On meetings: Thoughts of an introverted leader in health care

Dr. Laura Sauve

When there are 15 people around the table, I rarely put my hand up or get a word into the conversation. As an introvert, I have often reflected on the critical challenge of how to meaningfully engage all voices. Then, approximately one year into the pandemic, I had the opportunity to bring together operational and medical leaders to reflect on how they had experienced the support given by infection control, and how to improve support in future outbreaks.

Given the timing, it was online only, and we used a structured meeting facilitation technique along with a graphic recorder to understand important insights that helped our team provide enhanced support in the subsequent waves.

We used small breakout groups and “W3” – “what, so what, now what?” to have people describe their observations, discuss the patterns or synthesis that they appreciated, and finally, their recommendations for the future. Smaller breakout groups allowed for engaging the thoughts of quieter participants, while targeted questions posed to the whole group let people describe what they had experienced, and build on other participant feedback to consider future solutions. Visuals produced by the graphic recorder as we talked helped further the engagement.

When we gather to solve challenges in paediatric health, it is imperative to create an environment where every individual feels empowered to contribute, regardless of their comfort level with speaking in large groups or their position of power or privilege. This commitment is not merely a matter of effective collaboration; it is a fundamental component of our efforts to be inclusive and actively anti-racist in all the work we do at the Canadian Paediatric Society. To best meet the needs of children who face the most barriers to care, we need to consider voices that may be quieter. Outcomes are often better when many perspectives have a chance to be heard.

An effective way to foster this inclusive environment, especially in situations marked by power differentials, is to use structured facilitation strategies (Liberating Structures is one example that has worked well in my experience). It is always a fascinating and rewarding process to draw out the quietest and most hesitant voices in the room, ensuring their perspectives are heard and valued. I have found that these tools work nearly as well in a virtual environment as they do in-person.

As Susan Cain discusses in her book Quiet, the importance of adequate time for listening and reflection is important for introverts at the table. Also important is being able to contribute in ways that don’t require jumping into group discussion.

In large group settings, I can freeze or clam up – but if given the opportunity to listen to others, read relevant materials, and reflect on the information presented, I can formulate contributions that are both relevant and insightful. I strongly suspect I am not the only one. The quieter voices may not be the first to speak, but their carefully considered insights are invaluable and can be lost if we do not create the space for them to emerge.

This need for thoughtful, inclusive communication has never been more urgent. We are navigating a confluence of pressures in paediatric health: the pervasive and often negative impact of social media, mounting stressors on a strained healthcare system, and worsening gaps in health human resources, just to name a few.

As we work to devise creative solutions to these complex problems, it is crucial that everyone involved in the process is heard. For example, to address workforce shortages, we can encourage collaboration between groups that may not typically work together: operational leaders and physicians, or community paediatricians and hospital-based subspecialists, or public health and medical providers.

I encourage all of us to actively seek out and implement methods to enable everyone’s meaningful contribution to critical conversations that will shape the future of our healthcare system. By championing these practices, we not only enhance the quality of our solutions but also affirm the value of every member of our professional community.

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