Kelowna Dialogue on Health: Why, What, and How

Purpose: Why 

There has been minimal input from individual Canadians on how they would like to see their complex health care system adapt and evolve in response to the fiscal, demographic, and philosophical challenges facing Canada now and in the immediate future.  It is time for Canadians to be given the opportunity to add their voices into the health care dialogue.

Objectives: What 

The goal of this research is that core values fundamental to sustaining a flourishing and adaptable Canadian health care system will be discovered and developed into innovative ideas that will enable Canadians to enjoy improved health care.  The nature and results of the participatory dialogue will enliven and inform the Canadian public sphere.  These core-values based ideas will hopefully be communicated to the current health care decision makers and through this avenue all Canadians will have the opportunity to influence and ultimately become health care decision makers. 


1) How do individuals make sense of their own lived experiences of health through the sharing of their stories and how can these stories by used to better understand and guide the future direction of the Canadian health care system?

2) How can appreciative inquiry (AI) be used to explore and tell the stories of the typically unheard voices of the marginalized in the Canadian health care debate and how can AI be used to identify core values fundamental to sustaining a flourishing health care system?

Methodology: How

The research strategy of Appreciative inquiry (AI) will be used to explore and tell the stories of the typically unheard voices in the Canadian health care debate in an attempt to identify core values fundamental to sustaining a flourishing health care system (Whitney & Trosten-Bloom, 2010).  AI research, like action research, is firmly grounded in everyday practices and experiences and by being participative, iterative, and through having a whole system perspective AI leads to positive action and development (Reed, Nilsson, & Holmberg, 2009, pp. 633-635).  AI, first described by Cooperrider and Srivastra (1987), is a strengths based approach to organizational and system change that uses individual interviews to explore ideas that people have about what is valuable and tries to work out how these ideas can lead to knowledge creation about the social world (Reed, 2007, p. 2; Danielle & Cooperrider, 2008, p. 190).  In the AI process participants address a chosen affirmative topic through a dialogue laden 4-D cycle of: discovery – appreciating what gives life, dreaming – envisioning what might be, designing  – determining what will be, and destiny – planning what will be (Cooperrider, Whitney, & Stavros, 2008, p. 5; Reed, 2007, p. 35). 

In the discovery process, individuals engage in a positive question based one-on-one dialogue to discover the most vital and alive moments and stories in relation to the affirmative topic (Cooperrider et al., 2008, p. 6).  In the dream stage participants work together to creatively build on the collective outcomes of the discovery stage to envision new ideas of what might be in a preferred future (Cooperrider et al., 2008, p. 6, Reed, 2007, p. 35).  In the design stage participants work together to co-construct an ideal vision through a provocative proposition based on what has worked well in the past and what has been envisioned for the future (Cooperrider et al., 2008, p. 7, Reed, 2007, p.35).  The destiny stage directs the energy toward realizing the provocative proposals through thinking and committing to specific tasks and actions. (Cooperrider et al., 2008, p. 7; Reed, 2007, p. 35).  The main assumption of the 4-D AI model is that an organization is not a problem to be solved but is rather a solution to be embraced (Cooperrider, Whitney, & Stavros, 2008, p. 5; Reed, 2007, p. 26).   The data obtained about Canadian health care will be the stories and experiences appreciated through the inquiry of Canadians and this data will be analyzed in a collaborative manner to develop actionable items to be taken forward and entered into the national health dialogue (Reed, 2007; Rogers & Fraser, 2003).


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