Category: Unit 6

As I am on a missions trip in Kenya right now, I was directed to conduct my interview with someone on the missions team.  I was able to steal a little bit of time with the President and Founder of Sew Love Foundation Inc., Lori Peters late one evening when the tasks of the day had been completed.  Due to the fact that there are 5 ladies staying together in a room and Lori is a friend outside of our roles with Sew Love, the interview ended up being less formal than it would have been with a fellow student, or a colleague from work, but still a valuable learning experience.

Q:  What skill behaviours to see as contributing to your success?

A:  First and foremost is a passion for the “why” – why are we doing this.  Second would be a faith in God, that he will guide and provide, and trusting in what he shows me and leads me, and being led by the Holy Spirit.  Next would be dedication, which is different from passion.  When things get hard, you can’t not keep going, you “can’t not” get the job done and let things slide because the “why” holds us, and the “who’s” hold us.  Lastly would be learning to ask for help, and releasing people to help without getting in the way and not hyper-focus and not be controlling.

(At this point there was a break in the interview and there was a significant amount of coaching that took place but I was not the primary facilitator of that coaching.  One of the other members of the team staying in our room actually made the comment that Lori does not “do this well” – does not ask for help when needed.  Lori gave a number of reasons why it is difficult, but was also able, with prompting from both team members to give responses as to why these barriers cannot hold her back from continuing to ask for help.  She has been offered assistance in the past, and then had people not follow through, or assist in a way that was not helpful – she recognized that she needs to communicate and set expectations for follow through and what it is that she needs for assistance.  Another barrier she identified was that she has difficulty asking for assistance when she feels she isn’t organized and doesn’t have the entire plan set out, and she was able to self-identify that she doesn’t always need to have all the details in place and that she can release some of the planning and delegation to others.)

Q:  When are you at your best?  When do you perform well?

A:  Honestly, when there are crises.  In pressurized situations I can rise to the occasion when others would crumble.  I see this as a gift from God.

Q:  Where do you want to be 5 years from now?  Describe your idealized future as if it is happening.

A:  I want to be more present with my family – my family back in Canada and my Sew Love family here in Kenya.  Not so wrapped up in the tasks and the details, but present with the people and in relationship with them.  And I want to be in a place where I am taking better care of myself.

Q:  How do you get there?  What ideas do you have for realizing this?

A:  Ask for help.  Don’t get caught up in the details that don’t matter.  That is very difficult for me due to the way that my mind works, but it is absolutely necessary.

For the last 2 questions I recognize that as a leader there were opportunities to facilitate a more in-depth conversation and ask for greater specifics.  However, as I stated earlier the interview ended up being less formal than I had anticipated, and at one point Lori became quite emotional as she recalled that her first trip to Kenya was with a young woman from our church that we lost to cancer late last year.  My leadership decision at this point was to not pursue the line of questioning further and leave the coaching for another opportunity.

Employee development in health care appears to have its share of successes and failures. As I have disclosed in a previous post I am not very tech savvy, and certainly not very familiar with social media platforms and the ways to optimize their use, so I am looking forward to learning from my fellow students for this assignment. After completing the assigned readings, these are my thoughts on a potential employee development plan.

1. Include a way for patients to provide their feedback to employees and programs directly using social media or a survey that is communicated back to either the employees or to the manager in real time. The front line managers for most of my programs already have weekly huddles with all the staff so small improvements can be discussed in a timely manner with all staff. We also have quality teams for most of my programs, so large scale improvement suggestions can be taken to those teams. If patients are able to share their experience in other provinces and other countries, there could be learning from what others are doing to make the patient experience positive.
2. When patients submit ideas they could be invited to be patient or family representatives on quality teams or large scale projects. This would provide opportunities for co-creation and innovation and facilitate customer (patient) empowerment. Although this would not use technology directly, there should be a way to recognize patients for their contributions on a social media platform, website, or other means. If patients or families submit a suggestion for improvement and that change is implemented there should be an electronic feedback loop to that person that indicates that changes were made based on their suggestions. This would communicate to patients/families that their input is valued and acted on. Although not an internal organizational citizen behaviour, this could potentially lead to customers/patients speaking highly of their health care once discharged.
3. Have a way for patients to rate their provider. This is already available in an electronic format for physicians at RateMD.  Because of the number of healthcare professionals in our organization with varying education levels I would suggest that this direct feedback has potential to be useful for other self-regulated professionals, but any paraprofessionals or unregulated professionals I would suggest that the feedback only come back to the manager. As the literature suggests that different employees require different levels of feedback it is anticipated that this type of feedback would not be very useful for any provider without a professional background. For professionals, develop a way for the rankings to be de-identified and then presented in a way so that each employee can see how they compare to others in their ranking. This has the potential to be an internal motivator for professionals to improve in patient service in comparison to their colleagues. Recognition of employees who are consistently getting high rankings could influence customer focused citizen behaviour.
4. Also develop a technological platform for customers/patients to rank the facility, program or service in real time. Develop an app that every patient or family member can access to rank or comment on their overall experience. Again, develop a way for the rankings to be de-identified and then made available so that the managers and employees can visualize how they compare with other facilities or programs of a similar size.
5. Develop a platform that enables employees to provide peer feedback on each other. This could be set up on an internal SharePoint site with a notification sent every time someone submits a comment or feedback. As a disclaimer, I think that this would be difficult to monitor as it would need to be set up in a way ensure that the peer feedback is constructive and useful. If employees are permitted to submit anonymous feedback, this could potentially be destructive or lead to negative organizational citizen behaviours. If employees are not permitted to remain anonymous, they may not wish to come forward with any feedback that would be useful for employee development.
6. Develop a platform for employees to provide improvement ideas to management or senior leaders in real time. Often staff have great ideas but they get forgotten, or if they do get shared with their manager, they get lost due to the operational concerns of the day to day business. Ensure that when ideas are put forward that multiple people and departments receive notification (ie. The quality department, any other department who may be affected) so that those who are able to act on innovative ideas are able to more forward quickly. This would create greater momentum and staff engagement. Staff who bring forward innovative ideas would also need to be recognized to encourage the culture of creativity and idea generation.   This would create a culture of employee support and a positive organizational citizen behaviour.  Where possible, employees would also need to be empowered to make changes with patients/families without having to go through a manager for authorization every time.
7. Develop a technological platform in which employees are able to complete self-assessments, upload formal and informal learnings, post a learning or development plan, and request performance evaluations outside of the regular schedule. This would be a personal platform that only the employee can access with some limited permissions given to the manager to permit feedback where requested.

Because of my limited knowledge of technologies these are a few suggestions that are likely in use right now in other sectors, but only recently incorporated, or not utilized in health organizations. I look forward to reading the innovative and creative ideas that are being suggested in other contexts and any suggestions for my health care environment.

I have had the opportunity to teach groups of adults many times, and I would argue that my role as a physical therapist is highly, if not solely dependent on my ability to educate adults one on one. But my most profound experience in understanding andragogy is my personal experience

As a first year physical therapy student we were required to spend 8 months learning anatomy. Three hours per week in lecture, 2 hours per week in the cadaver lab. We were required to purchase tools, do our own dissection to see how tissue relates to one another, and learn from the dissected models already in the lab. In that first year of my bachelor’s degree it was overwhelming the amount of information that we needed to synthesize, learn and memorize. The practical learning alone was overwhelming – essentially learning Latin (ie. All the anatomical terminology) added to the complexity.

I doubt that I am alone in this experience, but the honest truth is, the learning in the first year of my bachelor’s degree was based on getting the best possible grade that I could in that class. I had always been a good student, and I measured my learning by my performance. I really, really enjoyed anatomy, but my study was based on wanting that good grade and completing my program – more of an external motivation than internal. Also, the time perspective of andragogy was in play – there was no immediate application of this knowledge, only future application. I understood the reason for learning anatomy, but did not really understand how it would relate to how I would treat people in physical therapy practice.

Many years later I had the opportunity to go back into the cadaver lab for a post-graduate course that I attended at the university of Toronto. The course was all about the upper limb (how the arm works in interaction with the neck and torso) and the morning was spent reviewing anatomy. Dissected pieces of the arm, neck, upper body were set up in stations all over the anatomy lab, and we were to review how the muscles, nerves, tendons, ligaments, joints interacted. The specimens were also set up in different anatomical positions to simulate how all of these structures relate when in motion. I had been told that going back to the anatomy lab after years of practice would be impactful – I had no idea how impactful.

I had been treating patients for years by this time, and what I was learning was at an entirely different level. I now had a reservoir of experience, and there was an immediacy of application to this learning. I had matured, and there was no longer a dependency on the curriculum or the professor directing what I needed to learn to get that good grade; I was now able to self-direct my learning and apply it to the pathophysiologic response of patients I had treated in the past. There was a keen readiness to learn because my internal motivation was to develop as a professional for the benefit of my patients and to have the personal fulfillment of growing in my career. There was a deeper understanding of the reason why the knowledge of anatomy is so critical to treating patients, and my self-directed learning as I viewed all the specimens was definitely more problem centred.

Separate from all of the principles and assumptions of andragogy, that learning opportunity not only impacted me intellectually, it was perhaps one of the most spiritual encounters I have ever experienced. With a strong belief in creation and intelligent design, I was not only able to recognize the practicality of the learning, but also able to step back from the intellectual exercise and experience the wonder and the beauty of the human body. I actually became emotional as I stood in awe of the creation and the Creator. Maturity and experience allowed me to step back from the science and appreciate the art. And the education that day was far from merely cerebral.

I look forward to hearing from others on their adult learning experiences and their impact.

References

Unit 6 Notes, Leadership 500