The document provides 10 tips for increasing resilience in medical education systems design. The tips are: 1) have responsibility to students, not just the program; 2) focus on important tasks; 3) involve others early in the process; 4) build trust, not just provide facts; 5) develop strong communication networks; 6) build a personal learning network; 7) be clear about your values; 8) increase connections between people and resources; 9) adapt to challenges rather than breaking down; and 10) regularly self-reflect on your approach. The overarching goal is to create a system that supports students and avoids burnout through collaboration, communication and flexibility.
9. 3. Involve others as early as
possible
If you want to go fast, go alone, if you
want to go far, go together”-African
proverb
10. 4. Be trustworthy, not just factual
“Trust is like the air we
breathe. When it’s present,
nobody really notices. But
when it’s absent, everyone
notices” – Warren Buffet
I was a program director for 13 years. When I first started, I thought that if I was the best clinician, worked the hardest, gave the best lectures, I would have the best residency. These are ten things I learned over the next decade
Think of three people that have been most influential in your work
Why?
What wellbeing and resilience traits do they have
You have a responsibility to the program, not for the program. When I first started, I would take every challenge personally, a resident not showing up on time, faculty not filling out their evaluations, budget cuts. I lost sleep, had difficulty with boundaries, and became angry. I finally realized that I had a responsibility to the program: E.g. be honest, kind, hard working, do what’s best for patients, be resident centered, align authority with accountability and responsibilities with resources.
I also recognized the importance of a shared vision. A vision not shared is a hallucination and spent a lot of my energy building a shared vision, with the rest of the department, with the hospital, and with the medical school
If things are not going well, ask yourself
Did I spend enough time envisioning bold and creative possibilities
Did I spend enough time enlisting others in a vision that is shared
My second lesson was to let go. I wanted to be the hardest working person and not impose on people. I was so excited about where we were headed that that I offered advice and comments on every part of the residency program. It was only after a few years that I realized that people did not want unsolicited advice, they wanted encouragement
Are you trying to add value to every conversation or do you let others maximize their contribution?
Are you making a point or making a difference?
Are you maximizing a position or elevating a conversation?
Change is as much about letting go of assumptions as it is creating new alternatives
Must have an open mind, open heart, and open will to let go of assumptions as truths
#meded is a service rather than a product, services are best co-designed, if it is produced sometimes people feel like their only options are to agree or to be disagreeable
This is about moving from the transaction to the relationship
Factual is mentioning the facts, being trustworthy, is having the facts in a shared context not a strategic context,.
Focus on context before focusing on the facts, so much mistrust is based on facts in strategic contextx
Be courageous
Be trusting
Be trustworthy
Be deliberate
Be generous
Values of HealthPartners are excellence and integrity and excellence and partnership and compassion, finance and measurement are support functions, not core values, in the absence of core values, sometimes support functions become core values
I recommend you articulate three to four core values for your program, and incorporate those in your communication platform
Anchoring and confirmation bias
Move up the Senn Delaney ladder
Bend, don’t break
Perfection
Illusion of central position
Maximize cognitive bending practice
ABCD of Robert Ellis (rational emotive behavioral therapy)
Activating; pull IM resident off EM service
Belief: residency does not value EM
Consequence: hostility to IM PD
Dispute: challenge initial belief and come up with alternative belief e.g. resident pulled from EM for other reason
There are sun, moons, and black holes.
Suns radiate energy, moons reflect energy, and black holes suck the energy out of you. The best PDs incorporate individual and systematic reflective practice
As an example, we did open source strategic planning for our residency every year, invited our competitors and put it on the web
The unexamined life is not worth living socrates
Think of other people that you can learn from in terms of resilience
Why is that
How can you reach out to them