Cast & Curious

Tag: Learning & Development

Learning and development (L&D) is a function within an organization that is responsible for empowering employees’ growth and developing their knowledge, skills, and capabilities to drive better provisions of healthcare.

  • Wheels of Willpower: How To Get Better at (Advising) Self-Control

    [su_pullquote align=”right”]Men are rather reasoning than reasonable animals for the most part governed by the impulse of
    passion.- Alexander Hamilton[/su_pullquote]

    During one badminton break, one friend asked my advice regarding his lingering knee pain while playing badminton. I advise him to stop playing badminton temporarily, seek medical consult for his knee injury and only resume playing when his doctor tells him so. On our next badminton game, I saw my knee pained friend still playing badminton and hasn’t consulted any doctor yet. I cautioned him again, but was really intrigued why he hasn’t followed my advice. His reply floored me. “We are almost of the same age. You also complain of occasional knee pain just like me. Yet you continue to play badminton. I guess this knee pain will just go away!”

    As someone who has tried (and failed) some of my own advices, I ask friends and colleagues how my “hardheadedness” affect their chances of “following” my advice. It seems for many of us health workers, advising self control seem easy yet we all had our share of self control struggles, and these have implications of our advising particularly with health issues.

    Of course there are many behavioral and social drivers when it comes to influencing health outcomes. Healthcare recommendations is just one of these, albeit an important one. We may not recognize this but when healthcare worker “self control” is out of control, the implications to our patients are as just as mind boggling. This is the topic of our #HealthXPh chat this Saturday October 15, 2022 9:00 PM Manila time.

    • T1. As a healthcare professional, have you advised a patient on a medical concern yet you struggle following the very same advise?

    When we talk of self control, the word “will power” comes to mind. Although there are many behavioral and social drivers to self control, we usually equate self control with “mind over body”, mind over flesh or simply the “will” to do things- will power. Many studies have already pointed the uncomforting truth that will power is often beyond our own “will”. Yet, we quixotically believe we have will power on so many things.

    • T2. Can you recommend a specific strategy to reinforce self control when advising patients on health concerns?

    One thing that comes to mind of course is avoiding too many self control habits at once or at the same time. There were studies now that prove that willpower is finite and our cognitive capacity is severely affected when its loaded all at the same time.

    • T3. What other behavioral, social strategies do you advise in addition to self control when influencing a health outcome in a patient?

    In the medical community our mantra for advising is “walk the talk”. This is easier said than done and I’m very interested in knowing how to improve our self control advises particularly when we try to improve our patients achieving a better health outcome! See you all in the #HealthXPh chat!

    Image by stockking on Freepik

  • Future of Healthcare Work and Learning

    Future of Healthcare Work and Learning

    It was never easy for healthcare professionals shifting to online learning and hybrid work during the pandemic. I never imagined though, that going back to pre pandemic set up, is equally challenging.

    I am one of those who wish we’d go back to pre pandemic healthcare work and learning once this pandemic is over. Alas, we’re two (2) and a half pandemic years and the end isn’t in the horizon. Something tells me we ain’t going back to where we used to be, no matter how hard we try.

    When our COVID cases went down in one institution for example, we tried face to face conferences again. Our OPD also resumed (albeit slower) seeing patients. Our OR also slowly reverted back to its old routine. Despite all the requisite precautions and vaccinations, some medical staff contracted COVID-19 two weeks into the resumption, prompting us to go back to online learning and hybrid work again.

    Trying to go back to an old routine should be easy, I thought. I’m one of those who once profess adaptability and flexibility as my strongest point. But the two years of traumatic, pandemic struggle probably ingrained an aversion to change in many of us, me included. And I am discovering how hard it is to go back now. Is it the design? Strategy of going back? Perhaps, before we can strategize going back or adapt we need to forecast what part of healthcare work and learning is here to stay, fade away or will be in demand in the future.

    Share your thoughts on the Future of Healthcare Work and Learning by joining the #HealthXPh tweetchat this Saturday July 23, 2022 9:00 PM Manila time. The guide questions are as follow:

    • T1. What will FUTURE healthcare work and learning HAVE that doesn’t exist today?
    • T2. What will FUTURE healthcare work and learning NOT HAVE that is common today?
    • T3 Is there a specific part of healthcare work and learning that will become more common in the future? ( e.g Zoom/ Hybrid learning, conferences, remote guided surgeries?)
    • T4. Where should healthcare look for inspiration in adapting to the future healthcare work and learning?

    (Note: This post is inspired by the #HCLDR chat on Future of Healthcare Facilities)

    Image by Freepik

  • Nurturing Safe and Braves Spaces on Social Media

    Social media has been a “comfortable” space ever since I joined most of these platforms. This is not just because I’m comfortable with computers and the internet, but mainly because I tend to gravitate and collaborate with people that allow me to grow in this space. In other words, I felt psychologically safe to grow in some groups I am with in social media.

    Two presidential elections and a pandemic drastically changed that “comfortable, safe” social media space. Sometimes, social media is so toxic I had to belabor curating my feed. Add to the difficulty is the changing algorithm of social media feeds, which is getting out of our control more than ever. Now I have to really do social media sabbaticals just to save my sanity from the milee.

    I (and I guess a number of others) wanted at east to reclaim this safe space on social media. And we cannot do it alone. I remember my coach telling me, “if you want a safe space, make one for others first”. This is the topic of our #HealthXPh chat this Saturday June 11, 2022 9PM Manila time.

    Psychological safety is defined as the

    belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. A shared belief held by members of a team that the team is safe for interpersonal risk taking

    -Edmonson 1999

    Today we will be revisiting the safe and brave spaces #HealthXPH as well as other #HCSM group started for other healthcare professionals to grow their networks on social media. We would seek advice from our colleagues on social media how they did make “safe and brave’ spaces t grow on social media.

    According to Clarke (2020) there are four stages of psychological safety in an environment- Inclusion Safety, Learner safety, Contributor safety and Challenger Safety. Let’s discuss how you can contribute to creating these stages of safe spaces.

    T1. How can you promote inclusion safety on social media?

    This stage simply meant all people in your social media group felt welcomed and included. I remember when we first formed #Healthxph, it was so informal and I felt very much welcomed even though we’re miles apart and very diverse persons at that. Some of us don’t know a thing about social media platforms. We included them first then helped them along the way. And we tried all platforms first to see what worked for all of us!

    T2. How can you promote learner safety on social media?

    Learner safety means “being able to ask questions, give and receive feedback, experiment, and make mistakes”. #HealthXPh is a very learning group. We assured each other we’ll help in everyone’s learning “the ropes” in social media. We have been doing this with our various summits and workshops since 2015. Here every time I speak in front of summit attendees, I often ask “what if I’m wrong”? One would answer, well we will know and learn together. Just go and do it”

    T3. How can you promote Contributor safety on social media?

    Contributor safety means “being able to participate as a member of the team, contribute ideas and suggestions, and raise threats and risks using members’ individual talents and abilities to contribute to the team without fear”. At #HealthXPh, each one contributes his or her best abilities. And even in areas where you have very minimal abilities, your contribution builds the overall program of the group. And since none were mainly an expert on everything in social media, we tried to contribute what we learned along our journey.

    T4. How can you promote challenger safety on social media?

    Challenger safety meant “being able to challenge the way the team works, come up with new ways of working, behaviours, and challenge the ideas of others – even the ideas of senior members” . We had some very controversial discussions at #HealthXPh, and even on twitter. We provide and hosted topics that were rather unpopular or divisive. #HealthXPh in some ways been able to diffuse the tension and made the discussion safe for everyone to contribute or challenge. This is what I later learned as increasing the ” academic tension but decreasing the social tension”. Social media feedbacking is very important here and we have tackled that in so many tweetchats before.

    Psychologically safe space is the “underpinning of high performing teams, bringing out creativity and innovation in teams” says Amy Edmonson in Fearless Organization. In one recent workshop I attended I heard one speaker mention ‘bravespace” for safe space. Indeed, if in the last stage of Psychological safety meant we are “safe” to challenge status quo in social media, then “brave space” would be an apt term.

    I am inviting you once again to join #HealthXPh tweetchat this Saturday June 11, 2022 9PM Manila time. See you all!

  • Psychological safety and health workers performance

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    Vignettes:

    A ward nurse noted an attending physician verbally ordering a medication but forgot to write it in the chart. When the ward nurse called the doctor who is already on her way out of the hospital, the attending berated the nurse for “not reminding” her during the rounds.

    A training consultant dismissively ridiculed a resident in training for proposing a procedure he has no experience at all.

    A medical professor cleared her busy schedule and sat with a medical student’s research group to listen and critique their proposal. The students prepared well for this research and eventually won a grant and prize for their output.

    In all these vignettes, one striking commonality is the relationship between performance and the “state of psychological safety “in their learning or working environments

    Definitions:

    First introduced by Schein and Bennis in 1960s, psychological safety as coined by Amy Edmonson, “is a shared belief that the team is safe for interpersonal risk-taking”.  It allows space for people to speak up and share their ideas without fear of being ridiculed, berated, or discriminated upon.

    Studies have shown that psychological safety affects the performance of an individual, team, or organization. Medical errors for example, are reported more frequently in healthcare institutions where psychological safety is encouraged. Yet on the overall, the same psychologically safe healthcare institution tends to have fewer medical errors.  Google’s Project Aristotle found out that psychologically safe environment underpins the success of high performing teams. In contrast, fear-based organizations may experience short term success but had catastrophic failures years later. Learning gets stifled when students are summarily berated by teachers for not performing par to standards. We all remembered, and attributed to the “good” mentors, who took time to listen and nurtured us through training, as one major reason for our success.

    Fear based leadership and psychological safety

    Sadly, our working and learning environments are still mired by psychologically unsafe culture and practices. I’ve come across colleagues who wanted a psychologically safe environment but is unable to break the cycle of fear-based motivation and performance culture. While leaders are ultimately responsible for creating and nurturing a psychologically safe environment, our own individual contributions are also very important. This will be the topic of upcoming #healthXPh tweet chat this coming April 29, 2022, 9-10PM Manila time.

    T1. Have you been in a psychologically safe/unsafe working/learning environment?

    We all do. Yet, until I mapped the relationship of performance to the “state of psychological safety”, knowing is always from a hindsight. Self-awareness is key but it only dawned on me at a later point in my life. Moreover, psychological safety is a recent phrase, though we all are very familiar with fear-based traditions, culture, and practices.  The term also became popular when bullying in work and learning environments was brought front and center. Vulnerable, uncertain, complex, and ambiguous environments like what we had this pandemic also highlighted the need for psychologically safe environment to reduce burnout, promote resilience and innovation.

    T2. What was/were the impact of psychologically safe/unsafe working/learning environment on your performance?

    I was fortunate to join several organizations in the academe and my professional practice where leaders have had varying degrees of awareness and support for psychologically safe learning and working environment. I felt safe to innovate, raise concerns and learned most (not to mention happy) in psychologically safe working environment. #HealthXPh for example was mainly created as a platform to discuss healthcare issues. We had several successful (or failed) innovations in the past 5 years, but all these couldn’t have happened without ensuring a psychologically safe environment to innovate. In my administrative work, policy output and successful implementation are almost always the province of psychologically safe environment.

    T3. How do you promote psychological safety in work/learning environment?

    Awareness is key. You must be aware of the prevailing organizational culture and practices of your work and learning environment Next is stopping the vicious cycle of perpetuating fear based organizational leadership. If you have been at the receiving end of a psychologically unsafe environment, make sure you don’t pass it along your colleagues and subordinates. Allow people to raise concerns and issues or create a safe listening platform.

    Finally, put an effort to break the cycle particularly if you are the leader or model of a team  team. Walk the talk. Easy said than done but this is very crucial in encouraging psychological safety in working and learning environments.

    Sketchnote by Tanmay Vora; Psychological safety concepts by Amy Edmondson

  • Rebuilding social connections, learning and finding purpose in the new, “post pandemic normal”.

    Rebuilding social connections, learning and finding purpose in the new, “post pandemic normal”.

    Two days ago we operated a fully vaccinated, asymptomatic RT-PCR + patient for a totally unrelated injury. Two years ago, treating a SARS COV 2 (+) patient is too risky and dangerous. Treatment is necessarily delayed until patient is deemed non infective. That could take weeks or even a month if the patient luckily survives COVID. Now, with vaccination, precautionary protocols and PPEs, we can proceed with the treatment with little delay. And I felt rather dull, apprehensive and weird. After struggling to adapt to this pandemic, I am once again witnessing another disruption. One that more is desirable but not necessarily easier, than its predecessor- adapting to the new, post pandemic normal.

    We all bear witness to our struggles in the new pandemic normal. We all prosletized that the “new pandemic normal” of COVID 19 restrictions will be the “new normal”. We painstakingly used and adapted to digital and electronic communications to carry us through this pandemic. When vaccines and safety protocols came minimizing the risks of COVID among us, we’re now looking at a face to face interactions soon. And there’s anything but the “old normal” in what I saw. A blended lecture, a new weird looking OR with all spacesuits, or dining with friends al fresco (but wet by the heavy rains), I felt weird. And now, I have this conundrum (albeit a lot desirable than its pandemic predecessor) on how to adapt to this emerging, post pandemic normal.

    COVID-19 severely disrupted the way we connect socially. Almost all of our social connections were built and maintained digitally during the pandemic. “I lost a few good people this pandemic and all I can say is RIP over the internet” said Dr. M. “That’s too damn shameful for my standards”! Now that we are emerging from this pandemic, I’m still apprehensive about physically, socially mingling even with my family. The mask-less, physical hugging I’m used too is a bit awkward now. I still avoid family dinners for fear of spreading the virus!

    T1. How will you rebuild social connections in the new post pandemic normal?

    As a distance education student, I am very much comfortable teaching and learning “from a distance” . Yet, I miss giving out face to face talks and the “hands on” teaching at the clinics. At a recent training workshop, I had this awkward dilemma – I don’t know how to talk to a camera and a face to face audience at the same time. I ended up talking to myself.

    T2. How will you continue teaching and learning in the new post pandemic normal?

    “I’m thinking about retiring early or maybe another less risky career” said one colleague. “I lost my purpose right there when I was gasping for air at the COVID ICU” he lamented. I can empathize with him. My mom died not of COVID but her healthcare needs was severely limited by this pandemic. And I not once blamed my inability to provide all her needs even if I am busy taking care of others. That, tested my career purpose. Finding your purpose in the new post pandemic normal would be difficult for many of us.

    T3. How will find or continue your purpose in the new post pandemic normal?

    Experiencing how we lived through this pandemic and hopefully soon, a post pandemic world, I had so many questions and realizations. In all these, adaptation has been our greatest ally in rebuilding in the post pandemic normal. The concept is easy to understand but is much harder to implement. This will be the topic of the #HealthXPh tweetchat this March 12, 2022, 9PM Manila time. Join us and share your thoughts!

    Image by pressfoto on Freepik