Systems resilience in medical education #meded
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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.
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Systems resilience in medical education #meded
- 1. 10 systems design tips to increase resilience in medical education Felix Ankel, Kelly Frisch
- 3. You
- 6. Burnout and clinical learning environment
- 7. 1. You have a responsibility to the program not for the program “A vision not shared is a hallucination”
- 8. 2. Move the big rocks
- 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
- 11. 5. Build your communication network
- 12. 6. Build your personal learning network
- 13. 7. Be clear with your values “It’s not hard to make decisions when you know what your values are” - Roy Disney
- 14. 8. Increase the density of connections
- 15. 9. Bend, don’t break “The best is the enemy of the good” - Voltaire The ABC's of REBT
- 16. 10. Be a moon “The unexamined life is not worth living” - Socrates
- 17. You
- 18. Questions?
Editor's Notes
- 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