What was the problem/issue to be solved? Were the overall goals communicated? Who benefited? Who were the stakeholders? Was there a project plan put in place? What did this look like? What changes in planning do you think would have helped with any of the barriers or challenges that were encountered?
COVID-19 caused significant issues in healthcare training programs. In hospitals, for imaging in particular, the cancellation of large-scale events like sports and concerts lead to a decrease of injuries. This is good news to the average person. It is not good news for x-ray tech students who are required to demonstrate competency in imaging such critical cases via a portfolio of cases. I felt this situation was very much the one described by Prinsloo and Slade (2014) describing educational triage which “is defined as balancing between the futility or impact of the intervention juxtaposed with the number of students requiring care, the scope of care required, and the resources available for care/interventions” (p. 1). Resources and time were limited, but impactful change was need in order to afford our students the best chance of success in a challenging situation. In response, I was lead in a project to develop role play scenarios, (simulations) for students to participate in as a replacement to real life cases. Students who did not have the opportunity to participate in the required minimum number of critical cases were assessed based on the constructed scenario. This goes against the current national expectations, but due to COVID and a hastily done literature review, I was confident in the proposed process. A plan was created and communicated to the relevant stakeholders including students, faculty, and clinical partners. Templates for scenario creation were made and others were recruited to help me construct actual scenarios. This required extensive and frequent communication with stakeholders due the fluid nature of the situation. The students were the ones who benefited the most from this plan as it allowed them to graduate on time, but the educational program also benefited as it showed us alternatives to how it had always been done before. There were no real barriers to initial implementation as all stakeholders were invested in making something work to allow students to graduate, but I would call it a moderate success upon reflection. We “got the job done” in an emergency situation, but the question moving forward what how much of this project would be carried forward as permanent curriculum.
What do you think were the barriers? Considering some of your readings, how would you suggest overcoming those?
As Cormier (2017) stated, “schools aren’t broken, they are hard”. Changing anything in a complex organization like post secondary health science programs can just be challenging. There are many stakeholders, internal and external, to consider and any change may create unintended consequences (Cormier, 2017). In considering power dynamics as suggested by Conway et al.(2017) model of change, healthcare and education are two giant hierarchical cultures helps to understand that change is something that takes time.Overcoming this issue is patience, knowledge on how to navigate the levels of bureaucracy, and communication. Many individuals within the hierarchical behemoths of education and healthcare, like myself have seen a lot of change initiatives fail. Therefore, I think it is important to work on getting buy in at every level.
What methods do you see yourself using in your practice?
As previously mentioned, I appreciated elements of Conway et al. (2017) “Think like a system, act like an entrepreneur” model of change that includes considering the problem type (simple to chaotic), problem situation (problem clear or unclear, solution known or unknown), power dynamics based on cultural theory domain, different intervention required depending on cultural domain (hierarchical, solidaristic, individualist, fatalistic). The University of Calgary Strategic Framework for Learning Technologies (2014) highlighted the importance of data collection and where data needs to be collected from. It also highlighted the importance of literature review and determining priorities.
And finally, Cormier’s paraphrase of the quote “Don’t tear down a fence unless you know why it is there in the first place” is significant to consider when leading change in hierarchal structures such as education and healthcare.
Conway, R., Masters, J., & Thorold, J., (2017). From design thinking to systems change: How to invest in innovation for social impact. Royal Society of Arts, Action and Research Centre. https://www.thersa.org/globalassets/pdfs/reports/rsa_from-design-thinking-to-system-change-report.pdf
Cormier, D. (2017, December 8). Our schools aren’t broken, they’re hard. [Blog post]. http://davecormier.com/edblog/2017/12/08/our-schools-arent-broken-theyre-hard/
Prinsloo, P., & Slade, S. (2014). Educational triage in open distance learning: Walking a moral tightrope. The International Review of Research In Open And Distributed Learning, 15(4), 306-331. https://doi.org/10.19173/irrodl.v15i4.1881
University of Calgary, Learning Technologies Task Force. (2014). Strategic framework for Learning Technologies. https://www.ucalgary.ca/provost/sites/default/files/teams/1/ final_lttf_report_gfc_june_2014.pdf