Henry Larsen

The Quality of Conversations in Participatory Innovation

In co-design there seems to be a widespread understanding that innovation is a planned, goal-oriented activity that can be propelled forward through well-facilitated events in which company employees collaborate with external parties (users in particular) and the conversations aim at consensus about new product and service ideas. Conflict belonged to the ‘old days’ when participatory design played a part in the struggle between workers and management. Based on the theory of complex responsive processes of relating, we suggest a new way of understanding innovation as the emergence of new meaning in – often conflictual – conversations. We argue that the meeting of participants with different stakes is crucial precisely because crossing intentions can create new insight and movement of thought and action. We use improvised theatre to investigate what happens in industrial (and other) organisations that embark on participatory activities, and the barriers that prevent them. By analysing improvised scenes and the way the audience reacts, we characterise the quality of conversations that seems to allow new meaning to emerge and thus stimulates innovation. We suggest that we need to develop new formats of collaboration for large, complex contingents of stakeholders, where conflicting intentions are encouraged.

Innovation as improvisation 'in the shadow'

In this article, we explore processes of innovation – which are inherently uncertain – from a complexity perspective, in which they are understood as new patterns of experiences as they emerge in human conversational interaction. We reflect on local interactions between people involved in emerging processes of innovation, with a particular emphasis on the improvisational nature of interaction. Through an abductive approach, by iterating actual experiences and our understanding of them, we show that such processes are collective efforts that take place as informal, highly improvised conversations — happening ‘below the radar’ — which may unpredictably offer windows of opportunity to enable change. We show that innovation often emerges as ‘shadow themes’, experienced as subversive by those involved in the moments of interaction. While these themes are embedded in informal conversations and processes, they can be induced by invitations – conscious or unconscious moves that encourage those involved to make spontaneous moves together in a mutually improvised context. Our experience shows that the emergence of shadow themes can have a long‐term impact on the organization and the people involved, and that managers may be ‘in charge but not in control’ of such innovation processes.

Improvising in the vulnerable encounter: Using improvised participatory theatre in change for healthcare practice

Healthcare practitioners are often presented with vulnerable encounters where their professional experience is insufficient when dealing with patients who suffer from illnesses such as chronic pain. How can one otherwise understand chronic pain and develop practices whereby medical healthcare practitioners can experience alternative ways of doing their practice? This essay describes how a group of researchers have, over a number of years, developed improvised participatory theatre as a means of engaging healthcare practitioners, patients and other lay people in situations where it is legitimate to reappraise their practice and reunderstand the nature of an illness such as chronic pain. One conclusion was to consider that it is a relational rather than an individual phenomenon that in turn demands alternative practice. Through iterative workshop processes of improvised theatre, participants are encouraged to experience the vulnerable, the unknown, and the need to be alternatively present when dealing with patients whose situation is imbued with suffering.

How participatory action research changed our view of the challenges of shared decision-making training

OBJECTIVE This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training. METHODS Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre workshops, (2) a pilot study of an SDM training module involving questionnaires and evaluation meetings, and (3) three reflection workshops. RESULTS The PAR process revealed that health professionals often struggled with addressing existential issues such as concerns about life, relationships, meaning, and ability to lead responsive dialogue. Following the PAR process, a communication programme that included communication on existential issues and coaching was drafted. CONCLUSION By involving multiple stakeholders in a comprehensive PAR process, valuable communication skills addressing a broader understanding of SDM were identified. A communication programme aimed to enhance skills in a mindful and responsive clinical dialogue on the expectations, values, and hopes of patients and their relatives was drafted. PRACTICAL IMPLICATIONS Before integrating new communication concepts such as SDM in communication training, research methods such as PAR can be used to improve understanding and identify the needs and priorities of both patients and health professionals.