Making Medical Mindshifts

Posted By cboyce on Dec 19, 2018 | 3 comments

Mindshifts are observed as we evolve our practice toward design-thinking and innovation in the race to re-create healthcare. (Photo credit to Pixabay user johnhain)

LRNT 524 has engaged us in readings that reflect on the meaning of innovation. Innovation is a word without a clear definition. Skillicorn’s (2016) blog post demonstrates the diversity in opinion around the meaning of innovation and guides our reflections on what innovation means to each of us.

Some definitions of innovation that I connected with in Skillicorn’s (2016) article:

Gijs van Wulfen: “An innovation is a feasible relevant offering such as a product, service, process or experience with a viable business model that is perceived as new and is adopted by customers” (Skillicorn, 2016)

Paul Hobcraft: “the fundamental way the company brings constant value to their customers business or life and consequently their shareholders and stakeholders”(Skillicorn, 2016).

Globalization + technology options + patient need = grounds for innovation to flourish. Photo credit to Pixabay user PIR04D

Through my contextual lens of health care, these reflections come at a pivotal time. Healthcare in Canada has come to a significant crossroads. Acute care services are stretched beyond all possible capacity.  Steps are being taken toward massive support of primary care programs and care structures for our community members. We could sure use some innovative ideas right about now; however, I question whether we are using the most innovative, most agile strategies possible to guide the design of contemporary healthcare practices. Skillicorn (2016) states that to think innovatively about a problem, “we must Flip it on its head, and look at every new thing [we] are trying [from] various customers’ perspectives” (para 8). Do the majority of healthcare policymakers have the skills required to maximize their innovative capacities? Are we supporting healthcare practitioners on the journey to becoming empathetic, design thinkers? If not, how do we begin to develop our innovative capabilities on a foundational level?

In Goldman et al.’s (2012) work the Journey to Becoming a Design-Thinker, the authors discovered that the “learning of design thinking dispositions and mindsets is an emergent journey—with various levels of sophistication, transformation, application, and integration” (p. 13). As we grasp concepts of design-thinking, we become more resilient, capable of adapting to change and able to think through an innovative lens. Goldman et al. (2012) introduce us to the concept of Mindshifts, i.e. the emergent “epistemological viewpoints and instincts that are strengthened while becoming a design thinker” (p. 13). I offer that healthcare providers require a reflection on the ‘lens’ through which we perceive ourselves and our patients in the dynamic of caring practices. I propose that observation and measurement of our Mindshifts will be necessary as we reorientate ourselves to a new era of primary healthcare.

Goldman et al. (2012) offer a framework for what is required as one adopts the orientation of a design-thinker. They identified four key conceptual Mindshifts:

  1. Human-centered – A focus on empathy as individuals “begin to move beyond egocentric views of the world and no longer design based on their own needs, desires, experiences or preferences” (2012). Human-centric thinking is a distinguishing feature of design thinking.
  2. Experimental – This Mindshift comes as a “realization that everything may be considered a prototype” and as such, is merely an evolving idea or creation.
  3. Collaboration – The Mindshift to collaborative practices support the belief that radical assemblies of individuals are required to problem-solve on an innovative scale.
  4.  Metacognitive – The realization that one must be able to reflect on their own position in the continuum of a design process to respond with agility to a problem.

Now, using the four Mindshifts, consider your practice as a healthcare provider (or within the context of your own organization). Do you believe your practices have moved beyond your own goals and motivations? Beyond your own preferences? Are you continually looking to problem-solve and looking for solutions that are unique to your users? Do you accept the status quo in your practices or do you believe that constant iterations of policy and process should be examined? Do you stretch out of comfort to collaborate beyond your immediate ‘community’ to gain insights or new opinions? Are you self-aware enough to realize where you lie in the continuum of addressing problems and can you pivot to make necessary adjustments without impact to your ego?

Goldman et al. (2012) called for a culture shift toward supporting the lives of learners in a move toward an innovative, collaborative and “technologically-sophisticated” culture (p. 17) In the effort to support patients in the community, we ask them to create healthier habits, focusing on disease prevention and self-management strategies. We ask our patients to work collaboratively with community care providers and stay connected, often with new technology such as telehealth or virtual care. I offer that if we expect our patients to engage in innovative health practices, healthcare providers will first require the capacity in ourselves. I propose the addition of design thinking in our professional ‘toolkits’ to support the necessary developments in healthcare re-design. In addition to our developed skills of critical thinking, problem-solving, communication, and collaboration, we will need to support future strengths of creativity, innovation, and digital literacy using technologies, as these are all required skills in the 21st century.



Goldman, S., Carroll, M.P., Kabayadondo, Z., Cavagnaro, L.B., Royalty, A.W., Roth, B., Kwek, S.H. & Kim, J.  (2012). Assessing d.learning: Capturing the journey of becoming a design thinker. In H. Plattner, C. Meinel & L. Leifer (eds). Design thinking research: Understanding innovation. (pp. 13-33). Berlin: Springer.

Skillicorn, N. (2016, March 18) What is innovation? 15 experts give us their opinion [web log post]. Retrieved from:



  1. Hi Christy,

    Thank you for a very engaging and thought-provoking blog post. Like you, I resonated with Goldman et al.’s (2012) conceptual mindshifts, especially in the process of adopting a more human-centered approach. I speak more to this and the link between innovation in my blog post.

    In consideration of your questions about how our current practices are actualized through the lens of the four Mindshifts, I would have to admit this has not been a strength of mine in the past. From my context in adult continuing education, the focus of program development exceedingly revolved around revenue generation. This is not to say market research didn’t play a significant role in developing programs to serve the needs of our local business community. Rather the pressure to generate revenue in order to cover development costs took priority from the get-go, exceedingly more in recent years due to budget cuts. As a result, the needs of our learners were pushed to the sidelines and program design greatly lacked human-centeredness. I am curious if financial constraints may also play a role in some of the disconnect between healthcare technology solutions and the patients they are meant to serve?

    Your proposal to add design thinking into a ‘professional toolkit’ also provides relevance and value across industries. Perhaps this is an area that adult continuing education programs could increasingly focus on more? Serving the needs of professionals by providing relevant knowledge and skills to infuse human-centered design thinking into their own professions. Thanks for inspiring this conversation!


    Goldman, S., Carroll, M.P., Kabayadondo, Z., Cavagnaro, L.B., Royalty, A. W., Roth, B., Kwek, S. W., & Kimet, J. (2012). Assessing d.learning: Capturing the journey of becoming a design thinker. In H. Plattner, C. Meinel & L. Leifer (eds). Design thinking research: Understanding innovation. (pp. 13-33). Berlin: Springer.

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    • Hi Mel! Thank you for your comments and questions.
      Your comment about the focus of program development being primarily revenue generation strike a chord with me. I believe that we have held focus on using our federal healthcare funds to serve our patients in their most immediate needs (or at least, what we understood to be their most immediate needs) for far too long. Keeping hospitals and their programs to tight budgets and focusing on improving patient flow through our systems has resulted in improved efficiency, but have these processes compromised our agency as care providers? Are we negatively impacting both the front line staff and our patients in our approaches to keep our systems afloat? As a frontline healthcare provider for 17 years, I offer a resounding ‘Yes!’.
      My health authority has realized the incredible value of our ‘user’ groups (our patients). One example of the use of empathy in that relationship is that we now have on-the-spot patient experience surveys occurring in some hospitals. Quick access to data is one step, but how we use the information to further inform our processes and policies is another. Can we analyze the data collaboratively? Can we envision our existing programs as prototypes that need constant refinement?
      As per Goldman et al. (2012) are we able to reflect on the fact that, perhaps we do not have all the skills in our current knowledge base as healthcare providers that we require to navigate in the healthcare programs of the future?

      I agree that adult continuing education programs should focus on building principles of design thinking into their programs. As a parent, I see the value in beginning this teaching even farther upstream in the K-12 context, as supported by Crichton and Carter (2017). Crichton and Carter (2017) speak to complex and wicked problems that our youth have been presented with and healthcare fits the bill as described.
      I, for one, am extremely excited about the potential of enabling healthcare professionals with the conceptual Mindshifts described by Goldman et al. (2012) in the process of training them to become design thinkers. The benefit to our patients could be incredible and I know that our new found skills would be well received.

      Crichton, S. & Carter, D. (2017). Taking Making into Classrooms Toolkit. Open School/ITA.

      Goldman, S. et al. (2012). Assessing d.learning: Capturing the journey of becoming a design thinker. In H. Plattner, C. Meinel & L. Leifer (eds). Design thinking research: Understanding innovation. (pp. 13-33). Berlin: Springer.

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  2. Hello Christy,

    Due to a creativty workshop taking place at our institution in three weeks, I decided to re-read your post. When I initially read it, I enjoyed the thought-provoking questions, and I was hoping it would prepare me for the three-day session where Durham College employees will develop critical thinking skills to become more fluent and resilient in our thinking.

    After reflecting on the four key conceptual mind-shifts developed by Goldman et al. (2012), I realized the growth I still require to move forward as a design-thinker. While I am a firm believer and practitioner of the collaborative and experimentation process, I still have room to evolve in developing empathy for the individuals I support and teach.

    The LRNT 524 course helped me develop in this area, as throughout the course we were supported through minor extensions, weekly meetings, and outside of office hours. The previously mentioned forms of empathy helped me evolve and I now employ similar approaches in my role as a professor and an individual who provides support to faculty on a daily basis.

    While I enjoyed the readings and the variety of assignments in LRNT 524, the aspect I enjoyed the most was seeing the human-centered approach used throughout the past ten weeks.


    Goldman, S., Carroll, M.P., Kabayadondo, Z., Cavagnaro, L.B., Royalty, A. W., Roth, B., Kwek, S. W., & Kimet, J. (2012). Assessing d.learning: Capturing the journey of becoming a design thinker. In H. Plattner, C. Meinel & L. Leifer (eds). Design thinking research: Understanding innovation. (pp. 13-33). Berlin: Springer.

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