February 4 - 9, 2018 |  Camp Allen, Navasota, TX


Course Directors: Kathy McGrail, MD and Marla Rowe Gorosh, MD

Winter Course is reserved for ACH Faculty, FITs, RCFs, and guests (typically those interested in the RCF or FIT program) to spend time in intensive communication skills training and personal awareness development in a retreat-like setting.

We went into healthcare with the goal of helping people and doing good in the world-  and we have learned, that in addition to the incredible importance of interpersonal and communication skills in the provider- patient relationship, the power and influence health care providers have in support of our patients and colleagues.  We have an opportunity to expand our awareness and actions by exploring injustice that affects the healthcare system, and fortifying our voice and actions.

Most of us believe, or at least hope, that we, as individual, ethical practitioners, are not biased in our treatment of patients.  But research tells us that belief is most often ill founded, that our interactions with patients activate all sorts of stereotypes and bias without our consent.  And once activated, despite our hopes and beliefs to the contrary, those biases affect our interactions and their outcomes in adverse ways.

In addition to interpersonal, unconscious bias, we practice, work and teach in systems that are themselves structurally biased, providing better care to some patients than to others, better opportunities to some learners, colleagues, and staff than others.

As our understanding of racism in healthcare grows and our understanding of health and healthcare disparities exapnds, we are left wanting and hoping to do better, and wondering how to do that.  But it is often said in QI circles, that “hope is not a strategy.”

Racial justice work in any setting requires that we look deeply at ourselves and that we learn what we are doing that undermines racial equity and justice, and that we look at the context in which we work and live for elements of institutional racism that might lie within our spheres of influence.

Though hope is not a strategy, Virginia Safford in her Inner Life of Rebellion says this:

“Our mission is to plant ourselves at the gates of hope —a very different, sometimes very lonely place, the place of truth-telling, about your own soul first of all and its condition, the place of resistance and defiance, the piece of ground from which you see the world both as it is and as it could be, as it might be, as it will be; the place from which you glimpse not only struggle, but joy in the struggle — and we stand there, beckoning and calling, telling people what we are seeing, asking people what they see.”

So, what does racial justice and healthcare equity work look like for us as healthcare educators, practitioners and leaders in relationship centered communication? This is the central work of this winter course.  It is not easy work, but you have asked to move forward with it. And so, this week, we will stand there “at the gates of hope”, and we will beckon, call, ask and tell until we can together find our way forward.

By the end of the course participants will be able to:

1. Define and demonstrate shared equity concepts and vocabulary
2. Articulate the specific values and skills we bring to equity work
3. Understand, and identify where and how, unconscious bias and institutional bias manifests itself in ourselves, our workplaces and ACH
4. Identify the manifestations of racism- power and privilege (and other “isms”) in our lives and work and collective life and use that to name our personal and collective equity goals
5. Identify actions we can take and specific skills we need to strengthen, as clinicians, teachers, mentors and colleagues, to move forward in our personal and organizational equity journeys

Key Learning Activities
  • Skills Training:
    FIT Skills-
    In a series of skills sessions, FITs learn, practice, and receive feedback on essential communication skills.  Past skills sessions have focused on group facilitation challenges, giving/receiving feedback, diversity, and role play.
    Faculty Skills- A faculty needs assessment revealed the skills in highest demand by our current and recently engaged faculty.  Based on the results, the inaugural Faculty Skills Sessions at Winter Course in 2017 consisted of "How to Improve Your Ability to Engage with Conflict."
    RCF Training-  RCFs receive intensive training in fundamental communication skills and setting up / running / debriefing straightforward role plays, in preparation for co-facilitating RCC workshop groups at ENRICH.  They attend the RCF training sessions and large group sessions, but do not participate in personal awareness groups or workshops.
  • Personal Awareness Groups (Domain #4 of FIT program)- FITs and faculty are placed in small groups (usually < 10 people) led by facilitation professionals, each with unique styles and approaches to personal awareness.  Styles may include Matrix Leadership, Diversity, Rogerian, Family of Origin, Anima Learning, etc.  The purpose of personal awareness groups is to: provide a learner-centered environment where participants can set personal learning goals related to interpersonal & communication skills, personal awareness and development, and reflection. Additionally, participants have the opportunity to practice challenging communication scenarios and receive feedback and coaching.
  • ​Workshop Content & Development (Domain #2 of FIT program)- FITs have an opportunity to work alongside AACH faculty in the development and delivery of a single workshop session to their FIT and faculty peers.  This provides a venue to "test run" a potential workshop in a safe environment and receive constructive feedback, to share about an emerging topic of interest, and can also serve as a venue for attaining EPAs in the workshop domain of the FIT program.  Samples of recent Winter Course workshops include: Mentoring for the 21st Century: Developing skills in mentoring across differences, Measurement in the Service of Compassion: RCC, Healthcare Disparities and Data, Exploring Cognitive Biases through Poetry and Visual Art, Making Role-Play Exercises Fun and Effective: Advanced Role-Play Techniques Addressing Communication Skills Training Challenges, etc.
  • Facilitated Large Group Sessions- All Winter Course participants attend large group sessions led by the same professional facilitators of the small personal awareness groups. Large group sessions provide the opportunity to learn more about timely themes within healthcare communication in a group activity-based format rather than a keynote didactic format.  Themes vary from year to year, but recent courses have focused on: diversity, vulnerability and imperfection, personal and organizational change, etc.
2018 Winter Course Planning Committee

Course Directors:
Kathy McGrail, MD
Marla Rowe Gorosh, MD, Henry Ford Health System

Committee Members:
Julie Crosson, MD, Boston University/Dorchester House
Sally Forter, MD, University of New Mexico
Erum Jadoon, MD, Mayo Scottsdale
Norm Jensen, MD, University of Wisconsin 
Ryan Laponis, MD, UCSF
Lynnea Mills, MD, UCSF
Kara Myers, CNM, MS, UCSF
Michael Nathan, MD, Massachusetts General Hospital and Harvard Medical School
Peter Weissmann, MD, Minneapolis VA Medical Center
Bronwyn Wilson, MS, ED, University of New Mexico