David Luke was recognized by his colleagues at Pfizer as a great facilitator. He had a standard opening line: “I’m an equal opportunity abuser,” he’d say to the assembled physicians.
“I will be calling on you at anytime on any subject during the meeting. So–heads up!”
It takes a skilled and confident facilitator to use an opening gambit like that, and while it worked well for David, it might not work for every facilitator out there.
David is no longer facilitating ad boards because he’s Senior Director, Clinical and Scientific Affairs at Target Health.
But he could make facilitating look easy, even though the job requires a sophisticated cluster of skills and meticulous attention to a range of details to ensure desired outcomes.
Logistical challenges include selecting and arranging an appropriate venue; inviting the right people; ensuring their attendance; and arranging lighting, temperature, sound quality, and size of room.
But those challenges can be met with a well-designed process. This article is about the more subtle personal abilities required for great facilitating.
More subtle challenges
While logistics are important, the soul of a great facilitator is a rare cocktail indeed. A good facilitator has contradictory goals. She wants to be a lively hostess, yet she doesn’t want to be the center of attention.
He wants to be the lion tamer, but his authority must come not from his whip, but from his passionate interest in the thoughts of others.
Phil Donahue and Oprah Winfrey are two of the best. In a nutshell, the gifted facilitator is an intoxicating blend of assertiveness and diplomacy, of knowledge and social skill. They know enough to challenge the audience, and have the social skills to make the conversation fun.
If the facility is appealing, the speaker effective, and the facilitator skillful and engaging, the sponsoring company can educate the audience, gather valuable information by getting beyond the obvious to learn about underlying prescriber attitudes and behaviors, and build a bond of trust and mutual respect between the company and the physicians.
What are some wise ways to prepare and perform well at facilitating ad boards?
Most battles are won before the fighting starts, and facilitating is no exception.
- Plan a logical cascade of questions and be willing to be flexible if more interesting topics arise.
- Take charge of the seating. Create name tents and assign seats.
- Choose a quarterback (most likely the facilitator), who will be the final arbiter at the meeting.
- Select and coach a wingman, someone to step in, like a rodeo clown, to rescue the facilitator if the meeting gets rough.
- Select a scribe to record what is said. The notes help summarize the conversation at the end of the meeting, and make it easier to reflect on the event.
- Craft a strong opening that makes a strong case for the value of the discussion. Include ground rules, expectations, goals, time of breaks, etc.
- Phrase your questions carefully and put each one on its own PowerPoint screen.
- Rehearse the opening and the flow of questions the night before with your colleagues.
- Use a flipchart for your parking lot, a place to park topics that are worthwhile, but not focused on the matter at hand.
Running the discussion
Now that you’ve planned thoroughly and are off to a good start, it’s time to get them to open up.
You can do this by being relaxed and natural. David Luke does it his own way. Self-effacing humor is always a good way to draw people to you, but if that’s not your style, authenticity trumps pizzazz.
In the beginning, it’s normal for people to say what they think you want to hear. Until they trust the facilitator and the environment, they will be careful about revealing their deepest thoughts.
Your job is to get them relaxed and engaged enough to open up–without the aid of cocktails.
Use your OARS
OARS is a technique taken from motivational therapy. OARS helps people reflect on their own thoughts.
“O” stands for open-ended questions–questions that can’t be answered with a “Yes,” or “No.” All your questions should be “O” questions.
“A” is for “Affirm.” For instance, when you detect a little griping in a doctor’s remark, you might say, “So you’re frustrated with the dosing requirements,” and then wait for a response. In this way, you are affirming an underlying feeling.
“R” is for “Reflect.” If a physician says, “I don’t think that message will fly with primary care,” you could say, “You don’t think it will fly,” and look him in the eye, waiting for a response.
And when a participant has finished speaking, you Summarize (the “S” in “OARS”). To summarize, you might say, “So what I hear you saying is that while the bio-availability is on a par with product X, you’re not so sure the side effects are so easily managed.”
By practicing the OARS technique, you encourage participants to think about their thinking, which can lead to greater insight. You also make them feel heard, which is one of the most satisfying feelings in the world.
Once you’ve used your OARS technique, and you’ve extracted deeper, more honest thoughts from a participant, you can turn to another and say, “Dr. Frank, in light of what you’ve just heard, and keeping in mind the ABD study, how would you reconcile the need to titrate with the needs of the emergency room?”
Then be silent, and listen carefully.
Watch them like a hawk
As the conversation heats up, keep your eye on everyone. Watch them for subtle changes in facial expression–raised eyebrows, curls of the lip.
Then, when you have a chance, pounce on them. “Dr. Williams, I sense you’re a little skeptical,” or, more neutral, “Tell me what you’re thinking.”
Tame the lions
Lions are those who love to hear themselves roar–physicians who dominate the conversation. It is estimated that they dominate 60% of the discussion in business meetings.
As the facilitator, you have a group responsibility to make the session successful for everyone. And most people consider a meeting successful if they have had a chance to talk.
Do not allow the lions to dominate. As soon as you’re aware that someone has become a lion, you can be sure that others are having the same thought. And they want you to take charge.
Look for an opportunity to jump in and interrupt the lion. “Excuse me, Dr. Lyons. I appreciate your input. In the interest of time, I’d like to hear from somebody else.”
Then call on somebody else. If the lion persists, use a strong assertive action (extend your hand in a “STOP” gesture) when saying, “I appreciate your enthusiasm, but I’d like to move on…”
Then call on someone who hasn’t contributed–a mouse.
Defend the mice
Call on them by name. Say something flattering to make them feel welcome and brave (do NOT say, “We haven’t heard from you yet.”) Walk to a spot in the room where you can protect the mouse from the lion–perhaps you can stand between them.
Mice often have interesting and unusual things to say. They just don’t like speaking in large groups. Make sure you make it comfortable for them.
Kill the snakes
Snakes are those nasty creatures who make you feel threatened. Some snakes attack you openly, while others accept an honorarium to attend and then clean their fingernails during the meeting.
Do not allow participants to read newspapers or conduct side conversations that are disruptive. The best way to prevent such behavior is to get them to agree to ground rules at the start of the session.
If the disruptive behavior persists, you might start your diplomacy by calling the snake by name and asking her a question.
Or you can take the more direct route. “Dr. Jones,” you could say, “Can I have your undivided attention please? In fact, we need your input. These are important matters for all of us.”
If that doesn’t work, you can speak to her at a break, or call a break and speak to her.
You could ask her what topic might be of interest to her, and if it suits your purpose, allow it to be addressed by the group later in the meeting.
The bottom line: Be strong and diplomatic. The facilitator is responsible for the experience of the group. Do not allow anyone to poison your meeting.
The substance of style
While David Luke had an irreverent and informal style, you have your own. Be yourself–everyone else is taken.
That said, borrow from those you admire. You can’t help but make use of the borrowed approach in your own peculiar way.
Cultivate an attitude of curiosity. Want more for the group than you want for yourself. Be the voice of the patient.
Your style will be part of the substance, and in fact may be what lingers in the memories of the attendees long after the details of the discussion are forgotten.
Wrapping it up
You have left no stone unturned in your planning.
You have crafted and delivered an engaging opening that captured their interest and established the ground rules for the meeting.
You have demonstrated calm assertiveness, taking charge of the room.
You have been highly attentive, demonstrating an authentic interest in each and every KOL.
You have practiced your OARS technique.
You have kept the meeting on track while allowing for valuable digression.
Bring the meeting to a close by tying the various threads of conversation together. Get agreement from the participants that you have accurately understood their thoughts.
You may need to call a break before the summation in order to get it right.
Make sure your scribe has been preparing for this moment, and has something to offer you.
Your closing remarks should also put the meeting into a larger perspective. Cast an eye over where the project has been, and where it still needs to go.
Say, “Thank you.” Remind them of the importance of the mission.
Follow up with them. People love getting personal, hand-written letters. Include a document summarizing the conversation.
And remember, Ad Boards are social occasions as well as scientific ones. Use them to strengthen your professional relationships.
A good facilitator is a rare cocktail–that magical blend of expertise, assertiveness, and genuine interest in others.
We are all on that journey, and I urge you to fare forward through all obstacles, within you and without you.
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