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Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education.

Challenging Assumptions: Your own, your tribe’s, and your community’s

The Harvard Macy Institute Program for Educators in Health Professions is an ideal place to develop and practice new teaching skills consistent with the current knowledge of experiential learning theory, as well as a place to enhance scholarly expertise and explore organizational leadership. As I found, it is also a place to recognize your personal potential and to help others find theirs by identifying ideas, commitments, and even biases, that knowingly or unknowingly hold us back. Ultimately, this allows us to transform into better versions of our educator and leader selves.

The transformational faculty development workshop with Bob Kegan was a personal highlight during my time at the Harvard Macy Institute. We began this reflective practice by identifying an area of potential growth, something others may have shown us or that we may have seen ourselves that could change for the better. From there, we learned how it’s not a process of putting more into the same vessel, but transforming the vessel to a different shape that we can truly grow, adapt and change. This is a challenging statement for someone who views the world through a rational lens.

Through this experience, I was able to see I was being held back professionally because I was not connecting with students. More clearly, I wasn’t connecting with students - not because I couldn’t, but because I wouldn’t. I had a lot of assumptions tied up in connecting with learners. Assumptions that if I connected with them, I might lose my authority as their instructor or that I would be misperceived as merciless if I had to make a tough call to keep the rules. These assumptions caused a lot of personal doubt and, honestly, pain as I read through annual evaluations from students where my overall effectiveness scores struggled and the comments were ruthless. Through that deeply personal transformative faculty development workshop, I found my assumptions. Once able to put a finger on them, I was able to make a plan of action, so that when I came back to my home institution, I was able to see the issue arise and challenge it directly!

Within just a few days of being back on campus, I had a student with an issue in a clinical site. Instead of emailing the student reiterating the rules as I would usually have done, I had the student call. During the call, I asked a couple of questions to clarify some details and then I just listened. I heard her concerns. I heard her angst. I saw more of her perspective than I’d ever taken the time to know before. In the end, I was still able to ensure the rules were followed and we had worked together to make a plan that was right for her. Her angst had resolved. My rules were still upheld. It was a win-win. Importantly, I saw the first wins quickly and one win gave way to another and another. After having this conversation with one student, my confidence increased and each time there was another opportunity to challenge my assumption, I jumped in feet first. Memorable moments have included meeting a student for lunch to discuss how to navigate a challenging learning environment or meeting several times with a learner who voiced that she appreciated my advice (even though I was meeting with her to remediate a learning need). She saw the remedial process as “advisement” versus a mandatory assignment and she has put the changes into practice. Even my effectiveness of instruction evaluations changed for the better. I truly feel I am not only a better educator, but also a better person for having completed just that one small portion of the much larger course.

Transformative change can be applied at an organizational level, improving leadership and affecting positive change. This we learned in our second session as we worked in “tribes” to develop action plans through a similar reflective practice led by Bob Kegan and Constance Bowe. This made me wonder if this could also be applied to other groups of persons. Upon returning to my home institution in May, I was tasked with providing a lecture during a community caregiver conference on the topic of “caregiver stress”--recognizing it, noting the significance, and helping the caregivers identify ways to combat this problem. The session was at 3pm, at the end of a long day for providers who were trying to find resources for their families in an all-day conference. The vendors who provide the resources were all available in the room, but it was clear that many times, people left these events without taking advantage of them. They continue to feel stressed and overwhelmed at the task.

After connecting the task at hand to my learning from Harvard Macy, I felt empowered and applied the principles of transformative learning and reflective practice to their situation and developed a worksheet to identify an indicator of stress they were exhibiting, what they were doing that perpetuated the activity, what might happen if they stopped doing those perpetuating actions, identifying competing commitments, finding their assumption and plan to challenge the assumption. The result? A 3pm session without yawns, a group of 50 caregivers exploring their stressors and what drives them to stay in a state of stress, a list of challenges all around the room, and a group of caregivers with the phone numbers of others at the table to stay connected with as they went back home. There were confused faces. There were tears. There were hugs.

Somehow, I feel like this is just the beginning of ways I will find to apply this exercise to the lives of myself, my tribe and my community. I challenge all my fellow Harvard Macy alums to do the same and would love to hear how your personal assumption challenge or organizational challenge played out!

  

References

Osterman K, Kottkamp B. Reflective Practice for Educators: Improving Schooling Through Professional Development. Corwin Press. 1993

Bowe CM, Lahey L, Armstrong E, Kegan R. Questioning the ‘big assumptions’. Part I: addressing personal contradictions that impede professional development. Medical Education. 2003;37:715-722.

Bowe CM, Lahey L, Kegan R, Armstrong E. Questioning the ‘big assumptions’. Part II: recognizing organizational contradictions that impede institutional change. Medical Education. 2003;37:723-733.

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Comments 1

 
Zheala Qayyum, MD on Tuesday, 25 September 2018 11:25
Follow up

This is really well done Kim. I’m so glad to hear about your ‘test’ results! Thanks so much!

This is really well done Kim. I’m so glad to hear about your ‘test’ results! Thanks so much!
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Friday, 27 November 2020