1. Talking and Really Listening – Taking
an Innovative Approach to Large
Scale Change
Tricia Boyle & Nicola Harkins
Organisational Development
Department
NHS Fife

2. Aims for the Session
• Explore when to use dialogue techniques for
achieving service change
• Outline three fundamental dialogue concepts
• NHS Fife examples explained
• Questions and Answers

3. Why use Dialogue Methodologies?
• Complex issue which is also important
• Project management or hierarchy processes have not
delivered positive results
• No obvious single solution
• Service delivered through interconnected roles/functions
all need to be bought in
• No clear lines of authority
• Need to increase understanding of all perspectives including
the customer/patient, before they will commit
• So that all voices involved can be heard and acted on

4. Monologue to Generative Conversation
Generative dialogue
Conception
Dialogue
Pool of water
Skilful conversation
Ploughing a field
Discussion
Table tennis
Debate
Monologue
Beating down
Solo voice
Adapted from W. Isaacs

5. Dialogue Actions & Intentions
Advocacy
Inquiry
Adapted from D Kantor “Four Player Model”

6. Fields of Conversation
Flow (rule generation) Inquiry (rule inquiry)
IV III
Generate new possibilities Self inquiry into assumptions
Collective intelligence Awareness of how we impact
The whole is greater than the on each other
sum of the parts
Acceptance of social norms Power contest
Clarifying power/positions in Power positions emerge
the room
Politeness (rule following) Breakdown (rule revealing)
I II
Adapted from C Otto Scharmer 1988

7. ISAAC, W. N. (1999) Dialogic Leadership. The Systems Thinker; Vol. 10 No. 1 Pages 1-5
PHILIPS, M.E. & HUZZARD T (2007) Developmental magic? Two takes on a dialogue conference. Journal of
Organizational Change Management Vol. 20 No. 1 Pages 8-25
DAVID, B. (1996) On Dialogue. Routledge, ISBN 0-415-14912-6
HILL, S.; HARE, U. & BALL, J. (2004) We’ve all come together as one – prisoners, staff and managers: Prison
Dialogue as a means of facilitating patient/public involvement and implementing new standards in prison
healthcare. Prison Service Journal No. 151 Pages 30-35
ISSACS, W. (1999) Dialogue and the Art of Thinking Together. Doubleday
SENGE, P., et al (2004) Presence. SoL, ISBN 0-9742390-1-1
WHEATLEY, M. (2002) Turning to One Another. Berrett-Koehler Publishers Inc, ISBN 1-57675-145-7
RIDINGS, A. (2011) Pause for Breath: Bringing the practices of mindfulness and dialogue to leadership
conversations. Live It Publishing, ISBN-13: 978-1906954239
KANTOR, D. (2012) Reading the Room: Group Dynamics for Coaches and Leaders. Jossey-Bass,
ISBN-13: 978-0470903438
FRIEDMAN, M.S. (2002) Martin Buber: The Life of Dialogue. Routledge, ISBN-13: 978-0415284752