The roomful of people went incredibly quiet when the GP spoke. “Some of the things that happened during this process have left me feeling very bruised. I will get over it, but I wanted you to know how difficult it has been for me”. Dr Marsh* was speaking during an After Action Review days before the Covid 19 outbreak took hold in the UK.
His GP business had been one of many in the borough of a big UK city that had wanted to move into a new building that had been built for a new housing development. This sought after location would provide the space and the facilities to give patients the very best primary care and easy access to diagnostic and treatment services. Dr Marsh’s practice was one of the doctors’ surgeries within 2 miles of this new site so he submitted an application to the boroughs’ commissioners who had designed a process to select the GP practice who most closely met the selection criteria.
Despite this being a highly regulated process, the lack of information reaching all the applicants and anxiety that there would be bias in the selection process mean that some of the behaviours’ Dr Marsh experienced from his colleagues went beyond the professional and into the personal. This was exacerbated when it was announced that his GP practice was the successful one.
The AAR had been called by the borough’s commissioners to ensure lessons were learnt about the process and to promote healing amongst those involved in the healthcare system.
The power of storytelling
The need to tell our story and have it heard and understood is part of the human experience and is central to our sense-making during and after difficult experiences. We do it informally all the time, in the coffee shop or the bar, at the dinner table or on WhatsApp. Our present situation as led to an increase in this desire to tell others what is going on in our disrupted lives as we strive to adjust and cope with it. Phone and video calls have multiplied as a consequence. Every mental health organisation promotes social interaction as a vital preventative measure to reduce stress because it allows for this essential sharing of stories and creates the opportunities for hearing other perspectives as well.
Building resilience with AAR
This is also why AAR works to build valuable emotional resilience. The AAR process creates the space for each individual to describe their own experiences and gives airtime to each to describe what happened in their part of the “action”. In other words, “storytelling” takes place. With a skilled AAR Conductor creating a psychologically safe environment, the listeners’ defences will also be lowered and so the quality of the listening is improved as well, and so the potential for lasting insights increases. Dr Marsh received two personal apologies after the AAR from clinical colleagues who had gained real understanding of Dr Marsh’s context during the AAR and could see their own actions more clearly.
AARs can also be used as a stress preventive because they create a space where all feel fully included. One of the sectors that has successfully incorporated AAR into regular practice is the US legal profession, where the mental health of the more junior employees is a current concern.
US Lawyer, Jack Bostelman said of AAR in US Law firms “After-action review meetings serve a training and morale-building purpose for associates. This meeting may be the only time during the matter where some associates get a sense of the scope of the entire matter and how the part on which they worked contributed to the whole. Also, merely participating in an after-action review meeting and being treated as an equal team member will contribute to more positive morale among associates” Ref
This isn’t usually the primary driver to use the AAR approach in an organisation but during the current situation, building the collective view of a shared experience through an AAR is more valuable than in normal times.
Three tips to improve resilience at this time:-
- Create time and space to listen to each person on your team, over and above what you would normally do. After all you are missing out on all the informal stories that you would gather as you stood together drinking coffee or taking the lift, so you need to give it a higher priority.
- Tell stories yourself: when leaders share their stories, vulnerabilities and successes, they act as powerful role models and support others to do the same.
- Run AARs online: we now offer an Online AAR Facilitation service which is proving to be incredibly helpful in supporting leadership teams make sense of their responses to the Covid 19 outbreak. It is also allowing the stories to be both told and heard, building resilience for the journey still to come.
*Not his real name & other details have been changed to protect the privacy of all those involved.