J. Life Sci. Biomed. 6(3): 53-59, May, 2016  
Journal of  
ISSN 2251-9939  
Life Science and Biomedicine  
An Adaptation of the Synectics Model for Effective Physician Counseling  
Jessica J. Monk1 , Adarsh K. Gupta2 and Lucia Weiss3  
1Rowan University School of Osteopathic Medicine, Stratford, NJ, United States; 42 East Laurel Road, Stratford, NJ 08084,  
2Center for Medical Weight Loss & Metabolic Control, Rowan University, Stratford, NJ, United States; 42 East Laurel Road, Suite  
2100, Stratford, NJ 08084, guptaad@rowan.edu  
3Rowan Medicine, Stratford, NJ, United States; 42 East Laurel Road, Suite 2100, Stratford, NJ 08084, weisslb@rowan.edu  
*Corresponding author’s e-mail: monkj5@rowan.edu  
ABSTRACT: Introduction: Physician counseling can influence healthy behavior change in patients, but the rate  
of physician counseling for physical activity is inconsistent. Most studies focus on the patient-reported or  
physician-reported presence of counseling and physician attitudes that may act as barriers to counseling. Far  
less research has been directed at understanding the content of physician counseling and aiming to improve  
upon that content. Methods: A group of patients seeking medical treatment for weight loss participated in a  
group ideation with the task of constructing realistic and novel approaches to achieving 45 minutes of daily  
activity. Patients’ approaches to achieving the recommended level of activity were recorded prior to the  
session and following the session in addition to other parameters. The ideation session was designed to reflect  
the Synectics model and guided by a trained facilitator. The study was both performed and the data analyzed  
in 2014. Results: The session yielded 52 patient-driven approaches to managing their physical activity. For  
example, popular strategies included photo and video diary progress tracking and incorporating physical  
activity into already planned tasks. Conclusions: The researchers conclude that use of the Synectics method  
may improve the quality and diversity of strategies used to achieve daily physical activity. Future research  
may explore the utility of these strategies as a supplement or adjunct to physician counseling in chronic  
disease management.  
Key words: Synectics, Activity, Patient-Centered, Counseling  
Physical activity is a known modifiable risk factor for heart disease, diabetes, hypertension, stroke, obesity  
and certain types of cancer [1]. The Physical Activity Guidelines for Americans published in 2008 outlines the  
national guidelines for physical activity in adults based on a strong body of research supporting the health  
benefits of regular exercise. For substantial health benefits, adults should achieve at least 150 minutes a week of  
moderate intensity exercise. For extensive health benefits, adults should achieve 300 minutes a week of moderate  
intensity exercise [2]. Most Americans do not get the amount of physical activity that they need [3]. Fortunately,  
eighty-two percent of Americans have had contact with a health care professional in the last 12 months [4]. This  
provides a unique opportunity for primary care providers to provide counseling that can substantially impact  
public health. Despite this, the rate of exercise counseling by physicians is generally low [1]. Most research on this  
matter relies on physician-reported and patient-reported evidence of counseling and these studies tend to be  
inconsistent in their results [1]. One study used trained medical students to directly observe physician counseling  
practices and determined that physicians counsel patients on dietary habits and exercise 20-25% of the time [1].  
The majority of research on physician counseling explores the frequency of counseling [1, 5-8], and the  
adoption of physical activity behavior changes as a result of counseling [9]. It is well known that a major deficit  
exists in the number of physicians taking advantage of the opportunity to counsel their patients, but research is  
needed to explore the quality of counseling where it does exist. Improvements in the quality of counseling may  
lead to better adoption of behavior changes in patients and subsequently increased frequency of physician  
counseling in primary care. One study used physical activity behavior change and aerobic capacity to measure the  
effectiveness of counseling interventions. The interventions employed in this study were developed by a  
coordination team consisting of individuals with healthcare backgrounds. The study included interventions under  
three categories: informational approach, behavioral skills management and environmental and policy  
approaches [9]. The development of intervention strategies by patients themselves is a unique opportunity that  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
has yet to be fully explored. The Synectics concept provides a model to extract patient-driven activity strategies  
that are both unique and effective.  
The Synectics model is a structured approach to brainstorming that constructs an environment for creative  
thinking and problem-solving. The model uses group idea construction in an organized system that aims to get  
participants to think broadly. It is often employed to tackle persistent challenges facing a group or organization.  
The Synectics model has been used to generate innovative solutions in a variety of industries, and has had much  
success in international business efforts. The Synectics Education Initiative, a registered charity, aims to use  
Synectics-based skills in the education system [10]. Much of the preparation of a Synectics session involves  
creating a collaborative environment and bringing together diverse groups of people who each have a stake in  
finding solutions. The goal of this research was to determine if the Synectics model could be effective in  
generating strategies for weight-management, specifically strategies for achieving the recommended daily levels  
of physical activity.  
The Synectics diamond model (Figure 1) is shaped to represent the notion that powerful ideation begins with  
a discrete task, followed by broad thinking, and then closing with a concrete, vetted solution.  
Figure 1. Synectics Diamond Model  
The specific task for this session was to construct realistic and yet novel  
tools and/or approaches to help patients achieve 45 minutes of activity  
every day. One of the investigators, a trained facilitator of the Synectics  
model, guided the session but did not participate in the ideation. The first  
stage of the model is the idea generation process, known as  
springboarding”. This stage seeks to have participants think creatively and  
without constraints. As one idea is generated and stated aloud by the  
participant the facilitator records it, and others use this idea as a platform, or  
springboard, to develop more ideas. An “excursion” can be used if necessary  
to broaden the list of ideas. An excursion is a creative exercise used during  
the session that allows participants to make connections to seemingly  
unrelated topics. For this session an excursion was not employed, but it is  
built into the model to use if needed. As ideas are generated during the  
springboarding process the facilitator groups the ideas into categories. After  
the allotted time for this idea generation, a group of ideas are selected by  
allowing each patient to place three votes on the list of ideas. The criteria for  
selecting an idea are that it is both thought-provoking and capable of being  
developed into a concrete solution. This stage is known as the selection  
phase. For this session, five ideas were selected to be developed further. At this point in the process the shape of  
the diamond model begins to narrow. This represents the process of building thought-provoking ideas into  
achievable solutions. The final step involves creating an itemized response, which encourages patients to outline  
the benefits and the concerns with each selected idea. This helps the group to elicit which ideas are more realistic  
to achieve.  
The principal investigators received approval from the Institutional Review Board (IRB) of Rowan University  
for the study design. The design included the development and execution of a Synectics adapted session  
comprised of 6 patients. Informed consent was received from all patients included as study participants. Inclusion  
criteria consisted of several factors. Patients were recruited from those currently seeking treatment in the Rowan  
University Center for Weight Loss and Metabolic Control. This includes patients who are currently considered  
obese or who have struggled with obesity in the past, are of diverse socioeconomic backgrounds, are within the  
ages 18-89 years, and who maintain a positive outlook towards their health. The session occurred over 3 hours in  
the evening and included a brief orientation to the process. Much of the preparation for a session involves  
creating an environment for effective problem solving. Defining the inclusion criteria is an important part of  
ensuring open collaboration. Before beginning the session and immediately following the session, patients were  
asked to complete a survey developed by the researchers. The pre-session survey asked patients to describe their  
current approaches to maintaining daily activity, whether these approaches are effective and what, if any  
alternatives do they know exist. The post session survey similarly asked what new approaches exist for  
maintaining daily activity, and for the study participants’ predictions of the effectiveness of these new  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
approaches. In addition, it asked patients to rate their experience with the model using a hedonic scale. Finally,  
investigators gathered data for classification purposes such as age, gender, ethnicity, education level, height and  
Raw data was collected, capturing each patient’s response and how those responses were grouped into  
categories. There were a total of 52 ideas generated in response to the task, and the categories developed from  
these ideas are provided in Table 1.  
After the allotted time for springboarding, patients were asked to place three votes for the ideas that meet the  
selection criteria. The top five ideas as determined by the patients are provided with their respective categories.  
The pre-session survey asked patients to list all current approaches to achieving 45 minutes of daily activity,  
and the effectiveness of those approaches. After the session, patients were asked to list any new approaches that  
they had learned, and how effective they predict those approaches would be. Patients included four to five  
approaches/tools and scored these from one to five, one representing an approach that would definitely not  
increase their physical activity, and five representing an approach that would definitely help them increase  
physical activity levels and ultimately achieve their weight loss goals. Responses are provided for each participant  
and the four to five scores were averaged for each patient (Figure 2). Figure 2 shows that patient-predicted  
effectiveness of the new approaches and/or tools varied in relation to the scores of their current strategies for  
achieving physical activity. Two patients predicted these new approaches would be more effective; three patients  
predicted they would be less effective, and one patient predicted the new approaches would be the same as what  
they are using currently.  
Table 1. Idea Categories  
Replacing everyday activities with a  
Get More Active  
Progress Tracking  
more active version  
Community Involvement  
Mind/Body Connection  
Reward Systems  
Get Organized  
Table 2. Top Five Ideas as Selected by Patients  
Mobile technology that visually captures goals  
Progress Tracking  
Wearable, audible or detectable reminders to stay active  
The use of a food journal  
Progress Tracking  
Progress Tracking  
Willingness to change the approach if lacking noticeable results  
Mind/Body Connection  
Keeping a schedule to document small intervals of exercise  
Get Organized  
Patients were also asked to rank their personal satisfaction with the session (Figure 3), the effectiveness of  
the session (Figure 4), and their level of personal motivation after having attended the session (Figure 5). All  
session participants ranked their experience with the Synectics model as very satisfying, either very effective or  
somewhat effective, and either very motivating or somewhat motivating. Based on the raw patient responses  
during the springboarding session, a word cloud was created that depicts words and terms that appear frequently  
in patient responses (Figure 6).  
Patients generally felt the use of a Synectics model as a tool for idea generation was effective, however they  
did not always believe that new ideas generated would be any more effective than the ones they are already  
trying. Because this finding is based on a patient-recorded prediction and not on measureable patient behavior  
changes, additional research is needed to confirm if the strategies developed by patients would in time prove  
useful in increasing physical activity in a manageable and sustainable way.  
The ideas generated during this case study were grouped by the patients into categories, and then the top  
ideas were voted by the patients based on the selection criteria. Three of the top five ideas came from the same  
category entitled, “Progress Tracking”. This type of categorization can be useful in predicting trends in patient-  
centered strategies to lifestyle modification. In this session, the task was to generate ideas for achieving daily  
physical activity. However, it is clear that the role of food in patients’ lives is an inextricable part of the  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
conversation, as this word was frequently used during the ideation. The use of the word cloud can be utilized in  
future research to better elucidate trends in patient ideation.  
Figure 2. Before and after session responses to activity strategies  
Figure 3. Personal satisfaction  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
Figure 4. Effectiveness  
Figure 5. Motivation  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
Figure 6. Word Cloud Depicting Patient Responses  
Prior research discusses the use of Synectics in education, business, marketing and invention [10]. However,  
in the medical community there is a need to utilize a type of intervention that can harness the patient perspective  
on chronic disease management. This study demonstrates it’s utility specific to achieving physical activity. Future  
next steps include additional sessions, which will serve to generate larger data sets to support this initial pilot.  
Once larger data sets are acquired the researchers can evaluate trends in patient-centered strategies and measure  
the impact those strategies may have on behavior change over time and successful adoption of the recommended  
levels of daily activity. This model can be widely used to explore patients’ management strategies of other chronic  
health conditions.  
The disparity in physician counseling is multifactorial and challenging to measure. The potential benefits of  
improved counseling in primary care are significant, and it is imperative that research continues to seek answers.  
Developing strategies for patients is often a task prescribed to physicians, researchers and those in the public  
health sector. Using patients themselves to develop strategies is a unique opportunity. In addition, harnessing the  
power of a model like Synectics may be useful in extracting creativity and open collaboration from those who  
have a vested interest in achieving results. Those patient-centered strategies can then be transplanted to the  
hands of physicians who can exponentially magnify the usefulness of those strategies by integrating them as a  
part of their counseling in a primary care setting.  
The authors would like to acknowledge Rose M. Rossiter for her help with coordination of the Synectics  
Competing Interests  
No conflicts of interest were reported by the authors of this paper.  
No financial disclosures were reported by the authors of this paper.  
1. Anis N a., Lee RE, Ellerbeck EF, Nazir N, Greiner KA, Ahluwalia JS. 2004. Direct observation of physician  
counseling on dietary habits and exercise: Patient, physician, and office correlates. Prev Med (Baltim).  
38(2):198-202. doi:10.1016/j.ypmed.2003.09.046.  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.  
2. 2008 Physical Activity. Heal (San Fr. 2008.  
3. U.S. Department of Health and Human Services. 1996. Physical activity and health: a report of the Surgeon  
General. 1-18. doi:10.1006/pmed.2000.0686.  
4. Blackwell DL, Lucas JW, Clarke TC. 2014. Summary health statistics for u.s. Adults: national health interview  
5. Egede LE, Zheng D. 2002. Modifiable Cardiovascular Risk Factors in Adults With Diabetes. Arch Intern Med.  
162(Dm):427-433. doi:10.1001/archinte.162.4.427.  
6. Glasgow RE, Eakin EG, Fisher EB, Bacak SJ, Brownson RC. 2001. Physician advice and support for physical  
activity. Results from a national survey. Am J Prev Med. 21(3):189-196. doi:10.1016/S0749-3797(01)00350-  
7. Nawaz H, Adams ML, Katz DL. 2000. Physician-patient interactions regarding diet, exercise, and smoking. Prev  
Med (Baltim). 31(6):652-657. doi:10.1006/pmed.2000.0760.  
8. Walsh JME, Swangard DM, Davis T, McPhee SJ. 1999. Exercise counseling by primary care physicians in the  
era of managed care. Am J Prev Med. 16(4):307-313. doi:10.1016/S0749-3797(99)00021-5.  
9. Kahn E, Ramsey L, Brownson R, et al. 2002. The effectiveness of interventions to increase physical activity: A  
systematic review. Am J Prev Med. 22(4):73-107. doi:10.1016/S0749-3797(02)00434-8.  
10. Ehrlich A. 1985. Whatever happened to...? Dent Econ.;75(3):99-100, 102-103. doi:10.1145/956733.956735.  
To cite this paper: Monk J.J., Gupta A.K. and Weiss L. 2016. An Adaptation of the Synectics Model for Effective Physician Counseling. J. Life Sci. Biomed. 6(3): 53-59.