Learning Groups
A significant portion of the ENRICH course is dedicated to learning group time, in which attendees interact in small groups facilitated by ACH faculty, and work on communication skills and awareness of interpersonal interactions.  Attendees remain in the same learning group for the entire course, so relationships are formed and the presence of each member is important to the cohesion of the group.  Missing sessions or leaving early take away from an individual's experience at the course, and also impact the experience of other group members.  For this reason, all attendees are strongly encouraged to attend and fully participate in all sessions for the entire course.  
The goal of these learning groups is to provide a learner-centered venue where each participant will clarify her/his own learning goals in interpersonal and communication skills, personal awareness, and reflection. Trained ACH facilitators and fellow group participants will collaborate to fashion exercises that will help accomplish those goals. These goals may involve enhancing one’s relationships with patients, colleagues, or other team members; processing challenging relationships with patients or colleagues and formulating approaches for further management; or, for intact teams that may come to the course, understanding and improving the team‐building process and team function. These groups have low faculty to learner ratios and present a unique opportunity to address challenging communication scenarios, to practice skills learned in course workshops, and to receive feedback from faculty and peers.  In the learning groups, learner safety is key to support learning. 
We offer several options for personal awareness learning, so that you may choose one that meets your learning needs and style.  A basic description of each learning group is provided below.
For first-time attendees to ENRICH, we recommend the integrated groups, since these are the most flexible, adaptable, and fundamental groups we offer. Groups of people from the same organization should register for the 'intact team' groups (minimum 5 participants).

 Integrated groups combine exploration of personal awareness and skills learning.  Collaborative work within gthis group is built on the working assumption that personal awareness issues are best addressed in the context of daily work, rather than at specified times in a curriculum. 

Participants find this framework helpful when navigating any number of professional challenges. For example, participants may choose to address personal challenges experienced during the medical interview, as well as broader communication dilemmas that may include difficult conversations with patients, colleagues and among teams. Facilitators and members of the Integrated Group work collaboratively to support the learning goals of each participant by identifying applicable skills tools and encouraging further “practice” using discussion and role play. The Integrated Group offers a flexible platform for participants to explore their learning goals and utilizes diverse approaches to addressing participants’ individual learning styles.  ACH integrated groups are typically composed of about 7 course participants, a faculty facilitator, and up to 2 co-facilitators.
What will you do and learn? Who should be in this type of group?

Participants will bring coaching dilemmas and the group will provide the opportunity to practice skills identified in the workshop or reflect on how these challenges impact them personally. The group may select to use a case-based approach to facilitate exploration of both the coach’s and coachee’s personal reactions.

Roles: Anyone with direct reports who is charged with developing their staff. And/or anyone who is charged with coaching others to improve performance.

Interests/goals: To enhance coaching effectiveness by infusing empathy into one’s coaching interactions. To practice an evidence-based approach to coaching through building relationships.  



Why pursue personal awareness?
Personal awareness (PA) is central to effective teaching and clinical practice. Self‐reflection is the basis of both personal growth and practice improvement. Clinicians solve problems by applying learning from previous experiences to current clinical dilemmas “automatically,” without conscious direction of thought. We know little about whether the same process occurs when we face relational, psychosocial or affective dilemmas. Feelings evoked by work with patients and students are among the most intimate and exhilarating or difficult that people face. We are all aware of barriers to self‐reflection, such as time pressures, predominance of the biomedical model, physicians’ and educators need for compartmentalization for survival, and burnout. It is becoming increasingly clear that if we leave feelings unexamined, they can become additional barriers to effective patient care or to competent teaching. One cornerstone of professionalism is to integrate our affective experiences in order to foster personal learning with subsequent benefits to our patients and students. Few chances for this kind of exploration and integration exist in traditional medical education.
Learning groups are opportunities for conversation about meaningful events (either from work at home with patients and students or from events within the course), and the effect of the feelings these events evoke on the work of health care provision, teaching, job satisfaction, and learning within the course. All ACH learning groups use as their essential model the teachings of Carl Rogers (widely recognized as the founder of the person‐centered approach, the basis of many applications in education, group/organizational
work, and counseling) and follow three group principles to create trust and safety that support personal discussion:

1. The conversation of the group remains confidential ‐ what is said in the group should remain within the group
2. Each participant decides how much or how little to say, and says as much or as little as s/he wishes
3. Each participant speaks for him/herself, not for others