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Collaborative Problem Solving (CPS) – Certified Tier 1 Training

The CPS approach focuses on building helping relationships and teaching at-risk kids the skills they need to succeed across a variety of different settings. It is a strengths-based, neurobiologically-grounded approach that provides concrete guideposts so as to operationalize trauma-informed care and empower youth and family voice.  

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Description

Collaborative Problem Solving is an evidence-based approach to understanding and helping children and adolescents with a wide range of social, emotional, and behavioural challenges.  

Participants learn to advance their skills in applying the model through a combination of didactic lectures, role-playing, videotape examples, case presentations, and breakout groups with topics of specific interest to clinicians and educators. Participants receive personal attention and individualized feedback during breakout sessions from Think:Kids trainers while also benefiting from opportunities for networking.   

Participants must attend all days to be considered for certification. Completion of the training is also a requirement of the professional certification program.  

Additional Topics Include:  

• Strategies for when a child refuses or has difficulty expressing his/her concerns.  
• Dealing with common resistances to the approach.  
• Troubleshooting other barriers to implementation in systems.  
• Integrating with other models (i.e. Positive Behavioural Supports).  
• Implementation in groups such as classrooms and transforming system-wide disciplinary policies.  

Learning Outcomes  

• Gain in-depth exposure to both the assessment and intervention components.  
• Practice drilling down to identify specific problems to be solved.  
• Practice identifying the specific cognitive skill deficits contributing to challenging behaviour.  
• Learn how to solve problems and train skills using the collaborative problem-solving process.  
• Practice indirect skills training with personalized feedback from trainers.  
• Develop the skills for troubleshooting Plan B.  

Who Should Attend   

This course is suitable for mental health front-line staff, clinicians and educators interested in becoming proficient in Collaborative Problem Solving.   

Course Dates & Format   

There are no scheduled dates for this course at this time, however in-service is available.

This is a 14-hour training. This course is delivered virtually over 4 half days. Attendance is required each day.   

Instructors:    

Michael Hone   

Since 1988, Michael Hone has worked in a variety of settings including child welfare, youth justice, education and child and youth mental health. Currently he is the Executive Director of a Children’s Mental Health Centre in Ottawa, Canada. Michael is one of 2 Master trainers in Canada for Collaborative Problem Solving and is involved with the Advisory Council of Think:Kids at Massachusetts General Hospital. Michael has been committed to implementing the Collaborative Problem Solving (CPS) approach across Ontario, and to date has trained approximately 8,000 people in Ontario.  

Natasha Tatartcheff-Quesnel  

Natasha has worked in child and adolescent services since 1991 in a variety of settings including residential services, secure treatment, youth justice, education, substance abuse, child and youth mental health, as well as in the private sector. She is a bilingual Certified Master Trainer and Consultant for Think:Kids and completed her fellowship for her Master’s in Social Work at Think:Kids in the department of Psychiatry at Massachusetts General Hospital. She is committed to implementing the CPS approach in Canada and the United States and has trained and provided implementation support to numerous sites. She has also reviewed child and youth mental health systems internationally using the SOCPR and presented on the topic at numerous conferences.  

Training Fee  

Group Registration: Save 20% off individual fees with a group registration of 4 or more participants. Download the group registration form   HERE .

Continuing Education Information   

Continuing education credits are offered at no extra cost through Think:Kids, Massachusetts General Hospital Department of Psychiatry.  

Licensing boards and professional organizations will grant Continuing Education credits for attendance at their discretion when participants submit the course outline and certificate.    

In-Service   

This is available as an in-person or virtual in-service training and customized to suit your needs.  

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Parenting, teaching and treating challenging kids: the collaborative problem solving approach.

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Think:Kids and the Department of Psychiatry at Massachusetts General Hospital are pleased to offer an online training program featuring Dr. J. Stuart Ablon. This introductory training provides a foundation for professionals and parents interested in learning the evidence-based approach to understanding and helping children and adolescents with behavioral challenges called Collaborative Problem Solving (CPS). This online training serves as the prerequisite for our professional intensive training.

The CPS approach provides a way of understanding and helping kids who struggle with behavioral challenges. Challenging behavior is thought of as willful and goal oriented which has led to approaches that focus on motivating better behavior using reward and punishment programs. If you’ve tried these strategies and they haven’t worked, this online training is for you! At Think:Kids we have some very different ideas about why these kids struggle. Research over the past 30 years demonstrates that for the majority of these kids, their challenges result from a lack of crucial thinking skills when it comes to things like problem solving, frustration tolerance and flexibility. The CPS approach, therefore, focuses on helping adults teach the skills these children lack while resolving the chronic problems that tend to precipitate challenging behavior.

This training is designed to allow you to learn at your own pace. You must complete the modules sequentially, but you can take your time with the content as your schedule allows. Additional resources for each module provide you with the opportunity for further development. Discussion boards for each module allow you to discuss concepts and your own experiences with other participants. Faculty from the Think:Kids program monitor the boards and offer their point of view.

Registrants will have access to course materials from the date of their registration through the course expiration date.

All care Providers: $149 Due to COVID-19, we are offering this course at the reduced rate of $99 for a limited time.

NOTE: If you are paying for your registration via Purchase Order, please send the PO to [email protected] . Our customer service agent will respond with further instructions.

Cancellation Policy

Refunds will be issued for requests received within 10 business days of purchase, but an administrative fee of $35 will be deducted from your refund. No refunds will be made thereafter. Additionally, no refunds will be made for individuals who claim CME or credit, regardless of when they request a refund.

Through the duration of the course, the faculty moderator will respond to any clinical questions that are submitted to the interactive discussion board. The faculty moderator for this course will be:

J. Stuart Ablon, PhD

*** Please note that discussion boards are reviewed on a regular basis, and responses to all questions will be posted within one week of receipt. ***

Target Audience

This program is intended for: Parents, clinicians, educators, allied mental health professionals, and direct care staff.

Learning Objectives

At the end of this program, participants will be able to:

• Shift thinking and approach to foster positive relationships with children
• Reduce challenging behavior
• Foster proactive, rather than reactive interventions
• Teach skills related to self-regulation, communication and problem solving

MaMHCA, and its agent, MMCEP has been designated by the Board of Allied Mental Health and Human Service Professions to approve sponsors of continuing education for licensed mental health counselors in the Commonwealth of Massachusetts for licensure renewal, in accordance with the requirements of 262 CMR 3.00.

This program has been approved for 3.00 CE credit for Licensed Mental Health Counselors MaMHCA.

Authorization number: 17-0490

The Collaborative of NASW, Boston College, and Simmons College Schools of Social Work authorizes social work continuing education credits for courses, workshops, and educational programs that meet the criteria outlined in 258 CMR of the Massachusetts Board of Registration of Social Workers

This program has been approved for 3.00 Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. Collaborative of NASW and the Boston College and Simmons Schools of Social Work Authorization Number D 61675-E

This course allows other providers to claim a Participation Certificate upon successful completion of this course.

Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.

The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content.

This offering meets the criteria for 3.00 Continuing Education (CE) credits per presentation for psychologists.

Stuart Ablon, PhD

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Cross Functional Collaboration

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Instructor: Hector Sandoval

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Recommended experience

Intermediate level

Should have 3-5 years of experience in roles that require leading, supervising, and managing people and critical processes within organizations.

What you'll learn

Identify challenges, overcome barriers, foster teamwork, and leverage diverse perspectives for effective cross-functional collaboration.

Learn techniques to enhance communication, establish clear channels, and promote active listening and feedback within cross-functional teams.

Strengthen problem-solving skills, analyze different perspectives, and make informed decisions within collaborative efforts.

Utilize techniques for collaborative problem-solving, decision-making, consensus-building, and informed choices as a team.

Skills you'll gain

• conflict resolution
• Communication Enhancement
• Problem-Solving through Collaboration
• Collaborative Strategies
• Teamwork and Cooperation

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There is 1 module in this course

Welcome to the "Cross-Functional Collaboration" course! This course focuses on the principles and strategies for collaborating effectively with colleagues from different functional areas. Through this course, you will learn techniques to overcome challenges, foster teamwork, and leverage diverse perspectives to achieve common goals. The course emphasizes the importance of building a culture of trust and cooperation among team members and covers various techniques to improve communication, manage conflicts, and make informed decisions through collaborative efforts.

This course is designed for front-line, junior to mid-level supervisors and manager roles who are responsible for leading teams, projects, and processes in a diverse range of organizations. By the end of the course, you will be equipped with the necessary skills to collaborate successfully with colleagues from different backgrounds and functional areas, leading to enhanced productivity and overall organizational success. To enroll in this course, participants should have 3-5 years of experience in roles that require leading, supervising, and managing people and critical processes within organizations. Join us in developing your collaborative skills and becoming a more effective leader in your organization.

Cross-Functional Collaboration

This course focuses on the principles and strategies for collaborating effectively with colleagues from different functional areas. Students will learn to overcome challenges, foster teamwork, and leverage diverse perspectives to achieve common goals. The course covers various techniques to improve communication and information sharing across departments and develop strategies for managing conflict and resolving disputes. Through case studies and group exercises, students will enhance their problem-solving skills and learn how to make informed decisions through collaborative efforts. The course also emphasizes the importance of building a culture of trust and cooperation among team members. By the end of the course, students will be equipped with the necessary skills to collaborate successfully with colleagues from different backgrounds and functional areas, leading to enhanced productivity and overall organizational success.

What's included

26 videos 2 readings 5 quizzes 1 assignment

26 videos • Total 51 minutes

• Introduction to the course and instructor • 1 minute • Preview module
• Learning objectives and outcomes  • 0 minutes
• Overview of different functional areas within organizations  • 1 minute
• Common challenges and barriers to cross-functional collaboration  • 2 minutes
• Specific examples highlighting real-world collaboration obstacles  • 1 minute
• Identifying the role of entry-level supervisors and managers in fostering collaboration  • 3 minutes
• Strategies for creating a culture of trust and cooperation  • 1 minute
• Creating the right environment  • 1 minute
• Techniques for clear and concise communication  • 2 minutes
• Active listening and empathy in cross-functional settings  • 2 minutes
• Selecting appropriate communication channels  • 1 minute
• Leveraging technology for seamless information sharing  • 1 minute
• Recognizing sources of conflict in cross-functional teams  • 1 minute
• Strategies for managing and resolving conflicts constructively  • 2 minutes
• Developing negotiation and problem-solving skills  • 2 minutes
• Analytical thinking and critical decision-making in collaborative settings  • 1 minute
• Brainstorming techniques for cross-functional teams  • 1 minute
• Evaluating potential solutions and making informed decisions  • 1 minute
• Recognizing the value of diverse perspectives in cross-functional teams  • 1 minute
• Creating an inclusive environment for diverse viewpoints  • 0 minutes
• Encouraging creativity and innovation through diverse thinking  • 2 minutes
• Techniques for integrating different perspectives for better outcomes  • 2 minutes
• Strategies for fostering teamwork and collaboration  • 1 minute
• Promoting a sense of shared purpose and goals  • 2 minutes
• Recognizing and rewarding collaborative achievements  • 3 minutes
• Recap of key takeaways  • 2 minutes

2 readings • Total 20 minutes

• Welcome to the course • 10 minutes
• Additional resources • 10 minutes

5 quizzes • Total 150 minutes

• Understanding functional areas and challenges • 30 minutes
• Effective communication and information sharing • 30 minutes
• Managing conflict and problem solving • 30 minutes
• Leveraging diverse perspectives • 30 minutes
• Cultivating effective teamwork • 30 minutes

1 assignment • Total 180 minutes

• Final Assessment • 180 minutes

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Frequently asked questions

When will i have access to the lectures and assignments.

Access to lectures and assignments depends on your type of enrollment. If you take a course in audit mode, you will be able to see most course materials for free. To access graded assignments and to earn a Certificate, you will need to purchase the Certificate experience, during or after your audit. If you don't see the audit option:

The course may not offer an audit option. You can try a Free Trial instead, or apply for Financial Aid.

The course may offer 'Full Course, No Certificate' instead. This option lets you see all course materials, submit required assessments, and get a final grade. This also means that you will not be able to purchase a Certificate experience.

What will I get if I purchase the Certificate?

When you purchase a Certificate you get access to all course materials, including graded assignments. Upon completing the course, your electronic Certificate will be added to your Accomplishments page - from there, you can print your Certificate or add it to your LinkedIn profile. If you only want to read and view the course content, you can audit the course for free.

What is the refund policy?

You will be eligible for a full refund until two weeks after your payment date, or (for courses that have just launched) until two weeks after the first session of the course begins, whichever is later. You cannot receive a refund once you’ve earned a Course Certificate, even if you complete the course within the two-week refund period. See our full refund policy Opens in a new tab .

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Yes. In select learning programs, you can apply for financial aid or a scholarship if you can’t afford the enrollment fee. If fin aid or scholarship is available for your learning program selection, you’ll find a link to apply on the description page.

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Collaborative Problem Solving® (CPS)

About this program.

Target Population: Children and adolescents (ages 3-21) with a variety of behavioral challenges, including both externalizing (e.g., aggression, defiance, tantrums) and internalizing (e.g., implosions, shutdowns, withdrawal) who may carry a variety of related psychiatric diagnoses, and their parents/caregivers, unless not age appropriate (e.g. young adult or transition age youth)

For children/adolescents ages: 3 – 21

For parents/caregivers of children ages: 3 – 21

Program Overview

Collaborative Problem Solving® (CPS) is an approach to understanding and helping children with behavioral challenges who may carry a variety of psychiatric diagnoses, including oppositional defiant disorder, conduct disorder, attention-deficit/hyperactivity disorder, mood disorders, bipolar disorder, autism spectrum disorders, posttraumatic stress disorder, etc. CPS uses a structured problem solving process to help adults pursue their expectations while reducing challenging behavior and building helping relationships and thinking skills. Specifically, the CPS approach focuses on teaching the neurocognitive skills that challenging kids lack related to problem solving, flexibility, and frustration tolerance. Unlike traditional models of discipline, this approach avoids the use of power, control, and motivational procedures and instead focuses on teaching at-risk kids the skills they need to succeed. CPS provides a common philosophy, language and process with clear guideposts that can be used across settings. In addition, CPS operationalizes principles of trauma-informed care.

Program Goals

The goals of Collaborative Problem Solving® (CPS) are:

• Reduction in externalizing and internalizing behaviors
• Reduction in use of restrictive interventions (restraint, seclusion)
• Reduction in caregiver/teacher stress
• Increase in neurocognitive skills in youth and caregivers
• Increase in family involvement
• Increase in parent-child relationships
• Increase in program cost savings

Logic Model

The program representative did not provide information about a Logic Model for Collaborative Problem Solving® (CPS) .

Essential Components

The essential components of Collaborative Problem Solving® (CPS) include:

• Three different types of intervention delivery to parents and/or children/adolescents depending on the personal situation:
• Family therapy sessions (conducted both with and without the youth) which typically take place weekly for approximately 10-12 weeks
• 4- and 8-week parent training curricula that teach the basics of the model to parents in a group format (maximum group size = 12 participants)
• Direct delivery to youth in treatment or educational settings in planned sessions or in a milieu
• In the family sessions or parent training sessions, parents receive:
• An overarching philosophy to guide the practice of the approach ("kids do well if they can")
• A specific assessment process and measures to identify challenging behaviors, predictable precipitants, and specific thinking skill deficits. Lagging thinking skills are identified in five primary domains:
• Language and Communication Skills
• Attention and Working Memory Skills
• Emotion and Self-Regulation Skills
• Cognitive Flexibility Skills
• Social Thinking Skills
• A specific planning process that helps adults prioritize behavioral goals and decide how to respond to predictable difficulties using 3 simple options based upon the goals they are trying to pursue:
• Plan A – Imposition of adult will
• Plan B – Solve the problem collaboratively
• Plan C – Drop the expectation (for now, at least)
• A specific problem solving process (operationalizing "Plan B") with three core ingredients that is used to collaborate with the youth to solve problems durably, pursue adult expectations, reduce challenging behaviors, teach skills, and create or restore a helping relationship.
• When directly working with the youth in treatment or education settings, providers engage youth with:

Program Delivery

Child/adolescent services.

Collaborative Problem Solving® (CPS) directly provides services to children/adolescents and addresses the following:

• A range of internalizing and externalizing behaviors, including (but not limited to) physical and verbal aggression, destruction of property, self-harm, substance abuse, tantrums, meltdowns, explosions, implosive behaviors (shutting down), crying, pouting, whining, withdrawal, defiance, and oppositionality

Parent/Caregiver Services

Collaborative Problem Solving® (CPS) directly provides services to parents/caregivers and addresses the following:

• Child with internalizing and/or externalizing behaviors, difficulty effectively problem solving with their child

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Any caregivers, educators, and other supports are essential to the success of the approach. Caregivers, teachers and other adult supporters are taught to use the approach with the child outside the context of the clinical setting. School and clinical staff typically learn the model via single or multi-day workshops and through follow-up training and coaching.

Recommended Intensity:

Typically family therapy (in which the youth is the identified patient, but the parents are heavily involved in the sessions so that they can get better at using the approach with their child on their own) occurs once per week for approximately 1 hour. The approach can also be delivered in the home with greater frequency/intensity, such as twice a week for 90 minutes. Parent training group sessions occur once a week for 90 minutes over the course of 4 or 8 weeks. The approach can also be delivered by direct care staff in a treatment setting and/or educators in a school system, in which case delivery is not limited to scheduled sessions, but occurs in the context of regular contact in a residence or classroom.

Recommended Duration:

Family therapy: 8-12 weeks; In-home therapy: 8-12 weeks; Parent training groups: 4-8 weeks

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Foster / Kinship Care
• Outpatient Clinic
• Community-based Agency / Organization / Provider
• Group or Residential Care
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Collaborative Problem Solving® (CPS) includes a homework component:

Identifying specific precipitants, prioritizing behavioral goals, and practicing the problem solving process are expected to be completed by the caregiver and youth between sessions.

Collaborative Problem Solving® (CPS) has materials available in languages other than English :

Chinese, French, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative ( contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Trained personnel. If being delivered as parent group training, it requires a room big enough to hold the number of families (anywhere from a couple of parents up to 12 participants), as well as A/V equipment or printed materials for delivery of material in training curriculum.

Manuals and Training

Prerequisite/minimum provider qualifications.

Service providers and supervisors must be certified in CPS . There is no minimum educational level required before certification process can begin.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Treatment Manual: Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach . Guilford Press.

Training Information

There is training available for this program.

Training Contact:

• Think: Kids at Massachusetts General Hospital [email protected] phone: (617) 643-6300

Training Type/Location:

Training can be obtained onsite, at Massachusetts General Hospital in Boston, at trainings hosted in other locations, online (introductory training only), or via video/phone training and coaching.

Number of days/hours:

Ranges from a 2-hour exposure training to more intensive (2.5 day) advanced sessions as well as hourly coaching:

• Exposure/Introductory training: These in-person and online trainings typically last from 2–6 hours and provide a general overview exposure of the model including the overarching philosophy, the assessment , planning and intervention process. Training can accommodate an unlimited number of participants.
• Two-and-a-half day intensive trainings that provide participants in-depth exposure to all aspects of the model using didactic training, video demonstration, role play and breakout group practice. Tier 1 training is limited to 150 participants. Tier 2 training is limited to 75 participants.
• Coaching sessions for up to 12 participants that provide ongoing support and troubleshooting in the model

Additional Resources:

There currently are additional qualified resources for training:

There are many certified trainers throughout North America who teach the model as well as well as systems that use the approach. The list is available at https://thinkkids.org/our-communities

Implementation Information

Pre-implementation materials.

There are pre-implementation materials to measure organizational or provider readiness for Collaborative Problem Solving® (CPS) as listed below:

A CPS Organizational Readiness Assessment measure has been developed that is available for systems interested in implementing the model. It can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

Formal Support for Implementation

There is formal support available for implementation of Collaborative Problem Solving® (CPS) as listed below:

Think:Kids provides implementation support in the form of ongoing coaching and fidelity and outcome monitoring. There is a Director of Implementation who oversees these activities.

Fidelity Measures

There are fidelity measures for Collaborative Problem Solving® (CPS) as listed below:

Self Study of CPS Sustainability, Updated 06/2019 : A guide for systems to assess the degree to which they are have put the structures in place to implement CPS with fidelity . Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

CPS Manualized Expert-Rated Integrity Coding System (CPS-MEtRICS) and Treatment Integrity Rating Form-Short (CPS-TIRFS) : Fidelity tools to help measure the degree to which CPS is being practiced with fidelity in a specific encounter. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

Implementation Guides or Manuals

There are implementation guides or manuals for Collaborative Problem Solving® (CPS) as listed below:

Clinician Session Guide : Guides the clinician in all aspects of the treatment, from initial assessment to ongoing work. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

CPS Coaching Guide : A guide specifically geared towards trainer individuals who are helping caregivers to implement the model over time. Available to certified trainers.

Research on How to Implement the Program

Research has been conducted on how to implement Collaborative Problem Solving® (CPS) as listed below:

Ercole-Fricke, E., Fritz, P., Hill, L. E., & Snelders, J. (2016). Effects of a Collaborative Problem Solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29 (3), 127–134. https://doi.org/10.1111/jcap.12149

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth, 33 (3-4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Pollastri, A. R., Ablon, J. S., & Hone, M. J. (Eds.). (2019). Collaborative Problem Solving: An evidence-based approach to implementation and practice. Springer.

Pollastri, A. R., Wang, L., Youn, S. J., Ablon, J. S., & Marques, L. (2020). The value of implementation frameworks: Using the active implementation frameworks to guide system-wide implementation of Collaborative Problem Solving. Journal of Community Psychology , 48 (4), 1114–1131. https://doi.org/10.1002/jcop.22325

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Greene, R. W., Ablon J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., Henin, A, Edwards, G., & Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72 (6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157

Type of Study: Randomized controlled trial Number of Participants: 47

Population:

• Age — 4–12 years
• Race/Ethnicity — Not specified
• Gender — 32 Male and 15 Female
• Status — Participants were parents and their children with oppositional defiant disorder (ODD).

Location/Institution: Massachusetts

Summary: (To include basic study design, measures, results, and notable limitations) The purpose of the study was to examine the efficacy of Collaborative Problem Solving (CPS) in affectively dysregulated children with oppositional defiant disorder (ODD). Participants were randomized to either the parent training version of CPS or parent training (PT). Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Epidemiologic version (K-SADS–E), the Wechsler Intelligence Scale for Children—Revised, the Parent–Child Relationship Inventory (PCRI), the Parenting Stress Index (PSI), the Oppositional Defiant Disorder Rating Scale (ODDRS), and the Clinical Global Impression–Improvement (CGI-I) . Results indicate that CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 4 months.

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth. 33 (3–4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental) Number of Participants: Not specified

• Age — Not specified
• Gender — Not specified
• Status — Participants were in residential and day treatment and included youth in foster care and child welfare.

Location/Institution: Oregon

Summary: (To include basic study design, measures, results, and notable limitations) The purpose of the study was to describe the results of one agency’s experience implementing the Collaborative Problem Solving (CPS) approach organization-wide and its effect on reducing seclusion and restraint (S/R) rates. Participants were grouped into the CPS intervention at a residential or day treatment facility. Measures utilized include the Child and Adolescent Functional Assessment Scale (CAFAS) and the Child and Adolescent Needs Assessment (CANS) . Results indicate that during the time studied, frequency of restrictive events in the residential facility decreased from an average of 25.5 per week to 2.5 per week, and restrictive events in the day treatment facility decreased from an average of 2.8 per week to 7 per year. Limitations include lack of randomization of participants, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Additional References

Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach . Guilford Press.

Greene, R. W., Ablon, J. S., Goring, J. C., Fazio, V., & Morse, L. R. (2003). Treatment of oppositional defiant disorder in children and adolescents. In P. Barrett & T. H. Ollendick (Eds.), Handbook of Interventions that work with children and adolescents: Prevention and treatment. John Wiley & Sons.

Pollastri, A. R., Epstein, L. D., Heath, G. H., & Ablon, J. S. (2013). The Collaborative Problem Solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21 (4), 188–199. https://doi.org/10.1097/HRP.0b013e3182961017

Contact Information

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Date Program Content Last Reviewed by Program Staff: March 2020

Date Program Originally Loaded onto CEBC: May 2017

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Collaborative Problem Solving: What It Is and How to Do It

What is collaborative problem solving, how to solve problems as a team, celebrating success as a team.

Problems arise. That's a well-known fact of life and business. When they do, it may seem more straightforward to take individual ownership of the problem and immediately run with trying to solve it. However, the most effective problem-solving solutions often come through collaborative problem solving.

As defined by Webster's Dictionary , the word collaborate is to work jointly with others or together, especially in an intellectual endeavor. Therefore, collaborative problem solving (CPS) is essentially solving problems by working together as a team. While problems can and are solved individually, CPS often brings about the best resolution to a problem while also developing a team atmosphere and encouraging creative thinking.

Because collaborative problem solving involves multiple people and ideas, there are some techniques that can help you stay on track, engage efficiently, and communicate effectively during collaboration.

• Set Expectations. From the very beginning, expectations for openness and respect must be established for CPS to be effective. Everyone participating should feel that their ideas will be heard and valued.
• Provide Variety. Another way of providing variety can be by eliciting individuals outside the organization but affected by the problem. This may mean involving various levels of leadership from the ground floor to the top of the organization. It may be that you involve someone from bookkeeping in a marketing problem-solving session. A perspective from someone not involved in the day-to-day of the problem can often provide valuable insight.
• Communicate Clearly.  If the problem is not well-defined, the solution can't be. By clearly defining the problem, the framework for collaborative problem solving is narrowed and more effective.
• Expand the Possibilities.  Think beyond what is offered. Take a discarded idea and expand upon it. Turn it upside down and inside out. What is good about it? What needs improvement? Sometimes the best ideas are those that have been discarded rather than reworked.
• Encourage Creativity.  Out-of-the-box thinking is one of the great benefits of collaborative problem-solving. This may mean that solutions are proposed that have no way of working, but a small nugget makes its way from that creative thought to evolution into the perfect solution.
• Provide Positive Feedback. There are many reasons participants may hold back in a collaborative problem-solving meeting. Fear of performance evaluation, lack of confidence, lack of clarity, and hierarchy concerns are just a few of the reasons people may not initially participate in a meeting. Positive public feedback early on in the meeting will eliminate some of these concerns and create more participation and more possible solutions.
• Consider Solutions. Once several possible ideas have been identified, discuss the advantages and drawbacks of each one until a consensus is made.
• Assign Tasks.  A problem identified and a solution selected is not a problem solved. Once a solution is determined, assign tasks to work towards a resolution. A team that has been invested in the creation of the solution will be invested in its resolution. The best time to act is now.
• Evaluate the Solution. Reconnect as a team once the solution is implemented and the problem is solved. What went well? What didn't? Why? Collaboration doesn't necessarily end when the problem is solved. The solution to the problem is often the next step towards a new collaboration.

The burden that is lifted when a problem is solved is enough victory for some. However, a team that plays together should celebrate together. It's not only collaboration that brings unity to a team. It's also the combined celebration of a unified victory—the moment you look around and realize the collectiveness of your success.

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Our Mission: Bowman Consulting Group is dedicated to partnering with organizations, agencies, communities and systems to provide collaborative problem solving training, trauma-informed care, coaching, consultation and support to staff serving children, youth and adults who struggle as a result of trauma, neurodiversity, developmental differences, or mental health challenges.

We have had the privilege of working with Rick and Doris for over a year, both as a school and now a school district. To say this work has been transformative is an understatement. It has changed the way we work with students, improved our school culture and provided steps to build durable, life-long skills in our students. Collaborative Problem Solving has become necessary training for EVERY educator in our building. We have worked exclusively with Rick and Doris as their expertise, experience and presentation skills are second to none. CPS has helped us find our vision for how we want to work with our children, Rick and Doris have provided the stepping stones to get there.

Our Vision: We envision a future in which every child, youth & adult, regardless of trauma history, neuro-developmental differences or mental health diagnoses will receive the neurobiologically and developmentally appropriate education, treatment & services that will enable them to grow, develop and reach their potential as an individual and member of their community, AND that every Adult serving them will receive the neurobiologically grounded training & support needed to enable them to generate and sustain their own optimal wellness & resilience.

Learn more about who we are and what our team brings to the table. Read what others have said about our trainings and our work with them.

Find connection, support and next-level resilience & self-care/wellness training for YOU or YOUR STAFF in our Connected Community!

We offer consultation, coaching, observation, and team-building. Find out how we can partner with you on your important journey of serving children, youth or adults.

Rick and Doris are experienced practitioners that can speak to the daily challenges student serving professionals face. Their trainings provide a sense of validation and help us make sense of what we are experiencing with our students and in ourselves. No we aren’t crazy and this is why! Their solid understanding of the neurobiology of trauma puts them on the leading edge of how best to work with students, families and coworkers most impacted by trauma.

HBCC has been hosting trainings with Rick and Doris Bowman since 2016 and we receive exceptional feedback! Parents, teachers and service providers report back immediate results in their homes, classrooms and practices due to what they learned at a Bowman Consulting training. HBCC is continually asked to schedule more of their trainings from participants in our community. As the founder of HBCC, it is always pleasurable to work with the Bowmans’ high standards and willingness to go above and beyond, delivering powerful, effective and expert training and consultation!

Why Bowman Consulting Group?

Conventional wisdom isn’t working!! If it were going to work, it would have done so a lonnng time ago!

Kids in our schools or treatment centers, people in our communities, employees in our organizations… ALL matter, ALL need support, and ALL WANT TO DO WELL!

You understand, as do we, that commitment to the long-term is crucial! You also understand that system-wide change is hard! We aren’t showing up with a magic wand… We’re going to deliver solid, research-based training, followed by coaching, consultation & support that will GUARANTEE RESULTS!!

Presentation was great – practicality, humor and organization!

Thank you so much! It was 100% worth my time!

CONTACT US NOW FOR TRAUMA-INFORMED CARE, RESILIENCE & SELF-REGULATION, OR COLLABORATIVE PROBLEM SOLVING TRAINING

Founding Members of the Resilience Coalition

Bowman Consulting Group is proud to have been selected as one of the founding members of the Resilience Coalition led by the Resilient Educator .

Bowman Consulting Group, along with 11 other members of the coalition, are serving in an advisory and partnership capacity with Resilient Educator, as well as with fellow coalition partners which include:

• The Urban Assembly
• Columbia College, South Carolina
• The Zamperini Foundation
• Attachment and Trauma Network
• Case Western University
• Jim Sporleder, former Principal, Lincoln HS
• Thriving Schools, Kaiser Permanente
• Jody Johnson, Associate Professor, ECE
• Creighton University
• Alliant University International
• Northcentral University

TRAININGS OF ALL SHAPES AND SIZES FOR CAREGIVERS OF ALL STRIPES

So there’s definitely something for you, your school, or your treatment facility.

• CONFERENCES
• SCHOOLS & FACILITIES
• CLINICIANS & EDUCATORS

WORKSHOPS & TRAINING

Whether you’re a clinician, educator, or parent, if you’re seeking additional exposure to and expertise in the Collaborative & Proactive Solutions model, there’s a training option to meet your needs, including virtual trainings, annual conferences, trainings specific to schools and facilities, trainings for individual clinicians and educators, and on-demand programming. All of these options are described in detail below. (And there are additional trainings are listed on a different website… click here .) If you’re having trouble deciding which training is best for you or your school or treatment facility, contact us…we’d be happy to help you out.

ANNUAL CONFERENCES

What a day! Our  2024 Annual Summit on Collaborative & Proactive Solutions was held on April 12th, and over 4000 people were registered. This year’s theme was Voices of the Neurodivergent Community , and we had some amazing keynote speakers, including Alex Kimmel, Kristy Forbes, Meghan Ashburn, Jules Edward, and Jenny Hunt , along with fantastic breakout groups for parents, educators, and mental health clinicians at various points in their journey with the CPS model. We’ll be streaming highlights here as soon as we get the film edited! If you didn’t register but would still like to watch all the presentations, contact us .

Hope – Solutions – Action was the tagline for our 2023 Children’s Mental Health Advocacy Conference , which was held on October 27th, 2023 . Over 3000 people registered for the conference. The hope is in the legislation and policy changes that tell us that punitive, exclusionary disciplinary practices won’t be around forever. The solutions can be found in innovative, collaborative, proactive interventions like Collaborative & Proactive Solutions that are proven to dramatically reduce or eliminate discipline referrals, suspensions, restraints, and seclusions. And the action …there are lots of things you to can do to move things in the right direction, starting with signing up to be a Lives in the Balance Advocator. As always, the conference was free. If you missed it, couldn’t stay for all of it, or want to see it again, you can watch the conference in its entirety he re . And we’ll be posting the dates of our 2024 Conference here soon.

VIRTUAL TRAININGS

Our next live, virtual, 2-day combined introductory and advanced training on Collaborative & Proactive Solutions with Dr. Greene is on May 30 & 31, 2024 . If you can’t join in live, your registration gives you access to the recording. Registration is now open!

If you don’t want to wait — or if those dates don’t work for you — our last 2-day training is available with a pay-per-view option.

CONSULTATION AND TRAINING FOR SCHOOLS AND THERAPEUTIC FACILITIES

HALF AND FULL-DAY WORKSHOPS If you or your staff are relatively new to the CPS model, Lives in the Balance offers half- and full-day workshops, which provide a general overview of the CPS model (key themes, use of assessment instrumentation, and solving problems collaboratively), and can be provided either on-site or by webinar.

TWO-DAY ON-SITE INTRODUCTORY TRAININGS   For a more intensive introductory experience, we provide a two-day introductory training, either on-site or by webinar . The addition of the second day allows for presenting video examples of the CPS model, along with greater opportunity for practice, processing, discussion, and questions.

PROFICIENCY TRAININGS These trainings have a new format for 2024. The goal, as always, is to help a cadre of staff become proficient in using the assessment tool (the ASUP) and problem-solving process (Plan B)  and then model these facets for other staff, thereby facilitating the spread of CPS through a school or facility. The training now begins with a brief school climate questionnaire and a free introductory video (to make sure school leadership understands what’s involved in the training before committing). Then 3-4 members of your implementation team – the key folks that are spearheading the change – will view two video modules and complete readiness checks to set the stage for what’s to come. Then, a “core group” of 8-10 staff — including the implementation team members — will view an overview video describing the CPS model. (The core group is typically comprised of a cross-section of administrators and classroom teachers/line staff.) Then the core group works with a Lives in the Balance trainer for 8-10 teleconference sessions to become proficient in using the ASUP and Plan B, by submitting work samples and receiving feedback. Key prerequisites for participants are (a) an open mind, (b) a willingness to practice the model between sessions, and (c) the courage to receive feedback in a group format.

CONSULTATION AND TRAINING ON REDUCING/ELIMINATING RESTRAINT AND SECLUSION No, we’re not going to teach staff how to recognize that a student is becoming escalated (staff already know when a student is becoming escalated…and, by the time a student is becoming escalated, you’re in crisis  management mode). And we’re not going to teach staff how to safely restrain and seclude students (also crisis management). We’re going to help staff become almost totally proactive in identifying the expectations students are having difficulty meeting (known in the CPS model as unsolved problems), and we’re going to help staff learn how to solve those problems collaboratively and proactively. Along the way, we’re going to help with the logistical factors that so often set the stage for restraint and seclusion (e.g. lack of awareness of student medication changes, the belief that restraint and seclusion are necessary and promote safety, placing expectations on students that it’s quite clear they can’t meet). Then we’re going to watch your rates of restraints and seclusions plummet.

If you want to discuss any of these options or the needs of your school or facility with a real human being, CONTACT Lives in the Balance and we’ll make sure you get what you need. Trainings are available in English, Swedish, Danish, German, Finnish, Norwegian, and French.

TRAININGS FOR INDIVIDUAL EDUCATORS AND CLINICIANS

2-DAY TRAININGS Our 2-day trainings (described above) provide participants with additional exposure to and instruction in key facets of the CPS model, video examples of its application, and model updates. These trainings are offered in various locations throughout the world, and also via webinar . The advanced trainings are for those who have had some prior exposure to the model, often through attendance at one of Dr. Greene’s one-day introductory trainings (see below), as well as for those who have already attended a prior 2-day training and have been actively applying the model in clinical work or in a treatment or education setting. All 2-day trainings are taught by Dr. Greene. Many are posted on a different website .

CERTIFICATION TRAININGS   Certification trainings are designed for individual clinicians, educators, and other providers interested in developing proficiency in the application of the CPS model and training others. The training provides supervised practice and feedback in 24 weekly, 60-90 minute Zoom supervision sessions. The first ten weeks focuses on use of the Assessment of Skills and Unsolved Problems [ASUP] and Plan B. Participants who demonstrate proficiency in these two components are eligible to participate in the subsequent 14-weeks of training, in which skills related to explaining the model, demonstrating it, and coaching it are the focal point. Each supervision group is limited to six participants, and we typically run multiple groups simultaneously. Submission of weekly work samples are required, so access to a sufficient number of kids and families/teachers is necessary. Upon successful completion of this training, participants are eligible to provide demonstration, coaching, and feedback to staff in their schools and provide the CPS model in their outpatient setting or therapeutic facility. Certified providers are also eligible to begin receiving training in speaking on the CPS model and providing consultation, supervision, and coaching to train others outside of their setting. These trainings take place all year on rolling admission. In addition to English, the certification training is offered in Swedish, Danish, Finnish, Norwegian, and French. You can submit your application here. In general, we encourage some prior experience in using the model before applying for this training. If you still have questions, please read our FAQs and/or contact us at [email protected] .

SKILL ENHANCEMENT TRAININGS These trainings are an alternative to the lengthier, more intensive 24-week certification trainings (see below). Over the course of five 60-minute group Zoom sessions, participants receive coaching and feedback from certified providers in CPS to increase their skills in the application of the CPS model. The first 1-2 sessions are focused on the use of the Assessment of Skills and Unsolved Problems (ASUP). The remaining sessions are focused on Plan B, and involve having participants audiotape their use of Plan B with actual kids and their caregivers so as to receive highly individualized coaching and feedback. Registration is limited to six participants per training. Trainings are available in English, Swedish, Danish, and French. New sessions will be added soon!  If you have questions, email us at [email protected] .

TRAINING FOR PARENTS

We’re in the midst of revising and refreshing our training options for parents. Please visit this section again soon to see what we’ve cooked up!

ON-DEMAND PROGRAMMING

2-Day Training on Collaborative & Proactive Solutions with Dr. Ross Greene

Infusing Collaborative & Proactive Solutions Into PBIS with assistant principal Kelly Sarah and school psychologist Rachel Polacek  (FREE!)

Addressing Disproportionality in School Discipline with Collaborative & Proactive Solutions with Dr. Stacy Haynes (FREE!)

School Implementation of CPS: Building leadership density & a positive culture with Principal Ryan Gleason  (FREE!)

CPS & the Neurodivergent Student with Dr. Stacy Haynes  (FREE!)

If you’re interested in learning more about any of the above options, just use the Contact form on this website.

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What Is Collaborative Problem Solving?

Imagine collaborative problem solving as a symphony where each instrument plays an important part in creating harmony.

As you explore the intricacies of this method, you'll uncover the intricate dance of minds working together to unravel complex issues.

The beauty lies in the synergy of diverse perspectives, the orchestration of communication, and the finesse of teamwork.

But how does this symphony truly come together, and what are the secrets behind its success?

Stay tuned to unravel the mysteries and open the potential of collaborative problem solving.

Table of Contents

Key Takeaways

• Collaborative problem solving enhances efficiency and innovation through diverse perspectives.
• Core principles guide the process for effective outcomes and improved team dynamics.
• Effective communication strategies, like active listening, foster a collaborative problem-solving environment.
• Conflict resolution skills and creativity are essential for successful collaborative problem solving.

Benefits of Collaborative Problem Solving

Collaborative problem solving enhances efficiency and fosters innovative solutions through collective expertise and diverse perspectives. Team synergy plays an important role in this process, as individuals bring forth unique insights that contribute to a thorough understanding of the issue at hand. By leveraging the combined problem-solving strategies of team members, collaborative innovation flourishes, leading to more effective outcomes.

One of the key advantages of collaborative problem solving is the ability to tap into a diverse range of perspectives when making decisions. This diversity allows for a more detailed exploration of potential solutions, as individuals with varying backgrounds and experiences offer fresh insights that one person alone may not have considered. Additionally, the collaborative nature of problem solving fosters a sense of ownership among team members, increasing their commitment to implementing the chosen solution effectively.

Key Elements of CPS Process

When engaging in collaborative problem solving, it's important to understand the core CPS principles that guide the process.

Effective communication strategies play an essential role in ensuring that all team members are on the same page and can contribute their insights.

Collaborative decision-making is key to reaching solutions that consider diverse perspectives and foster a sense of ownership among participants.

Core CPS Principles

Effective problem solving in collaborative settings depends on adherence to the core principles that underpin the CPS process. The core principles encompass a set of guidelines that form the foundation for successful problem-solving techniques within a collaborative framework.

These principles emphasize the importance of active listening, open-mindedness, and mutual respect among team members. By embracing these core principles, individuals can enhance their ability to generate innovative solutions, leverage diverse perspectives, and foster a supportive team environment.

Additionally, these principles highlight the significance of maintaining a solution-focused mindset, promoting constructive feedback, and valuing contributions from all team members. Overall, integrating these core principles into collaborative problem-solving endeavors can lead to more effective outcomes and improved team dynamics.

Effective Communication Strategies

Adherence to the core principles of Collaborative Problem Solving lays the groundwork for implementing Effective Communication Strategies essential to the Key Elements of the CPS Process. Active listening, a fundamental component of effective communication, involves fully concentrating, understanding, responding, and remembering what's being said.

By actively listening, you show respect, build trust, and foster a collaborative environment conducive to problem-solving. Additionally, importance training plays a critical role in communication within the CPS framework. Importance training helps individuals express their needs, thoughts, and feelings in a direct and honest manner while respecting the perspectives of others.

This skill enables effective communication by promoting clarity, openness, and constructive dialogue in addressing conflicts and finding solutions collaboratively.

Collaborative Decision-Making

To achieve successful collaborative decision-making within the CPS process, understanding and integrating the key elements is essential. Group decision making plays an important role in the problem-solving process, ensuring that diverse perspectives are considered.

Collective problem resolution is achieved through a team approach, where individuals contribute their unique insights and expertise to reach a consensus. Effective collaborative decision-making requires active participation from all team members, open communication channels, and a shared commitment to the common goal.

Importance of Team Dynamics

Team dynamics play an important role in determining the success of collaborative problem-solving efforts. Team cohesion, which refers to the ability of a group to work together effectively and harmoniously, is vital in achieving shared goals. When group dynamics are positive, team members are more likely to trust each other, communicate openly, and support each other. Collaboration strategies that focus on enhancing team cohesion can lead to improved problem-solving outcomes. For instance, implementing team-building activities, establishing clear roles and responsibilities, and fostering a culture of respect and inclusivity are all ways to strengthen team dynamics.

Effective group dynamics can help teams navigate challenges, adapt to changing circumstances, and capitalize on diverse perspectives. By valuing each member's contributions and leveraging individual strengths, teams can enhance their problem-solving capabilities. When team members feel connected and engaged, they're more motivated to work collaboratively towards finding innovative solutions. Therefore, investing time and effort into nurturing positive team dynamics is essential for achieving successful collaborative problem-solving outcomes.

Role of Communication in CPS

Effective communication plays a crucial role in collaborative problem solving, facilitating the exchange of ideas and information among team members to drive successful outcomes. In the domain of Collaborative Problem Solving (CPS), effective communication strategies are essential for ensuring that the team functions cohesively and efficiently. Here are some key points highlighting the importance of communication in CPS:

• Clear and Transparent Communication : Ensuring that all team members are on the same page regarding goals and progress.
• Active Listening : Encouraging active listening amongst team members to comprehend diverse perspectives and ideas effectively.
• Feedback Mechanisms : Establishing feedback loops to provide constructive criticism and improve solutions iteratively.
• Non-Verbal Communication : Understanding the significance of body language and other non-verbal cues in enhancing communication.
• Conflict Resolution Skills : Developing techniques to address conflicts constructively and maintain a positive team environment.

Strategies for Effective Collaboration

To effectively collaborate, employ clear communication techniques to make sure all team members are on the same page.

Utilize conflict resolution skills to address any disagreements or disputes that may arise during the problem-solving process.

These strategies are crucial for fostering a productive and harmonious collaborative environment.

Clear Communication Techniques

In successful collaborative problem-solving endeavors, employing clear and concise communication techniques is paramount for fostering productive interactions and achieving common goals. To enhance your collaborative communication skills, consider the following strategies:

• Practice active listening to demonstrate your attentiveness and understanding.
• Pay attention to nonverbal cues such as body language and facial expressions for deeper insights.
• Use open-ended questions to encourage discussion and gather diverse perspectives.
• Clarify any uncertainties promptly to avoid misunderstandings or confusion.
• Summarize key points to make certain alignment and reinforce shared understanding.

Conflict Resolution Skills

Developing proficient conflict resolution skills is essential for ensuring smooth and successful collaboration among team members. Conflict resolution involves addressing disagreements or disputes in a constructive manner to reach a mutually agreeable solution.

Effective conflict resolution requires active listening, empathy, and the ability to remain calm under pressure. Utilizing negotiation skills is important in finding compromises and resolving conflicts amicably.

Team members should focus on understanding the root causes of conflicts and work together to find solutions that benefit all parties involved. By fostering an environment that encourages open communication and respectful dialogue, teams can navigate conflicts productively and strengthen their collaborative efforts.

Conflict resolution skills are important for maintaining positive relationships and achieving shared goals within a team.

Enhancing Creativity Through Collaboration

Enhancing creativity through collaborative problem-solving techniques can yield innovative solutions that transcend individual contributions. When individuals come together to solve problems collectively, creativity flourishes, leading to groundbreaking ideas and outcomes. Here are key ways collaboration enhances creativity:

• Innovation Exploration : Collaborating allows for the exploration of innovative ideas that may not have been possible individually.
• Group Brainstorming : Brainstorming as a group fosters a diverse range of ideas and perspectives, fueling creativity.
• Team Synergy : Working together harnesses the collective strengths of team members, boosting creativity and problem-solving abilities.
• Creative Problem Solving : Collaboration enables the application of different problem-solving approaches, resulting in unique solutions.
• Cross-Pollination of Ideas : Sharing and building upon each other's ideas can lead to the creation of novel and inventive solutions.

Leveraging Diverse Perspectives

Collaborative problem-solving thrives on the ability to leverage diverse perspectives, which play a pivotal role in enhancing the innovative potential of a team. By incorporating various viewpoints and approaches, teams can tap into a wealth of creativity and expertise, acting as innovation catalysts and problem-solving synergy engines. Embracing solution diversity leads to collaborative excellence, where different team members bring unique skills and experiences to the table, enriching the problem-solving process.

To illustrate the significance of leveraging diverse perspectives, consider the following table:

Each row exemplifies how diverse perspectives contribute to collaborative problem-solving by fostering creativity, aiding in decision-making, sparking innovation, broadening problem-solving capabilities, and strengthening team dynamics. Fundamentally, embracing diversity is crucial to achieving collaborative excellence in problem-solving endeavors.

Implementing CPS in Various Settings

Implementing Collaborative Problem Solving (CPS) in various settings requires a meticulous understanding of the context and specific needs of the team or organization. When applying CPS, consider the following:

• Workplace applications: CPS can enhance teamwork, communication, and innovation in a corporate setting, leading to more effective problem-solving and decision-making processes.
• Community engagement: Utilizing CPS in community projects fosters collaboration, empowers stakeholders, and guarantees sustainable solutions to local challenges.
• Educational settings: Implementing CPS in schools promotes critical thinking, creativity, and teamwork among students, preparing them for future challenges in the workforce.
• Healthcare industry: CPS can improve patient care by encouraging interdisciplinary collaboration, addressing complex medical issues, and enhancing overall healthcare delivery.
• Tailored approaches: Customizing CPS methods to fit the unique demands of each environment maximizes its effectiveness and ensures successful outcomes.

Overcoming Challenges in Group Problem Solving

To effectively navigate group problem-solving challenges, it's imperative to acknowledge and address potential obstacles that may hinder productive collaboration and decision-making. Group dynamics play an essential role in the success of collaborative problem-solving efforts. Understanding how individuals interact within the group, recognizing communication patterns, and being aware of potential conflicts are essential for overcoming challenges.

One common obstacle in group problem solving is the presence of dominant personalities that may overshadow others' contributions. Implementing strategies to guarantee equal participation, such as setting time limits for each member to speak or using anonymous idea generation techniques, can help mitigate this issue. Additionally, differing problem-solving strategies among group members can lead to inefficiencies. Encouraging open dialogue to discuss and combine diverse approaches can enhance the overall problem-solving process.

Measuring Success in Collaborative Teams

To measure success in collaborative teams, it's essential to focus on team performance metrics and assess goal attainment. These metrics provide concrete data to evaluate the effectiveness of teamwork strategies and the overall performance of the team.

Team Performance Metrics

How can you effectively measure the success of collaborative teams through team performance metrics? Team performance metrics play an important role in evaluating the effectiveness of collaborative efforts.

To gauge the performance of your team, consider implementing the following strategies:

• Conduct team satisfaction surveys to gather feedback on team dynamics.
• Utilize performance evaluations to assess individual contributions to the team.
• Encourage peer feedback to understand how team members perceive each other's contributions.
• Measure team cohesion by evaluating how well members work together towards common goals.
• Track key performance indicators relevant to the project to make sure progress aligns with objectives.

Goal Attainment Assessment

Evaluating goal attainment is a key aspect of evaluating the success of collaborative teams, providing concrete evidence of achievement in working towards shared objectives. To assess goal attainment effectively, start by setting clear, specific, and measurable goals that align with the team's overarching objectives.

Utilize problem-solving techniques like brainstorming, root cause analysis, and action planning to address obstacles hindering goal achievement. Regularly monitor progress towards these goals through data tracking, milestone checkpoints, and progress reports.

Engage team members in reflective discussions to evaluate the effectiveness of strategies employed and make necessary adjustments. By focusing on goal setting and employing structured problem-solving techniques, collaborative teams can track their progress accurately and enhance their overall performance.

As you navigate the intricate web of collaborative problem solving, remember that each team member is a unique puzzle piece contributing to the bigger picture.

Just as a symphony orchestra harmonizes individual instruments to create a beautiful melody, your team must work together in perfect synchronization to overcome challenges and achieve success.

Embrace the diversity of perspectives, communicate effectively, and leverage each member's strengths to reveal the true potential of collaborative problem solving.

It's the key to revealing greatness.

The eSoft Editorial Team, a blend of experienced professionals, leaders, and academics, specializes in soft skills, leadership, management, and personal and professional development. Committed to delivering thoroughly researched, high-quality, and reliable content, they abide by strict editorial guidelines ensuring accuracy and currency. Each article crafted is not merely informative but serves as a catalyst for growth, empowering individuals and organizations. As enablers, their trusted insights shape the leaders and organizations of tomorrow.

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ORPARC Training - An Introduction to Collaborative Problem Solving®

Thursday, january 21, 2021 – 6:00pm, 6:00pm - 7:00pm.

Please join Swindells Resource Center and certified trainers Marcus Saraceno and Paul Kammerzelt from Watershed Problem Solving LLC, for an introduction to Collaborative Problem Solving® (CPS).

• The Collaborative Problem Solving® approach
• Skills used for solving problems
• Interventions used in the Collaborative Problem Solving® model
• What to do next?

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The design and evaluation of gamified online role-play as a telehealth training strategy in dental education: an explanatory sequential mixed-methods study

• Chayanid Teerawongpairoj 1 ,
• Chanita Tantipoj 1 &
• Kawin Sipiyaruk 2  

Scientific Reports volume  14 , Article number:  9216 ( 2024 ) Cite this article

Metrics details

• Health care
• Health services
• Public health

To evaluate user perceptions and educational impact of gamified online role-play in teledentistry as well as to construct a conceptual framework highlighting how to design this interactive learning strategy, this research employed an explanatory sequential mixed-methods design. Participants were requested to complete self-perceived assessments toward confidence and awareness in teledentistry before and after participating in a gamified online role-play. They were also asked to complete a satisfaction questionnaire and participate in an in-depth interview to investigate their learning experience. The data were analyzed using descriptive statistics, paired sample t-test, one-way analysis of variance, and framework analysis. There were 18 participants who completed self-perceived assessments and satisfaction questionnaire, in which 12 of them participated in a semi-structured interview. There were statistically significant increases in self-perceived confidence and awareness after participating in the gamified online role-play ( P  < 0.001). In addition, the participants were likely to be satisfied with this learning strategy, where usefulness was perceived as the most positive aspect with a score of 4.44 out of 5, followed by ease of use (4.40) and enjoyment (4.03). The conceptual framework constructed from the qualitative findings has revealed five key elements in designing a gamified online role-play, including learner profile, learning settings, pedagogical components, interactive functions, and educational impact. The gamified online role-play has demonstrated its potential in improving self-perceived confidence and awareness in teledentistry. The conceptual framework developed in this research could be considered to design and implement a gamified online role-play in dental education. This research provides valuable evidence on the educational impact of gamified online role-play in teledentistry and how it could be designed and implemented in dental education. This information would be supportive for dental instructors or educators who are considering to implement teledentistry training in their practice.

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Introduction

Telehealth has gained significant attention from various organization due to its potential to improve healthcare quality and accessibility 1 . It can be supportive in several aspects in healthcare, including medical and nursing services, to enhance continuous monitoring and follow-up 2 . Its adoption has increased substantially during the COVID-19 pandemic, aiming to provide convenient healthcare services 3 . Even though the COVID-19 outbreak has passed, many patients still perceive telehealth as an effective tool in reducing a number of visits and enhancing access to health care services 4 , 5 . This supports the use of telehealth in the post-COVID-19 era.

Teledentistry, a form of telehealth specific to dentistry, has been employed to improve access to dental services 6 . This system offers benefits ranging from online history taking, oral diagnosis, treatment monitoring, and interdisciplinary communication among dental professionals, enabling comprehensive and holistic treatment planning for patients 7 . Teledentistry can also reduce travel time and costs associated with dental appointments 8 , 9 , 10 . There is evidence that teledentistry serves as a valuable tool to enhance access to dental care for patients 11 . Additionally, in the context of long-term management in patients, telehealth has contributed to patient-centered care, by enhancing their surrounding environments 12 . Therefore, teledentistry should be emphasized as one of digital dentistry to enhance treatment quality.

Albeit the benefits of teledentistry, available evidence demonstrates challenges and concerns in the implementation of telehealth. Lack of awareness and knowledge in the use of telehealth can hinder the adoption of telehealth 13 . Legal issues and privacy concerns also emerge as significant challenges in telehealth use 14 . Moreover, online communication skills and technology literacy, including competency in using technological tools and applications, have been frequently reported as challenges in teledentistry 15 , 16 . Concerns regarding limitations stemming from the lack of physical examination are also significant 17 . These challenges and complexities may impact the accuracy of diagnosis and the security and confidentiality of patient information. Therefore, telehealth training for dental professionals emerges as essential prerequisites to effectively navigate the use of teledentistry, fostering confidence and competence in remote oral healthcare delivery.

The feasibility and practicality of telehealth in dental education present ongoing challenges and concerns. Given the limitations of teledentistry compared to face-to-face appointments, areas of training should encompass the telehealth system, online communication, technical issues, confidentiality concerns, and legal compliance 18 . However, there is currently no educational strategy that effectively demonstrates the importance and application of teledentistry 19 . A role-play can be considered as a teaching strategy where learners play a role that closely resembles real-life scenarios. A well-organized storytelling allows learner to manage problematic situations, leading to the development of problem-solving skill 20 , 21 . When compared to traditional lecture-based learning, learners can also enhance their communication skills through conversations with simulated patients 22 , 23 . In addition, they could express their thoughts and emotions during a role-play through experiential learning 20 , 24 , 25 . Role-play through video teleconference would be considered as a distance learning tool for training dental professionals to effectively use teledentistry.

While there have been studies supporting online role-play as an effective learning tool due to its impact of flexibility, engagement, and anonymity 26 , 27 , no evidence has been yet reported whether or not this learning strategy could have potential for training teledentistry. Given the complicated issues in telehealth, role-play for training teledentistry should incorporate different learning aspects compared to face-to-face communication with patients. In addition, game components have proved to be supportive in dental education 28 , 29 . Consequently, this research aimed to evaluate user perceptions and educational impact of gamified online role-play to enhance learner competence and awareness in using teledentistry as well as to construct a conceptual framework highlighting how to design and implement this interactive learning strategy. This research would introduce and promote the design and implementation of gamified online role-play as a learning tool for training teledentistry. To achieve the aim, specific objectives were established as follows:

1. To design a gamified online role-play for teledentistry training.

2. To investigate learner perceptions regarding their confidence and awareness in the use of teledentistry after completing the gamified online role-play.

3. To explore user satisfactions toward the use of gamified online role-play.

4. To develop a conceptual framework for designing and implementing a gamified online role-play for teledentistry training.

Materials and methods

Research design.

This research employed an explanatory sequential mixed-methods design, where a quantitative phase was firstly performed followed by a qualitative phase 30 , 31 . The quantitative phase was conducted based on pre-experimental research using one-group pretest–posttest design. Participants were requested to complete self-perceived assessments toward confidence and awareness in the use of teledentistry before and after participating in a gamified online role-play. They were also asked to complete a satisfaction questionnaire in using a gamified online role-play for training teledentistry. The qualitative phase was afterwards conducted to explore in-depth information through semi-structured interviews, in order to enhance an understanding of the quantitative phase, and to develop a conceptual framework for designing and implementing an online role-play for training teledentistry.

A gamified online role-play for training teledentistry

A gamified online role-play was designed and developed by the author team. To ensure its educational impact was significant, the expected learning outcomes were formulated based on insights gathered from a survey with experienced instructors from the Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University. These learning outcomes covered areas of online communication skill, technical issues, technology literacy of patients, limitations of physical examination, and privacy concerns of personal information. Learning scenario and instructional content were subsequently designed to support learners in achieving the expected learning outcomes, with their alignments validated by three experts in dental education. A professional actress underwent training to role-play a patient with a dental problem, requesting a virtual consultation or teledentistry. Before conducting data collection, the simulated patient was required to undergo a training and adjusting process with a pilot group under supervision of two experts in advanced general dentistry and dental education who had experience with teledentistry to ensure realism and completeness of learning content.

According to the role-play scenario, an actress was assigned to portray a 34-year-old female with chief complaints of pain around both ears, accompanied by difficulties in chewing food due to tooth loss. She was instructed to express her anxiety and nervousness about addressing these issues. Additionally, it was specified that she could not take a day off from work during this period. Despite this constraint, she required a dental consultation to receive advice for initial self-care, as her symptoms significantly impacted her daily life. Furthermore, she was designated to encounter difficulties with the technological use of the teledentistry platform.

The game components were implemented into the online role-play to enhance motivation and engagement. As challenge and randomness appear to be game elements 32 , 33 , five challenge cards were designed and embedded into the online role-play, where a participant was asked to randomly select one of them before interacting with the simulated patient. The challenging situations were potential technical concerns which could occur frequently during video conferencing, including network problems (e.g., internet disconnection and poor connection) and audiovisual quality issues. The participants were blinded to the selected card, while it was revealed to only the simulated patient. The challenging conditions were mimicked by the organizers and simulated patient, allowing learners to deal with difficulties. Therefore, both challenges and randomness were implemented into this learning intervention not only to create learning situations but also to enhance engagement.

A feedback system was carefully considered and implemented into the gamified online role-play. Immediate feedback appears to be a key feature of interactive learning environments 29 . Formative feedback was instantly delivered to learners through verbal and non-verbal communication, including words (content), tone of voice, facial expressions, and gestures of the simulated patient. This type of feedback allowed participants to reflect on whether or not their inputs were appropriate, enabling them to learn from their mistakes, or so-called the role of failure 34 . Summative feedback was also provided at the end of the role-play through a reflection from a simulated patient and suggestions from an instructor.

Learners were able to interact with the simulated patient using an online meeting room by Cisco WebEx. According to the research setting (Fig.  1 ), a learner was asked to participate in the role-play activity using a computer laptop in a soundproof room, while a simulated patient was arranged in a prepared location showing her residential environment. The researcher and instructor also joined the online meeting room and observed the interaction between the simulated patient and learners during the role-play activity whether or not all necessary information was accurately obtained. The role-play activity took around 30 minutes.

A diagram demonstrating the setting of gamified online role-play.

Research participants

Quantitative phase.

The participants in this research were postgraduate students from the Residency Training Program in Advanced General Dentistry at Mahidol University Faculty of Dentistry in academic year 2022, using a volunteer sampling. This program was selected because its objective was to develop graduates capable of integrating competencies from various dental disciplines to provide comprehensive dental care for both normal patients and those with special needs. Therefore, teledentistry should be a supportive component of their service. The recruitment procedure involved posting a recruiting text in the group chat of the residents. Those interested in participating in the research were informed to directly contact us to request more information, and they were subsequently allowed to decide whether they would like to participate. This approach ensured that participation was voluntary. Although there could be a non-response bias within this non-probability sampling technique 35 , it was considered as appropriate for this study, as participants were willing to have contribution in the learning activity, and therefore accurate and reliable research findings with no dropout could be achieved 36 .

The inclusion and exclusion criteria were established to determine the eligibility of prospective participants for this research. This study included postgraduate students from Years 1 to 3 in the Residency Training Program in Advanced General Dentistry at Mahidol University Faculty of Dentistry, enrolled during the academic year 2022. They were also required to at least complete the first semester to be eligible for this research to ensure familiarity with comprehensive dental care. However, they were excluded if they had previous involvement in the pilot testing of the gamified online role-play or if they were not fluent in the Thai language. The sample size was determined using a formula for two dependent samples (comparing means) 37 . To detect a difference in self-perceived confidence and awareness between pre- and post-assessments at a power of 90% and a level of statistical significance of 1%, five participants were required. With an assumed dropout rate of 20%, the number of residents per year (Year 1–3) was set to be 6. Therefore, 18 residents were required for this research.

Qualitative phase

The participants from the quantitative phase were selected for semi-structured interviews using a purposive sampling. This sampling method involved the selection of information-rich participants based on specific criteria deemed relevant to the research objective and to ensure a diverse representation of perspectives and experiences within the sample group 38 . In this research, the information considered for the purposive sampling included demographic data (e.g., sex and year of study), along with self-perceived assessment scores. By incorporating perceptions from a variety of participants, a broad spectrum of insights from different experiences in comprehensive dental practice and diverse improvement levels in self-perceived confidence and awareness could inform the design and implementation of the training program effectively. The sample size for this phase was determined based on data saturation, wherein interviews continued until no new information or emerging themes were retrieved. This method ensured thorough exploration of the research topic and maximized the richness of the qualitative data obtained.

Outcome assessments

To evaluate the gamified online role-play, a triangular design approach was employed, enabling the researchers to compare the research outcomes from different assessment methods. In this research, self-perceived assessments (confidence and awareness) in teledentistry, satisfactions toward gamified online role-play, and learner experience were assessed to assure the quality and feasibility of the gamified online role-play.

Self-perceived confidence and awareness toward teledentistry

All participants were requested to rate their perceptions of teledentistry before and after participating in the gamified online role-play (Supplementary material 1 ). The self-perceived assessment was developed based on previous literature 39 , 40 , 41 , 42 . The assessment scores would inform whether or not the participants could improve their self-perceived confidence and awareness through a learning activity. The assessment consisted of two parts, which were (1) self-perceived confidence and (2) self-perceived awareness. Each part contained six items, which were similar between the pre- and post-assessments. All items were designed using a 5-point Likert scale, where 1 being ‘strongly disagree’ and 5 being ‘strongly agree’.

Satisfactions toward the gamified online role-play

All participants were asked to complete the satisfaction questionnaire after participating in the gamified online role-play, to investigate whether or not they felt satisfied with their learning (Supplementary material 2 ). The questionnaire was developed based on previous literature regarding gamification and role-play 41 , 42 , 43 , 44 . Most of the items were designed using a 5-point Likert scale, where 1 being ‘very dissatisfied’ and 5 being ‘very satisfied’. They were grouped into three aspects, which were (1) Perceived usefulness, (2) Perceived ease of use, and (3) Perceived enjoyment.

Learner experiences within the gamified online role-play

Semi-structured interviews were conducted with the purposively selected participants to gather in-depth information regarding their learning experiences within the gamified online role-play. This technique allowed researchers to ask additional interesting topics raised from the responses of participants. A topic guide for interviews were constructed based on the findings of previous literature 45 , 46 , 47 . The interview was conducted in a private room by a researcher who was trained in conducting qualitative research including interviews. The interview sessions took approximately 45–60 minutes, where all responses from participants were recorded using a digital audio recorder with their permission. The recorded audios were transcribed using a verbatim technique by a transcription service under a confidential agreement.

Validity and reliability of data collection tools

To enhance the quality of self-perceived assessment and satisfaction questionnaire, they were piloted and revised to assure their validity and reliability. According to the content validity, three experts in advanced general dentistry were asked to evaluate the questionnaire, where problematic items were iteratively revised until they achieved the index of item-objective congruence (IOC) higher than 0.5. To perform a test–retest reliability, the validated versions of both self-perceived assessment and satisfaction questionnaire were afterwards piloted in residents from other programs, and the data were analyzed using an intraclass correlation coefficient (ICC), where the values of all items were 0.7 or greater. The data from the first pilot completion of both data collection tools were analyzed using Cronbach’s alpha to ensure the internal consistency of all constructs. The problematic items were deleted to achieve the coefficient alpha of 0.7 or greater for all constructs, which was considered as acceptable internal consistency.

Data analysis

The quantitative data retrieved from self-perceived assessment and satisfaction questionnaire were analyzed with the Statistical Package for Social Sciences software (SPSS, version 29, IBM Corp.). Descriptive statistics were performed to present an overview of the data. The scores from pre- and post-assessments were analyzed using a paired sample t-test to evaluate whether or not the participants would better self-perceive their confidence and awareness in teledentistry after participating in the gamified online role-play. One-way analysis of variance (ANOVA) was conducted to compare whether or not there were statistically significant differences in self-perceived assessment and satisfaction scores among the three academic years.

The qualitative data retrieved from semi-structured interviews were analyzed using a framework analysis, where its procedure involved transcription, familiarization with the interview data, coding, developing an analytical framework, indexing, charting, and data interpreting qualitative findings 48 . In this research, the initial codes had been pre-defined from previous literature and subsequently adjusted following the analysis of each transcript to develop an analytical framework (themes and subthemes), requiring several iterations until no additional codes emerged. Subsequently, the established categories and codes were applied consistently across all transcripts (indexing). The data from each transcript were then charted to develop a matrix, facilitating the management and summarization of qualitative findings. This method enabled the researchers to compare and contrast differences within the data and to identify connections between categories, thereby exploring their relationships and informing data interpretation.

The procedure of framework analysis necessitated a transparent process for data management and interpretation of emerging themes to ensure the robustness of research 49 . The transparency of this analytic approach enabled two researchers (C.Te. and K.S.) to independently analyze the qualitative data, and the emerging themes afterwards were discussed to obtain consensus among the researchers. This technique can be considered as a triangular approach to assure the intercoder reliability and internal validity of this research. The transparent process also allowed an external expert in dental education to verify the accuracy of the analysis. All emerging themes and the decision on data saturation were based on a discussion of all researchers until an agreement was made. NVivo (version 14, QSR International) was used to performed the qualitative data analysis. Subsequently, a conceptual framework was constructed to demonstrate emerging themes and subthemes together with their relationships.

Ethical consideration

The ethical approval for the study was approved by the Institutional Review Board of Faculty of Dentistry and Faculty of Pharmacy, Mahidol University on 29 th September 2022, the ethical approval number: MU-DT/PY-IRB 2022/049.2909. All methods were performed in accordance with the relevant guidelines and regulations. Although the data were not anonymous in nature as they contained identifiable data, they were coded prior to the analysis to assure confidentiality of participants.

Informed consent

Informed consent was obtained from all participants.

There were 18 residents from Year 1 to 3 of the Residency Training Program in Advanced General Dentistry who participated in this research (six from each year). Of these, there were 14 females and 4 males. There was no participant dropout, as all of them completed all required tasks, including the pre- and post-perceived assessments, gamified online role-play, and satisfaction questionnaire. According to the purposive sampling, the participants from the quantitative phase were selected for semi-structured interviews by considering sex, year of study, and self-perceived assessment scores. Twelve students (ten females and two males) participated in semi-structured interviews, where their characteristics are presented in Table 1 .

Internal consistency of all constructs

The data collected from the research participants, in addition to the pilot samples, were analyzed with Cronbach’s alpha to confirm the internal consistency. The coefficient alpha of all constructs demonstrated high internal consistency, as demonstrated in Table 2 .

Self-perceived assessments toward confidence and awareness of teledentistry

There were statistically significant increases in the assessment scores of self-perceived confidence and awareness after participating in the gamified online role-play ( P  < 0.001). According to Table 3 , there was an increase in self-perceived confidence from 3.38 (SD = 0.68) for the pre-assessment to 4.22 (SD = 0.59) for the post-assessment ( P  < 0.001). The findings of self-perceived awareness also showed score improvement from 4.16 (SD = 0.48) to 4.55 (SD = 0.38) after interacting with the simulated patient ( P  < 0.001).

According to Fig.  2 , participants demonstrated a higher level of self-perceived assessments for both self-confidence and awareness in all aspects after participating in the gamified online role-play for teledentistry training.

Self-perceived assessments toward confidence and awareness of teledentistry.

When comparing the self-perceived assessment scores toward confidence and awareness in the use of teledentistry among the three years of study (Year 1–3), there were no statistically significant differences in the pre-assessment, post-assessment score, and score difference (Table 4 ).

Satisfactions toward the use of gamified online role-play

According to Fig.  3 , participants exhibited high levels of satisfaction with the use of gamified online role-play across all three aspects. The aspect of usefulness received the highest satisfaction rating with a score of 4.44 (SD = 0.23) out of 5, followed by ease of use and enjoyment, scoring 4.40 (SD = 0.23) and 4.03 (SD = 0.21), respectively. Particularly, participants expressed the highest satisfaction levels regarding the usefulness of gamified online role-play for identifying their role (Mean = 4.72, SD = 0.46) and developing problem-solving skills associated with teledentistry (Mean = 4.61, SD = 0.50). Additionally, they reported satisfaction with the learning sequence presented in the gamified online role-play (Mean = 4.61, SD = 0.50). However, participants did not strongly perceive that the format of the gamified online role-play could engage them with the learning task for an extended period (Mean = 3.72, SD = 0.83).

Satisfactions toward the use of gamified online role-play.

When comparing the satisfaction levels perceived by participants from different academic years (Table 5 ), no statistically significant differences were observed among the three groups for all three aspects ( P  > 0.05).

Following the framework analysis of qualitative data, there were five emerging themes, including: (1) learner profile, (2) learning settings of the gamified online role-play, (3) pedagogical components, (4) interactive functions, and (5) educational impact.

Theme 1: Learner profile

Learner experience and preferences appeared to have impact on how the participants perceived the use of gamified online role-play for teledentistry training. When learners preferred role-play or realized benefits of teledentistry, they were likely to support this learning intervention. In addition, they could have seen an overall picture of the assigned tasks before participating in this research.

“I had experience with a role-play activity when I was dental undergraduates, and I like this kind of learning where someone role-plays a patient with specific personalities in various contexts. This could be a reason why I felt interested to participate in this task (the gamified online role-play). I also believed that it would be supportive for my clinical practice.” Participant 12, Year 1, Female “Actually, I' have seen in several videos (about teledentistry), where dentists were teaching patients to perform self-examinations, such as checking their own mouth and taking pictures for consultations. Therefore, I could have thought about what I would experience during the activity (within the gamified online role-play).” Participant 8, Year 2, Female

Theme 2: Learning settings of the gamified online role-play

Subtheme 2.1: location.

Participants had agreed that the location for conducting a gamified online role-play should be in a private room without any disturbances, enabling learners to focus on the simulated patient. This could allow them to effectively communicate and understand of the needs of patient, leading to a better grasp of lesson content. In addition, the environments of both learners and simulated patient should be authentic to the learning quality.

“The room should be a private space without any disturbances. This will make us feel confident and engage in conversations with the simulated patient.” Participant 10, Year 1, Female “… simulating a realistic environment can engage me to interact with the simulated patient more effectively ...” Participant 8, Year 2, Female

Subtheme 2.2: Time allocated for the gamified online role-play

The time allocated for the gamified online role-play in this research was considered as appropriate, as participants believed that a 30-minutes period should be suitable to take information and afterwards give some advice to their patient. In addition, a 10-minutes discussion on how they interact with the patient could be supportive for participants to enhance their competencies in the use of teledentistry.

“… it would probably take about 20 minutes because we would need to gather a lot of information … it might need some time to request and gather various information … maybe another 10-15 minutes to provide some advice.” Participant 7, Year 1, Female “I think during the class … we could allocate around 30 minutes for role-play, … we may have discussion of learner performance for 10-15 minutes ... I think it should not be longer than 45 minutes in total.” Participant 6, Year 2, Female

Subtheme 2.3: Learning consequence within a postgraduate curriculum

Most participants suggested that the gamified online role-play in teledentistry should be arranged in the first year of their postgraduate program. This could maximize the effectiveness of online role-play, as they would be able to implement teledentistry for their clinical practice since the beginning of their training. However, some participants suggested that this learning approach could be rearranged in either second or third year of the program. As they already had experience in clinical practice, the gamified online role-play would reinforce their competence in teledentistry.

"Actually, it would be great if this session could be scheduled in the first year … I would feel more comfortable when dealing with my patients through an online platform." Participant 11, Year 2, Male "I believe this approach should be implemented in the first year because it allows students to be trained in teledentistry before being exposed to real patients. However, if this approach is implemented in either the second or third year when they have already had experience in patient care, they would be able to better learn from conversations with simulated patients." Participant 4, Year 3, Male

Theme 3: Pedagogical components

Subtheme 3.1: learning content.

Learning content appeared to be an important component of pedagogical aspect, as it would inform what participants should learn from the gamified online role-play. Based on the interview data, participants reported they could learn how to use a video teleconference platform for teledentistry. The conditions of simulated patient embedded in an online role-play also allowed them to realize the advantages of teledentistry. In addition, dental problems assigned to the simulated patient could reveal the limitations of teledentistry for participants.

“The learning tasks (within the gamified online role-play) let me know how to manage patients through the teleconference.” Participant 5, Year 2, Female “… there seemed to be limitations (of teledentistry) … there could be a risk of misdiagnosis … the poor quality of video may lead to diagnostic errors … it is difficult for patients to capture their oral lesions.” Participant 3, Year 2, Female

Subtheme 3.2: Feedback

During the use of online role-play, the simulated patient can provide formative feedback to participants through facial expressions and tones of voice, enabling participants to observe and learn to adjust their inquiries more accurately. In addition, at the completion of the gamified online role-play, summative feedback provided by instructors could summarize the performance of participants leading to further improvements in the implementation of teledentistry.

“I knew (whether or not I interacted correctly) from the gestures and emotions of the simulated patient between the conversation. I could have learnt from feedback provided during the role-play, especially from the facial expressions of the patient.” Participant 11, Year 2, Male “The feedback provided at the end let me know how well I performed within the learning tasks.” Participant 2, Year 1, Female

Theme 4: Interactive functions

Subtheme 4.1: the authenticity of the simulated patient.

Most participants believed that a simulated patient with high acting performance could enhance the flow of role-play, allowing learners to experience real consequences. The appropriate level of authenticity could engage learners with the learning activity, as they would have less awareness of time passing in the state of flow. Therefore, they could learn better from the gamified online role-play.

"It was so realistic. ... This allowed me to talk with the simulated patient naturally ... At first, when we were talking, I was not sure how I should perform … but afterwards I no longer had any doubts and felt like I wanted to explain things to her even more." Participant 3, Year 2, Female "At first, I believed that if there was a factor that could influence learning, it would probably be a simulated patient. I was impressed by how this simulated patient could perform very well. It made the conversation flow smoothly and gradually." Participant 9, Year 3, Female

Subtheme 4.2: Entertaining features

Participants were likely to be satisfied with the entertaining features embedded in the gamified online role-play. They felt excited when they were being exposed to the unrevealed challenge which they had randomly selected. In addition, participants suggested to have more learning scenarios or simulated patients where they could randomly select to enhance randomness and excitement.

“It was a playful experience while communicating with the simulated patient. There are elements of surprise from the challenge cards that make the conversation more engaging, and I did not feel bored during the role-play.” Participant 4, Year 3, Male “I like the challenge card we randomly selected, as we had no idea what we would encounter … more scenarios like eight choices and we can randomly choose to be more excited. I think we do not need additional challenge cards, as some of them have already been embedded in patient conditions.” Participant 5, Year 2, Female

Subtheme 4.3: Level of difficulty

Participants suggested the gamified online role-play to have various levels of difficulty, so learners could have a chance to select a suitable level for their competence. The difficulties could be represented through patient conditions (e.g., systemic diseases or socioeconomic status), personal health literacy, and emotional tendencies. They also recommended to design the gamified online role-play to have different levels where learners could select an option that is suitable for them.

“The patient had hidden their information, and I needed to bring them out from the conversation.” Participant 12, Year 1, Female “Patients' emotions could be more sensitive to increase level of challenges. This can provide us with more opportunities to enhance our management skills in handling patient emotions.” Participant 11, Year 2, Male “… we can gradually increase the difficult level, similar to playing a game. These challenges could be related to the simulated patient, such as limited knowledge or difficulties in communication, which is likely to occur in our profession.” Participant 6, Year 2, Female

Theme 5: Educational impact

Subtheme 5.1: self-perceived confidence in teledentistry, communication skills.

Participants were likely to perceive that they could learn from the gamified online role-play and felt more confident in the use of teledentistry. This educational impact was mostly achieved from the online conversation within the role-play activity, where the participants could improve their communication skills through a video teleconference platform.

“I feel like the online role-play was a unique form of learning. I believe that I gained confidence from the online communication the simulated patient. I could develop skills to communicate effectively with real patients.” Participant 11, Year 2, Male “I believe it support us to train communication skills ... It allowed us to practice both listening and speaking skills more comprehensively.” Participant 4, Year 3, Male

Critical thinking and problem-solving skills

In addition to communication skills, participants reported that challenges embedded in the role-play allowed them to enhance critical thinking and problem-solving skills, which were a set of skills required to deal with potential problems in the use of teledentistry.

"It was a way of training before experiencing real situations … It allowed us to think critically whether or not what we performed with the simulated patients was appropriate." Participant 7, Year 1, Female “It allowed us to learn how to effectively solve the arranged problems in simulated situation. We needed to solve problems in order to gather required information from the patient and think about how to deliver dental advice through teledentistry.” Participant 11, Year 2, Male

Subtheme 5.2: Self perceived awareness in teledentistry

Participants believed that they could realize the necessity of teledentistry from the gamified online role-play. The storytelling or patient conditions allowed learners to understand how teledentistry could have both physical and psychological support for dental patients.

“From the activity, I would consider teledentistry as a convenient tool for communicating with patients, especially if a patient cannot go to a dental office”. Participant 5, Year 2, Female “I learned about the benefits of teledentistry, particularly in terms of follow-up. The video conference platform could support information sharing, such as drawing images or presenting treatment plans, to patients.” Participant 8, Year 2, Female

A conceptual framework of learning experience within a gamified online role-play

Based on the qualitative findings, a conceptual framework was developed in which a gamified online role-play was conceptualized as a learning strategy in supporting learners to be able to implement teledentistry in their clinical practice (Fig.  4 ).

The conceptual framework of key elements in designing a gamified online role-play.

The conceptual framework has revealed key elements to be considered in designing a gamified online role-play. Learner profile, learning settings, pedagogical components, and interactive functions are considered as influential factors toward user experience within the gamified online role-play. The well-designed learning activity will support learners to achieve expected learning outcomes, considered as educational impact of the gamified online role-play. The contributions of these five key elements to the design of gamified online role-play were interpreted, as follows:

Learner profile: This element tailors the design of gamified online role-plays for teledentistry training involves considering the background knowledge, skills, and experiences of target learners to ensure relevance and engagement.

Learning settings: The element focuses the planning for gamified online role-plays in teledentistry training involves selecting appropriate contexts, such as location and timing, to enhance accessibility and achieve learning outcomes effectively.

Pedagogical components: This element emphasizes the alignment between learning components and learning outcomes within gamified online role-plays, to ensure that the content together with effective feedback design can support learners in improving their competencies from their mistakes.

Interactive functions: This element highlights interactivity features integrated into gamified online role-plays, such as the authenticity and entertaining components to enhance immersion and engagement, together with game difficulty for optimal flow. All these features should engage learners with the learning activities until the achievement of learner outcomes.

Educational impact: This element represents the expected learning outcomes, which will inform the design of learning content and activities within gamified online role-plays. In addition, this element could be considered to evaluate the efficacy of gamified online role-plays, reflecting how well learning designs align with the learning outcomes.

A gamified online role-play can be considered as a learning strategy for teledentistry according to its educational impact. This pedagogical approach could mimic real-life practice, where dental learners could gain experience in the use of teledentistry in simulated situations before interacting with actual patients. Role-play could provide learners opportunities to develop their required competencies, especially communication and real-time decision-making skills, in a predictable and safe learning environment 20 , 23 , 46 . Potential obstacles could also be arranged for learners to deal with, leading to the enhancement of problem-solving skill 50 . In addition, the recognition of teledentistry benefits can enhance awareness and encourage its adoption and implementation, which could be explained by the technology acceptance model 51 . Therefore, a gamified online role-play with a robust design and implementation appeared to have potential in enhancing self-perceived confidence and awareness in the use of teledentistry.

The pedagogical components comprised learning content, which was complemented by assessment and feedback. Learners could develop their competence with engagement through the learning content, gamified by storytelling of the online role-play 52 , 53 . Immediate feedback provided through facial expression and voice tone of simulated patients allowed participants to learn from their failure, considered as a key feature of game-based learning 29 , 45 . The discussion of summative feedback provided from an instructor at the end of role-play activity could support a debriefing process enabling participants to reflect their learning experience, considered as important of simulation-based game 54 . These key considerations should be initially considered in the design of gamified online role-play.

The interactive functions can be considered as another key component for designing and evaluating the gamified online role-play 45 . Several participants enjoyed with a learning process within the gamified online role-play and suggested it to have more learning scenarios. In other words, this tool could engage learners with an instructional process, leading to the achievement of learning outcomes 29 , 45 . As challenge and randomness appear to be game elements 32 , 33 , this learning intervention assigned a set of cards with obstacle tasks for learners to randomly pick up before interacting with simulated patients, which was perceived by participants as a feature to make the role-play more challenging and engaging. This is consistent with previous research, where challenging content for simulated patients could make learners more engaged with a learning process 55 . However, the balance between task challenges and learner competencies is certainly required for the design of learning activities 56 , 57 . The authenticity of simulated patient and immediate feedback could also affect the game flow, leading to the enhancement of learner engagement 45 . These elements could engage participants with a learning process, leading to the enhancement of educational impact.

The educational settings for implementing gamified online role-play into dental curriculum should be another concern. This aspect has been recognized as significant in existing evidence 45 . As this research found no significant differences in all aspects among the three groups of learners, this learning intervention demonstrated the potential for its implementation at any time of postgraduate dental curriculum. This argument can be supported by previous evidence where a role-play could be adaptable for learning at any time, as it requires a short learning period but provides learners with valuable experience prior to being exposed in real-life scenarios 58 . This strategy also provides opportunities for learners who have any question or concern to seek advice or guidance from their instructors 59 . Although the gamified online role-play can be arranged in the program at any time, the first academic year should be considered, as dental learners would be confidence in implementing teledentistry for their clinical practice.

While a gamified online role-play demonstrated its strengths as an interactive learning strategy specifically for teledentistry, there are a couple of potential drawbacks that need to be addressed. The requirement for synchronous participation could limit the flexibility of access time for learners (synchronous interactivity limitation). With only one learner able to engage with a simulated patient at a time (limited participants), more simulated patients would be required if there are a number of learners, otherwise they would need to wait for their turn. Time and resources are significantly required for preparing simulated patients 60 . Despite the use of trained and calibrated professional actors/actresses, inauthenticity may be perceived during role-plays, requiring a significant amount of effort to achieve both interactional and clinical authenticities 46 . Future research could investigate asynchronous learning approaches utilizing non-player character (NPC) controlled by an artificial intelligence system as a simulated patient. This setup would enable multiple learners to have the flexibility to engage with the material at their own pace and at times convenient to them 29 . While there are potential concerns about using gamified online role-plays, this interactive learning intervention offers opportunities for dental professionals to enhance their teledentistry competency in a safe and engaging environment.

Albeit the robust design and data collection tools to assure reliability and validity as well as transparency of this study, a few limitations were raised leading to a potential of further research. While this research recruited only postgraduate students to evaluate the feasibility of gamified online role-play in teledentistry training, further research should include not only experienced dental practitioners but also undergraduate students to confirm its potential use in participants with different learner profiles. More learning scenarios in other dental specialties should also be included to validate its effectiveness, as different specialties could have different limitations and variations. Additional learning scenarios from various dental disciplines should be considered to validate the effectiveness of gamified online role-plays, as different specialties may present unique limitations and variations. A randomized controlled trial with robust design should be required to compare the effectiveness of gamified online role-play with different approaches in training the use of teledentistry.

Conclusions

This research supports the design and implementation of a gamified online role-play in dental education, as dental learners could develop self-perceived confidence and awareness with satisfaction. A well-designed gamified online role-play is necessary to support learners to achieve expected learning outcomes, and the conceptual framework developed in this research can serve as a guidance to design and implement this interactive learning strategy in dental education. However, further research with robust design should be required to validate and ensure the educational impact of gamified online role-play in dental education. Additionally, efforts should be made to develop gamified online role-play in asynchronous learning approaches to enhance the flexibility of learning activities.

Data availability

The data that support the findings of this study are available from the corresponding author, up-on reasonable request. The data are not publicly available due to information that could compromise the privacy of research participants.

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Acknowledgements

The authors would like to express our sincere gratitude to participants for their contributions in this research. We would also like to thank the experts who provided their helpful suggestions in the validation process of the data collection tools.

This research project was funded by the Faculty of Dentistry, Mahidol University. The APC was funded by Mahidol University.

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Conceptualization, C.Te., C.Ta., and K.S.; methodology, C.Te., C.Ta., and K.S.; validation, C.Te., C.Ta., and K.S.; investigation, C.Te. and K.S.; formal analysis, C.Te., C.Ta., and K.S.; resources, C.Te., C.Ta., and K.S.; data curation, C.Ta. and K.S.; writing-original draft preparation, C.Te., C.Ta., and K.S.; writing-review and editing, C.Te., C.Ta., and K.S. All authors have read and agreed to the published version of the manuscript.

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Teerawongpairoj, C., Tantipoj, C. & Sipiyaruk, K. The design and evaluation of gamified online role-play as a telehealth training strategy in dental education: an explanatory sequential mixed-methods study. Sci Rep 14 , 9216 (2024). https://doi.org/10.1038/s41598-024-58425-9

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• What Is Collaborative Problem Solving? »

What Is Collaborative Problem Solving?

Helping kids with challenging behavior requires understanding why they struggle in the first place. But what if everything we thought was true about challenging behavior was actually wrong? Our Collaborative Problem Solving ® approach recognizes what research has pointed to for years – that kids with challenging behavior are already trying hard. They don’t lack the  will  to behave well. They lack the  skills  to behave well.

Collaborative Problem Solving ® is different than most approaches to working with kids with behavioral challenges in that it has a guiding philosophy attached to it. And the philosophy is a simple one. Kids do well if they can. And what that means is if a kid could do well, they would do well. And if they're not doing well, let's figure out what's standing in their way so we can help. Unfortunately, most people tend to adhere more to the philosophy of kids do well if they want to, which means if a kid isn't doing well, it must be because they don't want to. Our job is to try to make them want to, to motivate them to do better. We use 50 years of research in the neurosciences to help us understand what's getting in a kid's way. Because what we've learned over the years is that kids who struggle with their behavior, they actually don't lack the will to behave well. What they lack are the skills to behave well. Skills like flexibility, and frustration tolerance, and problem solving.

In Collaborative Problem Solving, we think of it much in the way you might think of a learning disability, except instead of areas like reading and math and writing. This is in areas like flexibility, frustration, tolerance, problem-solving. These kids are delayed in the development of those skills. Now, a long time ago, we used to think kids with learning disabilities were simply "lazy" or "dumb." Thank goodness we've come to a very different place in understanding kids with learning disabilities. However, we haven't made as much progress when it comes to kids with behavioral challenges. We still assume that they aren't trying hard to behave well when the truth of the matter is they're trying harder than anybody else because it doesn't come naturally to them. We've yet to meet a child that prefers doing poorly to doing well.

We believe kids do well if they can. We teach adults a practical assessment process that helps identify the specific skills that these kids struggle with and the situations in which they happen. Then we provide adults with three basic options for handling any of those situations. We call those our three plans. We call it Plan A. When you try to impose your will to make the child do what you want them to do, we call it Plan B. When you do Collaborative Problem Solving, and we call it Plan C, when you decide strategically to drop your expectation for now or solve the problem the way the child wants it solved. So we teach adults that they really only have these three options when it comes to handling any problem with a kid. Which one they choose depends on what they're trying to accomplish. Not surprisingly, we spend most of our time teaching adults how to do Plan B, collaborate with kids to solve problems in mutually satisfactory ways, not just to solve the problem and reduce challenging behavior, but to actually practice and build the skills that these kids lack.

Plan B has three ingredients to it. It seems simple, but don't confuse simple with easy. Those three ingredients are first and foremost, trying to understand the kid's perspective. The kid's concern, the kid's point of view about the problem to be solved. And only once we understand the child's concern can we move to the second ingredient of Plan B, where we put the adult's concern on the table, not our adult solution, but the adult concern on the table. And only once we have two sets of concerns on the table, the child's concern and the adult's concern, do we move to the third and final ingredient of Plan B. And that's where you invite the child to brainstorm potential solutions to the problem, which the two of you are going to test out together, aiming for one that is mutually satisfactory, doable, and realistic. And we teach adults lots of guideposts along the way to help facilitate that process. And once again, the goal of Plan B, not just reducing challenging behavior and solving the problem, but also helping the child and the adult to practice a whole host of skills related to flexibility, frustration, tolerance, and problem-solving. So in summary, Collaborative Problem Solving provides a guiding philosophy and then a corresponding set of assessment tools, a planning process, and a robust intervention that builds relationship, reduces challenging behavior, and builds skill. But let's remember that it all starts with the underlying philosophy that kids do well if they can. And this is about skill, not will.

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