2019.03.20 #futureofmeded
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03/31/2019 #CORDAA19 Seattle slides for #futureofmeded talk #meded
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2019.03.20 #futureofmeded
- 4. Knowledge
- 9. Identity
- 12. Diagnostic Assessor Content Curator Technology Adopter Learner Centered Navigator Professional Coach Clinical Role Model Learning Environment Designer
- 16. Structure
- 24. Thank you • Michelle Lin • Brad Gordon • Teresa Chan • Rob Cooney • Helen Bevens • Jason Frank • Donella Meadows • Cees Van der Vleuten • Denyse Richardson • Dan Pesut • Dan Cabrera • Kaz Nelson • Jon Sherbino • Ezgi Tiryaki • Brian Hodges • Brenda Zimmerman • Dee Hock • Mike Gisondi • Meghan Walsh • Paul Plesek • And many more
Editor's Notes
- I wanted to thank CORD and the Imed track for inviting me here, I wanted to start a conversation about the future, how do we plan? How do we develop foresight, what are foresight competencies, what is the language, what are models, what are resources? I will also speculate on the future of knowledge, the future of professional identity, the future of edcuational structure as hard trends, and then challenge you to see how this may affect soft trends such as assessment, facdev, P and T
- So there is a whole discipline of futurology and an association of professional futurists. They have come up with six core competencies developing strategic foresight. Some of these competencies we know about, or I feel comfortable in, eg framing a question, doing and environmental scan, using human centered design to pilot things and then scale up. I feel a little less comfortable about futuring and visioning. ######## We could spend a whole hour talking about strategic foresight and foresight competencies, but we are not, I will give you a couple of references, one is the association of professional futurist….they have a whole set of competencies, they include Framing: Scoping the project, defining the focal issues and current conditions Scanning: Exploring signals of change or indicators of the future, the ability to differentiate hard or soft signals or trends is a key foresight competency in my mind Futuring: Identifying a baseline and alternative futures, eg predicting what will happen and what would you like to see happen Visioning Developing and committing to a preferred future. Designing: Developing Prototype offerings or artifacts to achieve vision and gaols Adapting: Enabling organizations to generate options to alternative futures https://apf.org/wordpress/wp-content/uploads/APF-Foresight-competency-model-1.1-1.pdf
- A key to effective strategic foresight thinking is identifying hard and soft trends Hard trends are things that will change Soft trends are things that may change How many of you are involved in strategic and annual planning How many of you know of soft trends and hard trends in medical education I you are really a geek about this, I suggest you read this. What is the best way to anticipate the future? Create it. Author Daniel Burrus (2017) writes about the Anticipatory Organization. and And the value of transforming the way people and organizations plan. Key to the transformation is creation of the anticipatory organization (AO). The Anticipatory Organization model consist of four steps: know what’s next in terms of hard trends, develop opportunities related to the trends, shape the future, and transform results to accelerate success. Burrus notes to see the future more accurately one must think both/and not either/or. His future view principle states that how you view the future shapes your actions today, and your actions today will shape your future. Change your future view and you will change your future consider dropping
- ######## We could spend a whole hour talking about strategic foresight and foresight competencies, but we are not, I will give you a couple of references, one is the association of professional futurist….they have a whole set of competencies, they include Framing: Scoping the project, defining the focal issues and current conditions Scanning: Exploring signals of change or indicators of the future, the ability to differentiate hard or soft signals or trends is a key foresight competency in my mind Futuring: Identifying a baseline and alternative futures, eg predicting what will happen and what would you like to see happen Visioning Developing and committing to a preferred future. Designing: Developing Prototype offerings or artifacts to achieve vision and gaols Adapting: Enabling organizations to generate options to alternative futures https://apf.org/wordpress/wp-content/uploads/APF-Foresight-competency-model-1.1-1.pdf
- What is this graph?? Yes, it is a graph of what is known. It is exponential, and it also reflects what is known in medicine The first hard trend that I wanted to discuss is that our relationship to knowledge will change. There is this
- The context behind this is fascinating What is the double helix in the middle? Is this data? Is this information? Is this knowledge? Is this wisdom?? Is this organic? Is this inorganic? How about the nucleotides? How about carbon, nitrogen, oxygen, phosphorous? Before there were dot.com and real estate bubbles, there was an artificial (AI) bubble in the 1908s, with the rise and fall of such companies as Symbolics. Dreyfus and Dreyfus, brothers from UC-Berkeley- one an existential philosopher, the other industrial engineer-predicted the AI bubble. They suggested that humans has innate decision-making skills in the domains of autonomy, managing context, and managing complexity that could not been replicated by computers. So people have lived in an AI winter at least from the 1970s to the 1990s Today I want to provoke you a little in having a discussion about data, about information, about knowledge, about wisdom, about intelligence, about competence, about organic, and inorganic, about the head, the heart, the skeleton, and the skin, about where I think we are and where I think we are going in health care What is the definition of knowledge? What is the definition of intelligence? What is the definition of competence? ########################################### Concept: Creation and sharing of knowledge. How to manage this change. From data to knowledge: https://en.wikipedia.org/wiki/DIKW_pyramid Reflective practice https://icenetblog.royalcollege.ca/2016/12/13/170936/ Prayer, psychoanalysis, journaling Why information grows: https://www.ft.com/content/36cad2c0-1038-11e5-ad5a-00144feabdc0 Shared decision making and http://www.ipfcc.org/ Wealth is on attention (what is important and what is not) Creation of new things remixing old Characteristics of knowledge: immediate, personal, explained, accessible, discoverable Examples: Watson recommend chemotherapy (http://www.livescience.com/58124-ibm-watson-works-with-cancer-doctors.html) AI winter Dreyfus and dreyfus Paul Bataldan Cbme Watson and ohare Second spring of ai Data to knowledge Reflective practice Shoen Shared decision making How information grows (Hidalgo)
- There is a progression from data to information to knowledge to wisdom. For the last 50 years, the value proposition of clinicians has been in the information to knowledge space, patients would come to us give us some information, something magic would happen and we would give them some knowledge to tell the patient what to do. This is changing, the data to information to knowledge transition will be automated, the new value proposition of clinicians will be in the knowledge to wisdom space and that space is a shared space, a space shared with patients, families, team members, and the public
- SLIDE 5 | ANKEL KNOWLEDGE2 One of the most fascinating articles that I have read as a medical educator is this article in Health Affairs by these authors in 2002. Does anything strike you as interesting in the list of authors? For many years knowledge and even intelligence was equated with competence. These authors started us on a journey from from a knowledge based medical education system to a competency based medical education system through the lenses of autonomy, managing complexity, and managing context. Here you can see on the right is a lens I call autonomy (really metacognition)…able to think about thinking, able to see context, and able to manage complexity almost in an intuitive manner. Heading back to this knowledge management pyramid. I see moving data to information as pattern recognition, moving information to knowledge as context management, and moving knowledge to wisdom as reflective practice. Part of my learning process these days is spending much for time in context management and reflective practice and looking and relying on other tools for pattern recognition. ########################## Concept: Creation and sharing of knowledge. How to manage this change. From data to knowledge: https://en.wikipedia.org/wiki/DIKW_pyramid Reflective practice https://icenetblog.royalcollege.ca/2016/12/13/170936/ Prayer, psychoanalysis, journaling Why information grows: https://www.ft.com/content/36cad2c0-1038-11e5-ad5a-00144feabdc0 Shared decision making and http://www.ipfcc.org/ Wealth is on attention (what is important and what is not) Creation of new things remixing old Characteristics of knowledge: immediate, personal, explained, accessible, discoverable Examples: Watson recommend chemotherapy (http://www.livescience.com/58124-ibm-watson-works-with-cancer-doctors.html) AI winter Dreyfus and dreyfus Paul Bataldan Cbme Watson and ohare Second spring of ai Data to knowledge Reflective practice Shoen Shared decision making How information grows (Hidalgo)
- Roles 2020 Knowmads convener
- Roles 2020 Knowmads convener
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- I love history Earlier this summer, I visited the national museum of civil war medicine in Frederick Maryland This is how a trauma unit looked like 150 years ago, this is how a trauma unit looks like today This is how most of medical education was delivered 150 years ago, this is how most of medical education is being delivered today This is untenable. I will tell you why this is untenable, what is happening, and three things you can do to prepare yourself for the future
- SLIDE 9 | ANKEL NETWORKS1 So we talked about knowledge and agents, now I want to talk about our environment Humans are eusocial which is an advanced level of social organization and cooperation. We are hard wired to hang in tribes groups of around 30 people with a shared purpose What is interesting in health care, is that there are formal and informal tribes. The formal tribe is often based on the org chart and is hierarchical, the informal tribe is often based on networks and is best on common interest. Most real work is done in 3 networks. A trust network, a learning network, and a communication network. How many of you have deliberately cultivated a trust network?? Trust is the lubricant of networks. If you have trust, anything is possible, if you don’t have trust, nothing is possible. Warren Buffet once said. Trust is like the air we breathe, when it is present, nobody notices it, when it is absent, that is all one notices. There is a difference between being factual and trustworthy. Factual is the facts. Trustworthy is the facts presented in the context that the receiver would like to receive them rather than the facts sent from a strategic manner from the sender. A few tips in being trustworthy. Be trusting, be vulnerable. How many of you have a personal learning network and a personal development plan. My recommendation is to write down who you learn most from, identify where you want to go, and identify people you can learn from. Look for week links these are people at the periphery of networks that span multiple networks The third platform is the communication platform. How many of you have a communications platform?? Michael Hyatt wrote a great book about communications platforms and described thee parts. A home base where your information is eg a CV, a blog, a portfolio….the second is embassies on how people can access your home page many use twitter, email links etc…. The third are outposts or analytics to help you learn who is interacting with your communication platform and what you can learn. That is the skin of learning ############## We are eusocial Here we are going from inorganic to organic Most clinicians work in organizations with former org charts, trained in a heirirachial medical-industrial complex Natural in an information poor evirnment Unatural in an information rich environment Networks prevail in information rich envirnments Curate, CoP, creation of value In health care, three networks pln, 2. trust network, 3. communication network. What is your pln??, what is your plan to build your trust netwrk and communication network Mastermindgroup, incubators Learning org….head, heart, skeleton, skin…what is your personal learning envirnment Examples of learning envirnments Aliem, SMACC, Icenet Concept: We need to create our own networks based on learning and trust Importance of PLN, communication, and trust networks https://icenetblog.royalcollege.ca/2015/11/24/building-trust-more-oxytocin-less-epinephrine/ https://icenetblog.royalcollege.ca/2016/04/12/building-effective-communication-networks-part-ii-more-nerve-conduction-less-bone-conduction/ https://icenetblog.royalcollege.ca/2016/04/05/building-effective-communication-networks-part-i-home-bases-embassies-and-outposts/ https://icenetblog.royalcollege.ca/2015/10/02/personal-learning-networks-a-hack-to-maintain-competence/ Lack of ownership of objects Sharing data and objects Constant stream of data (like FB) will turn in a stream of objects (Netflix) Links to things are more important than ownership Dyads and density of connections in health care https://icenetblog.royalcollege.ca/2016/08/26/resilient-meded-leaders-using-a-co-leadership-dyad-model-to-increase-the-density-of-connections-part-2/ Immediate, personalized, distributed Structure: head, heart, skeleton and skin. We need to define those in our systems? Example https://www.healthpartners.com/hp/about/ head and heart, also need skeleton (org chart or network) https://www.healthpartners.com/hp/about/leadership/election/index.html or skin https://www.myvoicehealthpartners.com/Portal/default.aspx How I’m changing a system to be ready for the future https://en.wikipedia.org/wiki/Cynefin_framework Examples: ICENet/ALIEM learning networks Human work in organizations Organizations are edifices Information flow is linear and unidirectional R head and L head R heart and L heart R soul and L soul Trust network Oxytocin Vulnerability Communication network Home base, embassies, outposts Truly a learning org head, heart, skelton, skin Myvoice, st paul police Consumer governed
- How many of you are involved in strategic and annual planning How many of you know of soft trends and hard trends in medical education I you are really a geek about this, I suggest you read this. What is the best way to anticipate the future? Create it. Author Daniel Burrus (2017) writes about the Anticipatory Organization. and And the value of transforming the way people and organizations plan. Key to the transformation is creation of the anticipatory organization (AO). The Anticipatory Organization model consist of four steps: know what’s next in terms of hard trends, develop opportunities related to the trends, shape the future, and transform results to accelerate success. Burrus notes to see the future more accurately one must think both/and not either/or. His future view principle states that how you view the future shapes your actions today, and your actions today will shape your future. Change your future view and you will change your future consider dropping
- Photo of slack, smacc, brad, kaz, minnesota futura, collective co eptence, better deicison making by groups
- I wanted to thank CORD and the Imed track for inviting me here, I wanted to start a conversation about the future, how do we plan? How do we develop foresight, what are foresight competencies, what is the language, what are models, what are resources? I will also speculate on the future of knowledge, the future of professional identity, the future of learning networks (assessment, facdev, P and T)