5 Facilitation
“Facilitation is the process of helping groups, or individuals to learn, find solutions, or reach consensus without imposing or dictating an outcome. Facilitation works to empower individuals or groups to learn for themselves or find their own answers to problems” (College of Health Disciplines, 2013).
Facilitation Structures
Facilitation is key to successful interprofessional education. The facilitation structure will depend on the pedagogical approach, available resources, and learning objectives. For example, problem-based learning involving the facilitator providing updated information to students throughout may require the continuous presence of a facilitator, whereas a simulation may require a facilitator for pre-brief and debrief. Facilitation may also change based on level of learning. When more guidance is required, having a facilitator continuously present may be helpful, whereas some groups function more naturally without constant supervision and facilitation. Different components of the IPE may use different facilitation structures. For example, a debrief may have a different facilitation structure than the core activity.
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Facilitation Type |
Design Considerations |
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Single Facilitator |
|
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Multiple Facilitators |
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| Roaming Facilitators |
|
Table 3: Table showing different facilitation types and associated considerations
Role of Facilitators
A facilitator of Interprofessional Education can be a faculty member, a health professional, a family member, or a community member (Abu-Rish et al., 2012). IPE facilitators are expected to alter their conventional teaching practices to embody interprofessional collaborative practices (Godden-Webster & Murphy, 2014). This includes working as an equal colleague and showing respect for others’ professional cultures and knowledge (Godden-Webster & Murphy, 2014).
This video provides a quick introduction to the role and some characteristics of IPE facilitators.
Despite the growing evidence of the importance of interprofessional education, a lack of importance is put on properly training IPE facilitators (Hayward et al., 2021). Hayward et al. (2021) identified that most facilitators learn how to facilitate IPE during IPE, receiving no prior training. Facilitators feel tired, strained on time, unprepared and unappreciated (Hayward et al., 2021; Freeman et al., 2010; Milot et al., 2017). Many are concerned with their abilities to begin and lead positive and respectful conversations between students in different professions (Milot et al., 2017).
Successful facilitator training programs included reviewing training materials, participating in a shortened IPE, shadowing experienced facilitators, role-modelling, group discussions on IPE learning objectives and qualities of a facilitator, debriefing, and filling out evaluation forms (Freeman et al., 2010; Milot et al., 2017; LeGros et al., 2015). Milot et al., (2017) recommends training begin by teaching future facilitators about IPE, then help them adopt a facilitator attitude, and then focus on skills about how to successfully lead interprofessional groups of students. IPE training should combine role-modelling, and an explanation of why facilitation techniques were used (Milot et al., 2017). Providing extra print resources can give facilitators something helpful to refer back to while they lead IPE to refresh their minds about their role and goals of the session (Milot et al., 2017).
Research has shown that training IPE facilitators beforehand leads to improved facilitator attitudes, student performance, confidence, sense of control, preparedness and comfort (Freeman et al., 2010; Milot et al., 2017; LeGros et al., 2015). Training promotes reflection on facilitators’ “own collaborative behaviour, with the overall goal of creating good relationships with team members” (Milot et al., 2017, p. 203). LeGros et al., (2015) discusses the importance of facilitators shifting from dualism (seeing their own profession as most important) to developing professional relativism, where they can see the value and roles of other healthcare professions. Part of this comes with helping facilitators recognize their perspectives about IPE, and any biases they may have (LeGros et al., 2015). IPE training provides facilitators with the opportunity to be empathetic and considerate of those from different backgrounds (Milot et al., 2017). If conversations in IPE promote stereotypes, facilitators need to feel confident to intervene (LeGros et al., 2015).
Training gave facilitators an opportunity to work through their concerns and fears, realizing others felt the same way (Freeman et al., 2010; Milot et al., 2017). Working with facilitators from other professions allowed them to form relationships to support one another during and after the program and become confident in asking and answering questions about the roles and responsibilities of their profession (Freeman et al., 2010). In training, participants can brainstorm new facilitation and communication strategies together to help students learn more effectively (Milot et al., 2017). Students reported that after training, their facilitators could successfully model interprofessional collaboration. Facilitators also report that the skills learned from their facilitator training would be beneficial for their own clinical practice (LeGros et al., 2015).
Facilitation Resources
Facilitation Training at Dalhousie: Nova Scotia Health Interprofessional Simulation Facilitation Course [NewTab]
Interprofessional Facilitation Handbook, University of Alberta [NewTab]
Competencies and Characteristics of Facilitators
Figure 7: Anatomy of an IPE facilitator. Figure content drawn from Auvine et al. (1978), Godden-Webster and Murphy (2014), Health Sciences Education and Research Commons (2018), LeGros et al. (2015), Maddock et al. (2022), and Milot et al. (2017).
Facilitators should be competent in four areas to successfully lead a group of interprofessional students: collaborative, interprofessional, and interactive learning; leadership; organization and group dynamics. This can be remembered by following the acronym C.L.O.G.
Collaborative, Interprofessional and Interactive Learning:
IPE facilitators should have experience in interprofessional, collaborative and interactive learning (Freeth et al., 2005; Reeves, 2016). They are responsible for promoting critical thinking, leading participants in reflective analysis of their learning experiences, and bridging theoretical discourse to practical and real-world applications (Godden-Webster & Murphy, 2014).
Leadership:
Facilitators should be competent in facilitating meaningful group interaction, role-modelling and providing constructive feedback (Freeth et al., 2005; Reeves, 2016; Godden-Webster & Murphy, 2014). Facilitators should have a collective disciplinary expertise and help learners to express their professional views (Van Diggele et al., 2020).
Facilitators introduce themselves and state both their roles, the roles of each student and establish ground rules (Godden-Webster & Murphy, 2014). Before each activity, they explain its purpose, timeframe, and provide clear instructions to help students succeed (Godden-Webster & Murphy, 2014). Facilitators keep the conversation organized by asking students to explain potential jargon, and encourage tangents to be discussed at a later time if they occur (Godden-Webster & Murphy, 2014).
Group Dynamics:
IPE facilitators should be competent in fostering a culture of mutual respect that utilizes professional differences within the IPE group, creates an inclusive and supportive learning environment, and promotes interpersonal relationships among participants (Freeth et al., 2005; Reeves, 2016; Godden-Webster & Murphy, 2014). The facilitator is aware of and interprets verbal and non-verbal cues of participants, and ensures different disciplinary perspectives are considered (Godden-Webster & Murphy, 2014). They guide discussions and practice active listening (Health Sciences Education and Research Commons, 2018). Facilitators encourage students to explore beyond their own professional perspectives, promoting resilience when interprofessional challenges, tension or stagnation arise (Godden-Webster & Murphy, 2014). Facilitators need to identify and negotiate possible barriers and tensions, especially regarding status, hierarchy, and differing professional philosophies (Howkins & Bray, 2008).
Facilitator experiences, preparation, ongoing support, and co-facilitation, also contribute to IPE facilitation (Reeves et al., 2016). Experienced facilitators guide the debriefing process, prompting individual reflection, engaging participants, and helping integrate the theoretical and simulation components coherently (Maddock et al., 2022).
A facilitator…
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Is |
Is not |
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An Expert in IPE Facilitation |
An Expert in Every Discipline |
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A Guide |
A sage |
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A Facilitator for Discussion/ Practice |
A Lecturer |
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An Inquirer or Reviewer |
Directive |
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A Mediator |
The authority |
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A Supporter |
Imposing |
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Encouraging |
Disparaging |
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Reflective |
A Guest |
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Calm |
A Stressor |
Table 4: Characteristics that should, and should not describe an IPE facilitator. Table content drawn from the works of Auvine et al., (1978).
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Do |
Do not |
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Be aware of nonverbal communication |
Impose a solution on the group |
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Be explicit and clear |
Downplay people’s ideas |
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Set ground rules at the beginning of the session |
Push personal agendas as the right answer |
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Respond to challenging people |
Dominate the group |
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Ensure equal participation |
Make up an answer |
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Make full use of their Co-Facilitator (if applicable)
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Tell too much about their personal experience and life |
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Be ready to encounter disagreement that arises due to the collaboration process |
Present their own disciplinary perspective |
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Be attuned to group and interdisciplinary dynamics |
Let technology take over |
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Deal with emotion & conflict
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Trust their biases |
Table 5: Dos and Do nots of an IPE facilitator. Table content drawn from the works of Auvine et al., (1978).
Approaches to Facilitation
Different facilitation approaches can be used in Interprofessional Education (IPE). These approaches encompass learner and teacher-centric approaches, shared reflection, delivery of effective instruction before and feedback after IPE, exploration of diverse knowledge domains and professional responsibilities, and enthusiasm, humor, and empathy (Reeves et al., 2016).
A critical competency of an interprofessional facilitator is the capacity to recognize and magnify the moments of learning to guide participants toward common ground, usually resulting in an integrated patient care plan (Reeves et al., 2016). Providing facilitators with interprofessional training can lead to positive outcomes and eliminate stereotypes and negative perceptions about other professions (Kent et al., 2017).
- Manage logistics to support scheduling and usage of suitable spaces (Long et al., 2014).
- Ensure facilitators are knowledgeable about interactive methodologies, group dynamics, and the principles of mutual respect (Reeves, 2016).
- Ensure content is interactive, applicable, and relevant to clinical practice (College of Health Disciplines, 2013).
- Include prior preparation such as e-learning modules or quizzes that are interactive to enhance understanding in IPE (Shelvey et al., 2016).
- Provide important information about the activity before it begins (Godden-Webster & Murphy, 2014).
- Incorporate different disciplines of professionals throughout the implementation process (College of Health Disciplines, 2013).
Facilitation Barriers
- Students are not matched by levels of skills and experience (Abu-Rish et al., 2012).
- Limited faculty and staff are available to support implementation (Abu-Rish et al., 2012).
- The timeframe for educational experience is too brief (Pitout et al., 2022).
- Uneven participation rates among different professions (Hill et al., 2019).
- Participants have limited understanding of professional roles (Olson & Bialocerkowski, 2014).
- Historic interprofessional rivalries (Conroy, 2019).
- Lack of technical competence for online participation (McLoughlin et al., 2017).
- Instructions of activity not explained in a clear manner (College of Health Disciplines, 2013).
- Using language specific to one profession (College of Health Disciplines, 2013).
- Behaviours that suggest blame, criticism, unfriendliness, and minimal effort (Doornebosch et al, 2022).
For information about debriefing, visit the section on Debriefing and Prebriefing [NewTab].
Different types of facilitation may be used during a debrief. The benefits and challenges of different types of facilitation are summarized below.
Effective facilitation helps to promote psychological safety during the debrief (Lackie et al., 2022). Challenging situations may arise during debriefing. For strategies to navigate these situations, facilitators may wish to consult the following tool describing strategies for challenging situations.
Resources for Facilitating Simulation:
Paper that discusses dealing with common challenges in debriefing (Grant et al., 2018).
