Building your class vision… Musings from the 2014 CCME

Our product manager, Jason Ladicos, and I just finished a trip to Ottawa for the 2014 Canadian Conference on Medical Education and the Ottawa Conference. It was a lot of fun – we spoke to lots of our customers, confirmed some items for our product roadmap, and learned a ton.

My favorite talk was from Glenn Regehr, the Associate Director for Research at UBC’s Centre for Health Education Scholarship. In his talk, Regehr spoke about some inherent flaws in the approach of many medical educators. His point was that medical educators create their curriculum for “ideal” students. This ideal student wants nothing more than to become a great doctor. But, for anyone who’s ever met a medical student, he argues, this ideal is far from the truth.

Medical students are frequently NOT motivated to become great doctors during medical school. The typical medical student is so overwhelmed by work, financial pressure, and the continuous assessment barrage that she just wants to get through the four years alive – by any means necessary.

As I was thinking about this, I realized that this phenomenon applies not just to medical students, but to everyone! I bet every organization in the world has to deal with the challenge of employees, students, faculty, staff, etc, just trying to “get through life” — instead of the pure motivations we might wish they had.

It seems to me that there are two ways you can confront this problem. One, you can design your organization, your curriculum, or whatever, to be more geared to the actual motivations of people. And two, you can work to implement systems that raise their motivations with the ideal you wish they had. Both are probably important.

I’ll focus on the second point for this post. There’s a classic article in the business world by Good to Great author Jim Collins called “Building your company’s vision”. In this article, Collins describes core values, a set of values that an organization holds deeply, and that are used to help make decisions and guide behavior. Presumably your admissions process would have brought on students that share some innate set of core values: a desire to serve, a deep care for humanity, that kind of thing.

Since Collins wrote that article, many organizations have adopted his ideas. Great companies are always looking for ways to put their core values into practice, and I think the ones that do it most effectively are able to achieve levels of alignment with the “ideal behaviors” better than other companies.

One of the best examples of this I’ve ever seen was from Dina Dwyer-Owens, CEO of the Dwyer group. At the start of EVERY meeting of more than three people in her company, they recite the company’s core values. By doing this religiously, she says, their meetings are always guided by their values, instead of by the other motivations that the staff might have.

What would happen if, at the start of each of your PBL sessions, you had a few students comment on the principles of integrity and scholarship fundamental to being a physician? What if you had them practice calling each other out on ethical issues, so that they could see how ethical issues could be raised? What if you did this before each event in your curriculum?

Would this change the game that students are playing?

Brian Clare

About Brian Clare

Brian is the CEO of one45 Software. He joined one45 in 2003 and was one of the company's first developers. He currently serves in the MedBiquitous Curriculum Inventory Working Group as an Invited Expert.

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