Ewan Kelly & Ken Donaldson

In order to enable transactional interactions to become transformative or therapeutic…… human and practice/ professional culture self Values Beliefs Enabling our attitudes and behaviours – move from our unconscious to our conscious Reflexive Self

VBRP Tool 1 – Three levels of seeing Observation without interpretation Questioning and curiosity Penny drops, making connections What do you see or notice? What causes you to wonder, or arouses your curiosity? What do you realise or perceive?

Three Ways of Seeing 1st Level of seeing What do you see or notice: in the other, within yourself and in the interaction Observing without interpretation. Not judging or seeking to fix.

Three Levels of Seeing 2nd Level of Seeing What does it cause you to wonder about or arouses your curiosity? Questioning, turning things over in your mind

Three Ways of Seeing 3rd level of seeing What do you realise or perceive? The moment when the penny drops make connections. An AH-HAH moment! A TOOL TO ENABLE THE UNCONSCIOUS TO BECOME MORE CONSCIOUS

VBRP TOOL 2 in our practice? Five Dimensions of Practice   N whose needs are being met or overlooked by our practice? A what abilities/capabilities are at work in our practice? V whose voices are being heard/silenced , included/excluded from our practice? V what and who is being valued/undervalued/overvalued in our practice? Y what does this situation reveal about you, me and us as practitioners

Dr Ken Donaldson Deputy Medical Director NHS Dumfries and Galloway

Case History William (Bill) 89 years old Lives with his wife Carers 2x day ‘Mild’ dementia Diabetes High Blood Pressure Heart Disease

Over the course of 2 weeks Ultrasound Scan 2 Ct scans Gastroscopy Colonoscopy Blood tests every day Regular physio

Betty

“Our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality.” Atul Gawande

How do we learn?

NAVVY N – whose Needs are being met? A – what Abilities are at work in our practice? V – whose Voices are being heard/silenced? V – what and who is being Valued? Y – what does this reveal about You?