Notes from the Liminal Space
By Teresa Chan (@TChanMD)
This post includes interviews with two dynamic (and famous!) medical educators.
Dr. Brian Hodges, MD, PhD (@BDHodges1), is a Professor in the Faculty of Medicine and Faculty of Education (OISE/UT) at the University of Toronto.
He also holds the Richard and Elizabeth Currie Chair in Health Professions Education Research at the Wilson Centre for Research in Education. On top of all of that he is the Vice President Education at the University Health Network (Toronto General, Toronto Western Princess Margaret and Toronto Rehab Hospitals).
Dr. Lorelei Lingard, PhD (@LingardLorelei) is a Professor in the Schulich School of Medicine & Dentistry and Faculty of Education at Western University.
She is also senior scientist and founding director of the Centre for Education Research & Innovation (CERI) in the medical school.
1) Can you explain to me why you feel that we need to be public-facing intellectuals?
Brian (BDH): Healthcare is a public good. More and more, discussions about improving healthcare focus on concepts of patient engagement, quality, safety, equity and the like. Every element of improvement of the healthcare system contains within it some link to health professions education.
This may include such things as:
- Competence (frameworks for education, assessment, licensure);
- Systems for improvement (training for leadership, creating learning health organizations, etc.);
- Better practice/quality (an orientation to quality, mindful practice) ;
- New models of care (interprofessional education, team based practice); and
- Sustaining compassion and caring (focus of the AMS Phoenix project and work of the Gold Foundation).
This means that there is a tight link between what the public cares about (improving the quality of healthcare) and what we do in health professions education. For this reason, I see it as increasingly important that those interested in health professions education speak directly and regularly to the public.
This was the ethos of the Educating Future Physicians of Ontario project that would go on to be the foundation of CanMEDS.
Lorelei (LL): To the extent that there was, at some time in the past, a separation between academics (knowledge-creation) and life (knowledge-consumption), I think it’s breaking down. This is true in all disciplines, but perhaps particularly in disciplines like medical education, which work on questions relating to healthcare, which is a public entity, something we all have a stake in. So, the knowledge we produce must have relevance to the broader world of healthcare – to address its problems, to reflect its values, to advance its thinking and practices, to challenge its assumptions. There is no ivory tower in this domain, nor should there be. That does NOT mean all work needs to be ‘practical;’ it means all work needs to be ‘relevant.’ Even if we’re doing theoretical work, it must have relevance to the problems / values / practise / assumptions of health care and healthcare education.
2) Can you tell me a bit about your concept re: this generation’s academics needing to be entrepreneurial?
LL: I think the best academics in every generation have been entrepreneurial. But now, with the postmodern fluidity of knowledge – by fluidity I mean that a) it moves across time and space readily and b) that it doesn’t stay ‘still’, what is known is constantly shifting, evolving, cycling – our thinking has to be fluid too. By this I mean that our thinking has to be opportunistic, promiscuous, and dissatisfied (with the status quo); that is, we always have to be looking for the ‘spot’ where we can shape values, assumptions, ideas. That’s not possible if you’re not public facing.
But you might have meant ‘entrepreneurial’ in the more limited sense of ‘money making.’ And we need to be doing that too. Time is money in a medical school, whether you’re doing clinical or academic work. There is a cost associated with intellectual work – research assistants, grad students stipends, operating costs – and the government / university cannot cover those costs on our behalf. We need to participate in efforts to find new sources of funding. We need to communicate with potential donors — do lectures at the city library, radio interviews for the local station and talks for the Rotary club (yup, I’ve done all of these) [Editor’s note: Or a highly viewed TEDx talk]. We need to take media training, ask our fundraising offices how we can help.
BDH: Like all public institutions, healthcare and education are facing at least a freeze if not a reduction in funding. This is not a transient state. So, to propel healthcare education, leaders need to proactively identify ways of advancing their goals. This means that centres for education / research must be creative in enhancing their resources through philanthropy, revenue generation and partnerships. This is not perhaps of interest to all individual faculty members or researchers. This is the primary job of the leadership. However, every faculty member, fellow and even students can and should play a role here. To interest donors, sponsors, media and the like it is necessary to tell compelling stories about the value of health professions education, including research. It is also necessary to show links between the development of knowledge, new practices, improved healthcare, and my favourite, challenging the status quo, in ways that inspire others to get excited.
3) If you were mentoring a junior Clinician Educator who is entering into the world of #MedEd what tips do you have for developing their public-oriented materials?
LL: Hmmm, interesting phrase, ‘public oriented materials’. So concrete, when what I’ve been talking about has been so conceptual. I would not focus on materials, except insofar as ideas are the academics’ ‘materials.’ I would (I do!) mentor Clinician Educators / researchers (that’s mostly who I mentor) to think about how their ideas will be provocative, what conversation in the world they are joining, what story they’re telling and how they’ll make it memorable. I talk about having a good ‘sound bite,’ an idea rendered elegantly and simply so that people can take it away and raise it in conversation over drinks with their colleagues or their family. I ask them who’s listening – who do they want to hear them? – and we talk about how to frame their knowledge product expressly for that audience. And I would tell them to think about how they collect their public engagement efforts on their CV.
BDH: I would suggest a few things:
- You should have a clear ‘elevator speech’ about your work. You need to be able to get on an elevator on the ground floor and excite a total stranger about your work before you get off on the 10th floor.
- Don’t be afraid to include stories about real patients, real learners, real situations to illustrate the importance of your work.
- Prepare different scripts about your work: You need different ways of speaking for other educators, for institutional leaders, for members of the public, for students, etc.
- Write creative pieces for the health professionals education (HPE) literature (e.g. commentaries, editorials, letters, satire for special editions). Write for the popular press if you can. Write a blog. Use social media; generate excitement for the kind of work you are doing.
- Don’t work alone. Create a research group / writing group / interest group.
To end, I will simply quote Lorelei Lingard: “What conversation are you joining?” Add your voice to a discussion that others are having – be it as a champion, booster, critic, informant, or questioner.
Image courtesy of TobiasSchumann , via Wikimedia Commons