Transcript Clip 7: Impactful Closings

From: Power Up Your Teaching of Communication Skills with Techniques for Business and Performing Arts – Richard Snyder

Let’s switch gears. You’re now at the end of your teaching session. I could have been any mix of the four flavors: Didactics, Scripting, Simulation and Performance. No matter what it was, you want our students to use what they learned. Impactful closings help make this happen.

There are three elements:

1. Establish a Focus Point.
2. Set up an after class practice.
3. Have a Good Finish to the class.

The focus point addresses cognitive overload. At the end of a learning session, you student has done many new things. They are like our ski student who has just finished a lesson with 20 new pointers. How will he remember to do any of them the next time he’s out on the hill? The cognitive overload needs to be addressed. In skiing, the instructor gives the student a “focus point,” the one action to remember to do. The one thing I need to remember is keep my hands where I can see them ,the rest will follow. In a communication class, the focus point is the answer to the question, “What is one thing you want to take you want to take from today?”

**Let’s do this one. Please turn to your neighbor and share one thing you want to remember from this talk. Thank you.

After the 1st element, your students have their focus points. Now, how will they to remember to do them instead of old habits?

This is where the second element comes in. Set up an after class practice.

The most common method is diffusion. You assume that the class itself was sufficient and there is no specific after class practice. Almost every communication class ends this way and it works pretty well, especially if the learners were engaged.

A more “deliberate practice” would be Self Directed plan. You simply ask the students to share with the group a once-a-day method they would use to remember their focus point. Odds are that a group of healthcare professionals will already be using a lot of successful techniques to remember to do things. You could up the ante by asking them to send you an email at the end of every day for a week to report on their practice. Commitment to send emails does concentrate the mind. Receiving these emails is also very informative and gratifying for you as the teacher.

An even more “deliberate practice” would be a Tiny Habits, a technique created by BJ Fogg, the director of the Stanford Persuasion Lab. He and his colleagues are in the business of helping businesses change our behavior. He took the same underlying principles and created the life hack, Tiny Habits. In Tiny Habits, we change our behaviors.

It’s a very specific methodology. If you’re as passionate about the potential for tool as I am, you can go to his website and learn the details. Here’s the 20,000 foot view in my language. It’s Four T’s: Tinyfy, Trigger, Train and Triumph.

Step #1: Tinyfication: Pick a small step toward your goal that is so tiny as to seem ridiculuous. For example, if my behavior goal was to be big and commanding when I want to assume leadership, my tiny step would be to assume a big posture for 1 second once a day.

Step 2: Trigger: Choose a spot in your existing routine where it would fit. One of my routines is brushing my teeth. I can fit it in there.

Step 3: Train it. My training regimen is “after I brush my teeth, I will assume a big posture for 1 second.” Then I do it for 5 days or however long I want.

Step 4: Triumph: Do a celebration. Dr. Fogg suggests this celebration. “Awesome !” Let’s practice that one. “Awesome !”

Believe it or not, the odds of this translating to my leadership goal is greater than trying to remember it in the heat of the moment. This may seem a little “too easy,” and “self helpy,” but remember, it shares the same principles used by Facebook and Uber to get you to do things.

How can you Dr. Fogg’s technology in your class? It is easier to use than you might think. You don’t need to re-invent this wheel. You and your students can take your focus point to his on going web sessions at It’s free, it’s fun, and it takes about 10 minutes every day for 5 days. You can get as deep into the technique as you want via upper level classes.

There’s a lot of choices for after class practices.

The third element for your impactful closing is a good finish. A popular way to do this in Performance inspired business trainings is to do appreciations. These don’t need to be heavy. You can just express your appreciation for the work they did. If it feels appropriate, you can ask them to share appreciations for each other.

*Let’s try this one out. “Please share an appreciation you have for your partner’s work today.”

After appreciations it is customary to do a final activity. We will do one in a moment.

Let’s review where we have been today. We have been talking about powering up our teaching of ACGME communication skills. We talked about how all communication classes are mixtures of the four flavors: Didatics, Scripting, Role Play/Simulation and Performance Practice. Then we went over engaging openings and impactful closings which will power up any of those sessions. And we talked about a novel curriculum in the Performance Practice category, Medical Improv.

Let’s go back to my interaction with that patient’s sister. In 1988, there were no teachings for us on communication. There were no lectures, no role play and certainly no sessions like Medical Improv. What would it have been like if I had taken a class on then how to deliver bad news? What would it have like if that class used engaging openings and impactful closings so that I remembered to use it even in that difficult situation? What would it have been like if I had taken Medical Improv and was comfortable being authentic even when something terrible had happened?

Close your eyes. Imagine teaching your own class. The students have just arrived and are tapping away at their cell phones waiting for something to happen. You start the class with even just one engaging opening technique and you see a room go from uncertainty to enthusiasm. Fast forward to the end of the class and you’re sitting in a circle with the students. You use even just one impactful closing and you are confident that they will use what they learned. Imagine that you have collaborated with an Improv professional and you’re having the time of your life team teaching Medical Improv. A few months later, a colleague pulls you aside and tells you, there’s something remarkable about your students. They really know how to connect people. Take a deep breath and open your eyes.

I want to express my appreciation to Dr. Gaba and Sandi Feaster for inviting me to be here today and to you all for your work, especially the Game of Thrones exercise. I look forward to hearing your questions and comments.

Now let’s do a final activity. We are going to do a simultaneous single clap. It might end up not being so simultaneous, but it will be cool no matter what. The third try will be the final one and will signify that we are done !

<<Clap, clap, clap !>> see video on how to do this.