful and readable chunks; announce when your time is up and when it’s their (participants) turn to talk and do.
Many of the adults you work with may be returning to learning after a fairly long interruption. Nothing is more likely to make them clam up or send them screaming from the building than an avalanche of rules and homework. Quite simply, that way of doing things reeks of school. Communicate by word and action that you are there to listen, to take the participant seriously, and communicate that you want to work collaboratively with them. This gets away from the traditional role of note taking usually associated with school.
The possible negative effects associated with spelling and writing or other learning difficulties is best avoided. Do ‘pair shares’ instead exploring the potential of conversation and discussion on the material being presented with a focus on the elements of the material you need to have them learn.
Discuss material over a cup of tea or coffee while standing up, moving around and by using a variety of different seating arrangements when seating is required. Be a guide on the side, not a sage on the stage. Leave no one out. And remember that we all have our own way or style of learning.
If there is a writing task to be done, rotate it and give home-play exercises (as opposed to homework) that require observation, reflection and review at the next presentation. For those confident with writing skills, encourage, but do not make it a condition of participation. Above all make the engagement a FUN social event.
Have people ask questions of you and the other participants. Include a coaching session, each one teach one, and use the participant as a trainer.
Try to deliver some of the material in the form of a story and get others where possible to share their stories too. The truth is that ‘what is most personal is most universal’.
Brainstorming is good too but, always strive to have a balance between active and passive ways of learning.
As part of the ‘pair share’ idea have people do things as opposed to a thinking activity. Where there is a think and write down activity planned get the more confident writers to make the notes while having the more passive partner make the oral comments.
If reading skills are proving to be a problem, never ask someone to read aloud.
Stand-up and move-around exercises are great for getting connected but, too many can discourage participation if self-esteem is at issue.
Don’t preach about things you aren’t willing to do yourself or haven’t yet practiced. Talking about something is not quite the same as doing something. And remember a picture is worth a thousand words.
The process is as important as the product and as the saying goes there is no gain without pain. Getting people connected to each other in positive ways is as crucial a part of the workshop as is getting people connected with the material. The success of the session depends on it. The event itself crucially provides the learning opportunity, the activities provide the interaction, and as facilitator you provide the essential ingredients of recognition and model.
Remember it is okay to say “I don’t know” – followed by “let’s find out”. Plan the journey by having a starting point, a mid point and a conclusion for each workshop and try to close on a high-energy fun activity.
The greatest gift you can give to anyone is the gift of bringing people to the point of understanding how the ‘learning how to learn’ model works. A diagram of the Learning Wheel and required Tutor Skills, which enables the process to move on, is included below as part of this short paper.
Crucially this diagram points out the barriers participants face on their journey to successful learning. One of those barriers you will note is that of anxiety. Anxiety arises from fear, fear of being asked a question that I do not know the answer to, fear of being asked to read aloud are just two such fears of the many that exist. All of us experience some element of frustration and anxiety as part of our every day lives, but most of us have the skills to manage this frustration and anxiety. The participant presenting, who is shy, or who has a learning difficulty, will however experience the same frustration and anxiety but will not have the skills necessary to manage it. This being so, the initial frustration leads through anxiety to stress and it will have consequences for the participants’ health and development. At the very least the participant is likely to drop out.
Because the average participant is just like you and me the following the following list of signals may be of some help in identifying someone who may have a difficulty.
Be sensitive to the signals if you manage to spot them. Here are a few to watch for but this list is not comprehensive, you can probably think of more.
Reluctance to fill in forms or stopping after names and address
Asking for assistance with form filling
Asking for information which is displayed in written form
Asking for two forms or to bring the form home
Return form incomplete or incorrectly filled out
Body language: uneasy, facial expressions, embarrassment
Aggressive behaviour or complaints
Sudden loss of interest
Excuses: ‘I forgot my glasses’, ‘these are the wrong glasses’, or ‘I’ve hurt my hand’
Asking a lot of questions
Participant or client walks out when presented with reading/writing tasks
Participant or client does not respond to letters etc. posted out
Participant or client comes to an interview/appointment with a friend
Recognise that a participant or client may not have bank account and uses cash to pay bills etc.
Queries or comments mailto: info@frankmonaghan.com
- Wellbeing through groupwork (3rd Edition) ↩