Talking not Telling: Don’t domesticate, liberate!

Do you think (as Wellington and Austin suggest) education domesticates or liberates?  In this post I argue that talking rather than telling in teaching transforms one state into the other.

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Image shared under CC-BY-SA available here 

 

Many courses of education in the health and social care sector seem to follow to a standard or code of conduct – infection control, safeguarding children, fire safety to name a few – mandating and controlling what is taught, when and how.  I appreciate the importance of this topics…I just dislike the feeling of being made to conform.  Inevitably this training takes me away from the place where I put it into practice and throws me into an abstract, sanitised (no pun intended) classroom environment – even if that classroom is online.  It seems like such a waste of time and energy to go back through extracting, re-contextualizing and re-integrating this learning back to the workplace.  Particularly when that work place is not a controlled environment.

However much we might like it to be, health and social care is not a production line – or at least, not a very efficient one.  In the complex, ever-changing health and social world, we’ve got to start managing rather than overcoming these challenges.

The School for Health and Care Radicals was my first truly liberating experience of clinical education.   When we connect to  learn from and with each other, we are liberated because become more than the sum of our parts.  Take the issue of resistance to change – a topic I’m sure we are all familiar with.  Through the School, I began talking and listening rather than telling when I come up against resistance.  Discussing real-life problems that might compromise patient care and safety is more likely to uncover obstacles to success and increase motivation than using either a carrot or a stick.  This is the dialogic approach to change (Busche and Marshak, 2009).  Diagnosing the cause of the problem means solutions can be found.  Success comes when we look at it from every angle, in every condition and acknowledge every possible interpretation.

Of course, talking to people higher than you in the hierarchy can be tricky.  Those in positions of power and influence are busy, often over-stretched by lack of time and money.  This may explain why, in their evaluation of the SHCR, Gifford et al (2015) found that the SHCR’s newly-qualified change agents had little confidence in organisational abilities to commit to or enact change.  This makes me sad but at least I know there is a way to make this better.  When more senior leaders join – as equals-  the network of School for Health and Care Radicals change agents, we may begin to achieve a better balance, with less telling and more talking.

Other References

Wellington B, Austin, P (1996) Orientations to reflective practice. Educational Research, vol. 38, no.3, pp. 307-16.

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Talking not Telling: Don’t domesticate, liberate!

Why you should make time for the SHCR

The School for Health and Care Radicals’s live broadcasts traditionally take place in the New Year, a time for change and self-improvement. Unfortunately this coincides with a period of high demand on services, with many teams operating at full capacity and staff time for education limited. Here I will argue why participating in event-based education is time well spent.

Time-bound, mass-participation educational events within an organisation can rapidly weave learning into the rituals, roles and symbols that constitute its culture (Sharples et al, 2014). The SHCR goes beyond organisational boundaries, however, by bringing geographically-dispersed learners come together to with shared purpose. The School has also skilfully incorporated social media into its learning design to create “knowledge networks” centred on participation and collaboration (Leaver, 2012).

Ambient Awareness

In the SHCR, participants contemporaneously report, share and create understanding using social media and in-presentation chat.  This generates an awareness of authentic, live issues – or as O’Reilley and Batelle (2009, p.9) put it- a “real-time indication of what is in the collective mind”.  To understand this buzz, often seen nowadays in citizen journalism we need to discuss push-pull communication (Kaplan and Haenlein, 2011).  Twitter, for example,  automatically “pushes” tweets to  followers, who may  choose in turn to push onwards to their followers (“re-tweeting”), in an exponential fashion.  When the reader wants to discover more about the subject, they “pull” information, say from a link in the original post or search engine.  No other medium can spread the word quite so efficiently.

Knowledge Networks

As we push and pull our understandings within the SHCR community, we are also creating networks that continue beyond the learning event itself (Sharples et al, 2014).  The more open the social media, the more diverse this network becomes and so our learning opportunities increase and broaden (I hope to come back to this in a future post).   The players in these networks can confirm your experiences and reduce any sense of isolation.  They can answer a cry for help or provide a different perspective.  They may make you question your assumptions, go back to the beginning and start all over again.  Or can simply make you smile.

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Every Friday @Jim_Rawson_MD sends me and other like-minded change agents a tweet.  This is more than a social nicety.  It reminds me that out there are people who I can learn from and with.  People who, like Jim, may answer a call for help (as indeed he did when I found myself in a particular dilemma).  Through the SHCR I have met and learnt from so many people without having to travel much further than my office.  Yes I had to commit time that I didn’t really have in the beginning, but this is an investment that continues to pay its returns.

References

Kaplan, A.M, Haenlein, M. (2011) ‘The early bird catches the news: Nine things you should know about micro-blogging’ Business Horizons vol 54, pp 105-113.

Leaver, T. (2012) ‘Twittering informal learning and student engagement in first-year units’ in Herrington, A., Schrape, J. and Singh, K (eds.), Engaging students with learning technologies. Perth, Australia: Curtin University [Online]. Available at http://espace.library.curtin.edu.au/cgi-bin/espace.pdf?file=/2012/09/28/file_1/187379 (accessed 12 August 2016).

O’Reilly, T. and Battelle, J. (2009) Web Squared: Web 2.0 Five Years On [Online].  Available at http://www.web2summit.com/web2009/public/schedule/detail/10194 (accessed 12 August 2016).

Sharples, M., Adams, A., Ferguson, R., Gaved, M., McAndrew, P., Rienties, B., Weller, M. and Whitelock, D. (2014) Innovating Pedagogy 2014: Open University Innovation Report 3, Milton Keynes: The Open University [Online].  Available at http://www.open.ac.uk/iet/main/sites/www.open.ac.uk.iet.main/files/files/ecms/web-content/Innovating_Pedagogy_2014.pdf (accessed 12 August 2016).

Why you should make time for the SHCR

Reflective Learning: How change starts with me

In my last blog post I argued that stories can be a springboard for individual reflection.  As testament to the great champions of reflective learning, my experiences of practicing, teaching and learning medicine always seem to come back to module 1 of the SHCR: Change starts with me.  It taught me to examine my motivations and challenge my assumptions before committing to the change.  It isn’t easy and it certainly isn’t always comfortable.

In Change Starts with Me Helen Bevan told her story of life getting in the way of youthful aspirations, reminding us of the importance of finding and  reigniting our inner fire.  I cried as I listened to Helen’s story because I recognised, for the first time, so much of myself and my teenage desire to change the world one patient at time.  A desire that had seeped away so slowly with each medical exam and long shift that I hadn’t even noticed.  A fine example of the emotions elicited by storytelling precipitating a change in mindset.

Boud argues that we cannot truly transfer learning between contexts without reflection.   The problem comes when we underestimate how complex and challenging reflection is.  You have to access deeper levels of meaning than may be superficially evident, tapping into our beliefs, motivations, values and expectations.  Sometimes it’s difficult to accept that the experiences don’t “fit” with our internal map of the world.

Gibbs acknowledges that feelings influence the way be translate our experiences into practice.  A experience which evokes unpleasant emotions may lead to avoidance or the determination (just think of footballers in penalty shoot outs).   Our different values, beliefs, motivations, experiences, societal expectations and cultural norms have made us unique and often gloriously irrational.

But Gibbs doesn’t ask us to really question what makes us tick.  In trying to make sense of the world, we draw conclusions, refining them as more information is gathered (Schon, 1983).   Unfortunately, humans aren’t always critical consumers of information.  Atkins and Murphy (1993) designed a model of reflective learning that requires the learner to articulate an awareness of the situation and evaluate the relevance of knowledge and feelings.  In other words, are your assumptions valid?  Are they helping or hindering?  It is within these cognitive or emotional “gaps” that we learn and grow.

Storytelling is like a short-cut to our feelings.  Sometimes we cannot put our emotions into words, such is the power of the story.  Sometimes it is preferable to acknowledge the emotion and address the logic later.  This can take time – two years in my case.   Inspired by Helen’s story, I pledged to reconnect with the optimism of my youth and revisited those early motivations with 20 years of life experience behind me.  I realised that I wanted to be a teacher, which is where you find me now.  Stories helped me get here and keep me inspired, not as passive entertainment or knowledge transfer but as an active part of my own life narrative.

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References:

Atkins, S. and Murphy, K. (1993) ‘Reflection: a review of the literature’, Journal of Advanced Nursing, vol. 18, pp. 1188–1192.

Schon, D. (1983) The reflective practitioner: How professionals think in action, London, TempleSmith.Schon, D. (1983) The reflective practitioner: How professionals think in action, London, TempleSmith.

Reflective Learning: How change starts with me