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Explore the challenges of implementing organizational change and fostering accountability in the hidden curriculum of medical education. Discover the clash of cultures and strategies for effective leadership in this workshop.
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HMS AcademyMedical Education Day Workshop Organizational Change and Accountability in the Hidden Curriculum HMS Academy
Why little progress in 15 years? Adaptive Challenge “…there is no common agreed-on understanding of the problem…(people) have conflicting opinions about its causes. They propose different solutions. They have varied opinions about whose responsibility it is to solve the problem.” Souba C. The language of leadership. Acad Med 2010;85:1609 HMS Academy
What are the values of your institution? • Have they been articulated? • Do they reflect the academic mission? • Are they truly agreed upon by all departments? HMS Academy
Business == Outcomes oriented == Accountability == Continuous quality improvement == Priorities set centrally Education == Process oriented == Autonomous agents == Murky assessment == Priorities set locally Clash of Cultures HMS Academy
The Dilemma How do you get control of a large number of people who view themselves as expert, autonomous beings who know more than you do? HMS Academy
Language, Change, and Performance “Leading organizational change can be understood as a process that is managed and made sense of through language.” Souba C. The language of leadership. Acad Med 2010;85:1609 HMS Academy
Case Study 1 Chief of Radiology is adamantly opposed to the transparent allocation of teaching money (i.e., money goes to those who do the teaching). “It’s very hard to run a department these days. I need the flexibility of the teaching money to fill in holes.” HMS Academy
Appeal to Reason (gently)Be Willing to Compromise Paradox: we claim we don’t get enough money for teaching, but what we get we use for other purposes. Compromise: allow chiefs to have flexibility with 10% of the funds www.cartoonbank.com HMS Academy
Case Study 2 The Chief of Neurology is adamantly opposed to the proposal for a new curriculum approach to the third year clerkships. “Learning is about being on the wards and taking care of patients. If your program takes any time away from that, it is poorly conceived.” HMS Academy
Do the ExperimentThe Power of Pilots Use their language. “We have opposing hypotheses, Dr. S. Let’s do what you would do in your lab. Let’s do the experiment.” www.cartoonstock.com HMS Academy
Negotiating 101 • What does your “opponent” care about? Align your interests with theirs. • Go for the “win-win” solution; be willing to compromise. • It’s about interests; avoid making it personal. • Keep your eye on the target; you don’t have to win every battle to win the war. HMS Academy
Respect (and try to understand) Finances HMS Academy
Key Points • Understand your organization’s system and its priorities • Design your work-plan to support the organization’s priorities • Add value; outcomes driven • Respect finances • Look for the “win-win” solution HMS Academy