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Organizational Role Analysis by telephone: the client I met only once. - Dr. Rose Redding Mersky
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The Organizational Role Analysis Approach.
Description Coaching In Depth introduces the reader to the management consultancy technique of Organizational Role Analysis ORA ; a technique with the immensely practical purpose of helping managers to stay "in role and on task". The ORA method is grounded in a process of consultation that derives from the conjunction of open systems theory and psychodynamic understandings of human behaviour. The Best Books of Check out the top books of the year on our page Best Books of Groups are not simply clusters of people, working together towards a single end.
Instead, they are complex entities with their own histories as well as emotional dynamics that ebb and flow, at times predictably, but often in ways that seem profoundly unpredictable, and even irrational.
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In the last few decades there has been an increasing awareness in clinical education of socio-cultural learning theories [ 8 ], and how being part of a group has a strong effect on personal and professional identity development. And, specifically, the way in which groups tend to instinctively collude to avoid learning, because of the threat this change represents to the status quo [ 9 ].
Our focus in working with trainee doctors, therefore, had been to help them develop a deeper understanding of group process, and in so doing help them begin to develop a personal guide to the way that unconscious, group processes can have such a profound effect on their clinical work as doctors and as members of their NHS organisations.
There are many theories one could draw upon, in order to help clinicians to begin to develop this personal guide to group processes [ 10 - 13 ] and there are numerous postgraduate programmes which could last for years, focusing on this very issue alone. In summary, Bion noticed that every group has a task that they consciously strive to fulfill. For instance, on a hospital ward, the clinical team has the task of treating and caring for the patients on that ward and when they are engaged in this task, they are in work group mode.
In this mode, a group will be able to observe itself and reflect on what is going on. For example, we might all recognise a situation where we have been part of a group, set with a task that all members agree upon, but which makes little or no progress in achieving it. In the basic assumption mode, the group acts as one organism. It is as if the individual and an external reality outside the group do not exist; all that exists is the group, and its processes.
Bion identified three different basic assumptions: When this basic assumption is in ascendance, the group becomes fixated on the actions of one member-the designated leader. When this dependency mentality dominates, the designated group leader might feel energised, but simultaneously frustrated at the sluggishness of his or her fellow group members. An example might be when a clinical team meets for the purpose of discussing a potential change in how a fracture clinic is run.
In pairing mode, the two people who are joined find themselves engaging with one another, agreeing or arguing, while the rest of the group become silent and hopeful spectators. In our example of the clinical team, meeting to discuss re-organisation of the fracture clinic, an example of pairing would be a lively discussion occurring between a nurse and a doctor, about the way bookings need to be changed so to better regulate high-need versus low-need patients.
As the two clinicians talk, the group is filled with an air of hopeful expectation that they will provide the solution to the problem. Occasionally, a group itself can split into two, with the basic assumptions being assigned to one sub-group, whilst the other functions as the work-group. The important point is that basic assumptions operate unconsciously, so that the group mentality gets enacted without conscious awareness on the part of group members.
Our experience of working with students on a postgraduate module on change and leadership, however, showed that they found it resonated with their experience of working within their teams and helped explain why things happened in particular ways. We required the doctors on the postgraduate module described above to devise and conduct a service improvement project, over a 4 month period.
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The assignment for the module comprised a write up of what occurred, including a reflection on how they operated as leaders of the clinical changes they championed. In so doing, clinicians became more aware of how they actually operated inside their own team and departments as well as their role within the complex system of the NHS. During this module, one trainee doctor focused his improvement project on the impact of near peer teaching organised by junior doctors for final year medical students.
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In the process of leading this project he encountered the problem of keeping all the other junior doctors fully involved and contributing to the design and implementation of an improved teaching programme. The following excerpt shows how he framed this emerging new understanding of the group he was working in and leading. They [other group members] also tended not to ask to take on any more roles but would wait each week for us to tell them what to do and to provide material.