Dean’s Diversity Seminar Series Paul L. Foster School of Medicine

1. Dean’s Diversity Seminar SeriesPaul L. Foster School of Medicine R. Kevin Grigsby Sr. Director, Leadership & Talent Development March 2013

2. Objectives • Understand why it is so difficult to make changes in the academic health systems • Understand the nature of a complex, adaptive system • Learn to make creative use of influence as a leadership tool • Learn a new tool to communicate any idea in 30 seconds or less • Gain familiarity with strategic intent and how to communicate it successfully

3. Population demographics are changing dramatically – and not everyone is happy about it!Southern Poverty Law Center: Excellent description in simple language http://www.tolerance.org/activity/test-yourself-hidden-bias

4. What You Don't Know: • The Science of Unconscious Bias and What To Do About it in the Search and Recruitment Process • https://www.aamc.org/initiatives/leadership/recruitment/178420/unconscious_bias.html

5. “There is overwhelming scientific evidence that unconscious bias may influence the evaluation and selection of candidates from entry-level to leadership positions in all types of organizations, including medical schools and teaching hospitals.”

6. “The AAMC presentation, created for academic medicine audiences, is designed to acquaint search committees and others with this research as one step toward mitigating the effects of unconscious bias.”

7. Hidden bias • Biases, thought to be absent or extinguished, remain as "mental residue" in most of us. • People can be consciously committed to egalitarianism, and deliberately work to behave without prejudice, BUT continue to have hidden negative prejudices or stereotypes. • It’s not a conscious process – it happens unconsciously • Changes in behavior can modify bias and stereotyping

8. Complex, adaptive systems • Comprise a large number of elements • Self organizing and interactive in nature • Able to adapt to changing conditions • Emergent properties are common • Increases the survivability of the macro-system • Examples: Internet; global economy; embryo

9. Complex, adaptive systems • Complex, adaptive systems cannot reach full potential using command and control • Learning how to influence is necessary • Adaptation is critical and requires integrating multiple organizational components • Biggest risk? Diffusion rather integration • Diffusion creates silos . . . • Many exist now in the academic health enterprise

10. We need leaders equipped to lead in the face of these changes: • Greater ability to tolerate risk • Greater ability to tolerate ambiguity • An organizational culture reflective of a complex, adaptive system • Paying attention to organizational culture as much as we pay attention to strategy

11. Change in the academic health enterprise • In the past, change was slow and incremental.

12. Those days are over! • Deep change is the norm • New ways of thinking and behaving are necessary • Tolerating risk and giving up control are common • Learning to tolerate ambiguity is crucial

13. Are You Leading Now? “Vision without action is a daydream, Action without vision is a nightmare.” Japanese proverb

14. Or Is the Tyranny of the Urgent Leading You? “Life is what happens to you while you are making plans to do something else.”

15. The Tyranny of the Urgent Something always needs to be done RIGHT NOW! Feels like “putting out fires”

17. The Conspiracy of Interruption Just when you get to the point of thinking you can do what you want to do – Another URGENT need for action appears in your path!

18. People work in nonprofits to find meaning • Self-awareness – know your own moods and recognize how they effect others • Self-management – control emotions and act with integrity and authenticity • Social awareness – empathy and organizational intuition – show you care • Relationship management – Communicate clearly, disarm conflict, build strong personal relationships • Goleman, Boyatzis, McKee, 2002.

19. What does it take to change? • A clear, compelling case for change is necessary but not sufficient. • A thoughtful change strategy must be developed before leaving the present state. • People want to know how they will get to the new state (action steps, support, rewards). • They want to know what it will be like when they arrive (vision, roles, responsibilities, rewards). • And they want acknowledgment of their real losses.

20. If things were simple, word would have gotten around.- Jacques Derrida

21. People will change when what they value is threatened • Examples: • One’s self image as an attractive, healthy, active person is challenged. • How? • You overhear a child describe you as “that fat guy over there.”

22. A common belief: “Life is what happens to you. You have no say in what comes your way. Take what comes and make the best of it.”

23. Where Does Change Start? • It’s transformational – and it starts by building from the self up. • Erhard, Jensen, Granger, 2012.

24. Change process in people • Pre-contemplation • Contemplation • Preparation • Action • Maintenance • Termination • Prochaska & Diclemente, 1986.

25. Change process in people • Pre-contemplation • Contemplation • Preparation • Action • Maintenance • Termination • Prochaska & Diclemente, 1986.

26. Pre-Contemplation“Ignorance is bliss.” • Have not considered change, but you know you. Ask yourself “What is holding me back?” What will it take for me to make a commitment?

27. Contemplation“Sitting on the fence.” • Seriously considering change, but not yet ready to start the change process. Ask yourself “What is holding me back?” What will it take to make a commitment to weight loss and exercise?

29. Preparation“Testing the waters.” • You made a commitment to action. Think about the details involved. Will you take the stairs rather than the elevator? Order a la carte instead of having the buffet? Track your food intake and daily exercise routine? • Set some goals: One day, one week, one month, three months. Determine how you will reward yourself for accomplishing each goal.

30. Action“Practicing new behaviors.” • Put your plan in motion. Make your schedule and environment conducive to being active. Take the stairs, not the elevator. Don’t get the buffet. Go to the fitness center. • Think in the long-term and stick to the plan. Reward yourself for sticking to the plan.

31. Maintenance“Sustaining new behaviors.” • You are on your way to success. You have demonstrated the new behavior and sustained it over a specific time period – 6 months. • Create a mental image of yourself exercising. Tell yourself you are an active person and then enact it.

32. Termination“Consistent enactment of new behavior.” • You did it! You are more active, less sedentary. • Congratulations!!!

33. Relapse“Fall from grace (or off the wagon).” • Resumption of negative behaviors. • Consider it to be a part of recovery. Use it as impetus for developing better coping strategies.

34. Communication • Communication is essential to any successful change strategy. • Our organizations are known for insularity, “tribalism”, and “silos.” • Communication across our organizations is slow, fraught with misinformation, and often arrives too late to make a difference. • Change that runs counter to the prevailing organizational culture cannot be sustained.

35. Changing people can change the culture. Changing culture can change people.

36. Message Mapping: How to Pitch Anything in 15 seconds http://www.youtube.com/watch?v=phyU2BThK4Q&feature=player_embedded

37. Twitter Friendly Headline – 140 characters or less Core Message If you have 30 seconds, include additional points! Point 3 Point 1 Point 2 3 Supporting Points – easy to remember

38. In 15 seconds… In 30 seconds… Our campus needs to reflect the diversity of our community and nation Improves Med Education Shows our commitment to the community Consistent with our values

39. Exercise • Think of an idea/concept you want to communicate • Use message mapping to describe the concept and three supporting points within a 15-30 second time period • Share your message with others seated near you

40. Strategic Intent • A strategic theme filled with emotion for the whole organization • A compelling statement about where an organization is going that succinctly conveys a sense of what the organization wants to achieve long-term • “Adds clarity, gives focus, inspires people . . . ” • “Direction, discovery, and destiny . . .” • Example: Canon – “Beat Xerox.” • Hamel G, Prahalad, CK, 1989.

42. Meta-Messaging Exercise • Work with a group of 5-8 to reach consensus about a message you wish to communicate widely • Refine the message to the point where ANYONE can “get it” by walking past you and reading the message on a T shirt • Using words and graphics, create a message designed to appear on a T-shirt • Explain your design to everyone

43. References (1) • Argyris C. Teaching Smart People to How to Learn. Harvard Business Review. May-June 1991, 99-109. Reprint 91301. • Cohen AR, Bradford DL. Influence without Authority. New York: John Wiley & Sons, 1991. Erhard WH, Jensen MC, Granger KL. Creating Leaders: An Ontological/Phenomenological Model. In Snook S, Nohria N, Khurana R. The Handbook for Teaching Leadership: Knowing, Doing and Being. Sage, 2012: 245-262. Frisina ME. Influential Leadership. Chicago: AHA Press, 2011. Goleman D, Boyatzis R, McKee A. Primal leadership: Realizing the power of emotional intelligence.Harvard Business School Press, 2002. • Grigsby RK, Hefner DS., Souba WW., Kirch DG. The future-oriented department chair. Academic Medicine 2004; 79 (6):571-577.

44. References (2) Oshry B. Middles of the World, Integrate! Boston: Power and Systems Training, Inc., 1982. Pfeffer J, Sutton RI. The Smart-Talk Trap. Harvard Business Review. May-June 1999, 135-142. Reprint 99310. Schein EH. Organizational Culture and Leadership (2nd ed.). Jossey-Bass, 1992. Wiseman E. Multipliers. Harper Business, 2010. Management defined: http://managementinnovations.wordpress.com/2008/12/03/define-management-its-functions/ Message mapping: http://www.youtube.com/watch?v=phyU2BThK4Q&feature=player_embedded