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Six thinking hats technique for evaluation and strategic formulation in postgraduate medical teaching
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Six thinking hats technique for evaluation and strategic formulation in postgraduate medical teaching

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Six thinking hats technique for evaluation and strategic formulation in postgraduate medical teaching Six thinking hats technique for evaluation and strategic formulation in postgraduate medical teaching Document Transcript

  • Six thinking hats technique for evaluation and strategicformulation in postgraduate medical teaching systemThira Woratanarat*, Patarawan Woratanarat*** Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand** Department of Orthopaedics, Clinical Epidemiology Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University,Bangkok, Thailand.Abstract methods in assessment, monitoring, evaluation, and formulation of effective development strategy. Six thinking hats technique has been used in private andBackground government sectors worldwide 1, 2 . The techniqueSix thinking hats” technique has been used in both private symbolizes six different colors of the hat, i.e. yellow, black,and government sectors worldwide. The technique white, red, green, and blue, to induce group brainstormingsymbolizes six different colors of the hat to induce group in systematic fashion. Yellow color is to let the group assessbrainstorming in systematic fashion. We share our strengths or good points of the system they areexperience of applying this technique in medical school considering, whereas black is to spell out weak points orsetting. bad things happening in the system. White hat is used to induce the analysis whether the system has run onMaterial and methods evidence-based fashion or not, and which evidence hasTwenty-one departments were invited to send two been used as well as any necessary evidences is absent.faculties and at least one resident to participate in this For red color, a rapid emotional reflection from the memberactivity. “Six thinking hats” technique was introduced to of the group will be generated in order to see overallall participants, then seven minutes were allocated to each atmosphere regarding the system we are considering.hat for brainstorming session. Green hat is used to stimulate creative thinking from group members to find out improvement strategies, and finallyResults the blue hat is for assisting the group to summarize what and how they may go back to their department toTwenty-one faculties and 11 residents attended in the implement those strategies step-by-step. This study is tomorning for postgraduate medical teaching session, and share our experience of applying strategic analysis16 faculties with 11 residents participated in the afternoon technique from business sector named “Six thinking hats”for medical research session. The analytic results from “Six in medical school setting.thinking hats” technique were delivered from the groupmembers in systematic fashion. Material and methodsConclusions As a pilot project, twenty-one departments involving postgraduate medical training and medical research were“Six thinking hats” technique has been demonstrated as a invited to send two faculties and at least one resident tofeasible and acceptable choice to create responsive and participate in this activity. The activity was divided into twopossible interventions to existing problems in the medical main sessions: three hours in the morning involvedschool system. evaluation and strategic formulation for postgraduate medical teaching system, and another three hours in theKeywords afternoon for medical research.Six thinking hats, Strategic formulation, Medical school The participants were divided into three groups, 10-12 members in each group. The objective of the activity wasBackground explained and the questions were welcome with clarification until well understanding was achieved.Faculty of Medicine, Chulalongkorn University, has been Six thinking hats technique was introduced to allrecognized as one of the best medical schools in Thailand. participants by Dr.Thira Woratanarat, a facilitator of thisOur missions comprise provision of tertiary medical activity. Since this was the first time for all participantsservices, undergraduate and postgraduate medical exercising this technique, seven minutes were allocatedtraining, and generation of high quality and high impact to each hat for determining and discussing on the issue ofmedical research. In order to maintain a top level of teaching and research in accordance with the sessions. Instandard in those missions amid rapid changes from real life, five minutes are usually spent for each hat exceptglobalization trend, it is noticeable that many organizations a minute for red hat. There was a note-taker in each grouphas tried to utilize both conventional and innovative for jotting down the details as well as consensus on the108 Indian Journal of Public Health Research & Development. July - December, 2011, Vol. 2, No. 2
  • flip chart. Black hatIn order to assist better understanding and wrapping up Regarding the weakness of existing teaching system, theall outputs, after six hats session finished, a representative results from both faculty group and resident group werefrom each group went up to present their outputs to all shown in Table 2.participants.After the activity, all outputs were compiled and analyzedby knowledge management subcommittee of the Faculty White hatof Medicine, Chulalongkorn University, so as to write up a The groups spent their time discussing the evidences theypolicy recommendation as well as action plan for the used in current teaching system, and what they thoughtadministrators, and in parallel send those documents back were necessary to have for teaching system improvement.to each department for their further use. The results were demonstrated in Table 3.Findings Green hatTwenty-one faculties and 11 residents attended in the The participants scrutinized the results frommorning for postgraduate medical teaching session, and aforementioned discussion to generate some “how-to”16 faculties with 11 residents participated in the afternoon processes in order to improve postgraduate medicalfor medical research session. However, the results of teaching system as shown in Table4.medical research session were reported elsewhere. Blue hatPostgraduate medical teaching session After finishing previous five hats, the members configured the steps necessary to fostering “how-to” ideas into actualRed hat implementation either at their own departments or at the Faculty level. The results were demonstrated in Table 5.After consensus was achieved, there were two types ofexpression regarding postgraduate medical teaching atFaculty of Medicine, Chulalongkorn University. Most of the Discussionfaculties expressed urgent need for improvement in Main missions of the medical schools in Thailand comprisecurrent teaching system, whereas the resident group teaching, research, and service provision. We have beenreflected this as a tough system with impaired work-life acquainted with common problems in every institution,balance. for instances, limited resources, high work burdens, etc. Frequently, most of medical schools exercises single-loopYellow hat problem solving strategy, i.e., encountering the problem and then find out alleviating solution. For this kind ofIn light of the strengths of existing teaching system, the problem solving, the solution may be only symptomaticresults from faculty group and resident group were and temporarily effective. Sometimes this measure alsodescribed in Table 1.Table 1: Strengths of postgraduate medical teaching system Faculty group Resident group• Appropriate specialty diversity· • Good academic environment• Support for medical service and research system· • Quality of the faculties• Good source for prospective faculty screening· • Critical and systematic thinking• Flexibility· • Patience training for tough situation• Unity and warm relationship such as workloads toleranceTable 2: Weaknesses of postgraduate medical teaching system Faculty group Resident group • Very high workloads • Very high workloads • Low compensation • Low compensation • Inadequate workforce • Inadequate welfare • Young faculty and resident have low tolerance to • Working more than studying tough works • Inadequate teaching resources • Inadequate teaching resources such as limited • Complicated working system spaces, materials, and budget • Limited work safety system • Some faculties and residents have limited capabilities on teaching and communication skillsIndian Journal of Public Health Research & Development. July - December, 2011, Vol. 2, No. 2 109
  • Table 3: Evidences used and evidences in need for postgraduate medical teaching system Evidences used Evidences in need • Detailed curriculum • Reasons for resignation from residents • Some monitoring surrogates/indicators such as • Evaluation and feedback from society numbers of publication, faculty:resident ratio, • Resident guideline for inter-departmental working workloads report, work schedule, satisfaction survey • Department working guideline for residents • Resident evaluation results • Employers’ feedbacks for residentsTable 4: How to improve current postgraduate medical teaching system Faculty group Resident group • Positive reinforcement strategies to increase faculty • Increase the number of faculties motivation such as increase compensation • Increase compensation for the residents • Changes teaching system in accordance with societal • Improve welfare and teaching resources needs • Simplify working process and get rid of redundancy • Training the faculty for teaching skills at timely for inter-departmental works fashion • Focus more on work safety for health personnel • Establish “Professional teaching development team” in Faculty of Medicine, Chulalongkorn University • Improve welfare and teaching resources • Focus more on work-life balance policyTable 5: Steps to implement for postgraduate medical teaching system improvement Faculty group Resident group • Establish a war room for SWOT analysis, priority • Inter-departmental resident meeting for knowledge setting, and implementation planning and experience exchange • Additional needs assessment for all faculties • Setting up resident union to have better negotiation • Collecting residents’ feedback to be essential inputs power for policy formulationherald subsequent complication with regards to sessions.unexpected impact from different demands and needsamong various stakeholders in the system. Conclusion“Six thinking hats” technique has been demonstrated as a “Six thinking hats” technique has been shown to befeasible and acceptable choice in applying the strategic feasible, acceptable, and useful for system assessment andmanagement technique for system assessment and strategy formulation in medical school setting. Data-strategy formulation so as to create responsive and returning strategy might be of value to keep in touch withpossible interventions to existing problems in the system. all stakeholders after finishing the activity.With appropriate planning for brainstorming activity byinviting all stakeholders to share their concerns, needs, and Acknowledgementopinions, in a systematic manner, we did achieve the resultsthat may be used to direct our postgraduate medical The author would like to thank all members of knowledgeteaching system in a common goal. However, the management subcommittee at Faculty of Medicine,limitations of this technique are the number of Chulalongkorn University, for their invaluable advices.experienced facilitators, and requirement of only small tomedium sized group (e.g. no more than 7-10 persons per Referencegroup). 1. de Bono E. Six Thinking Hats: An Essential ApproachIn the organization like medical schools, it would be wise to Business Management. Little Brown and Company;to utilize this technique by organizing several forums with 1985.specific aims and appropriate stakeholders in each session. 2. Kamal SB. Evaluating the effectiveness of creativityA data-returning strategy might be useful in order to training. Journal of European Industrial Training, 2005;continuously engage all stakeholders after finishing the 29(2):102-111.110 Indian Journal of Public Health Research & Development. July - December, 2011, Vol. 2, No. 2