Health Professions Schools: A stand-alone workplace culture crisis
The outstanding fact about all organizations is that they are very complex systems. No matter what the organization type is, the same construct remains. In higher education institutions the model might be denser and perhaps more compact, yet it is the very same challenging multi-relation structure.
The way we perceive the organization has a great impact on the plan we set for any transformation. The challenge here is for anyone defying the status quo, be him a manager, leader, or a team member. Leaders who instill innovation into their institutions and approach these structures with a vision are usually challenged by many off-the-radar issues that were not in the initial plan.
“The problem we tend to live in is the culture of the academic environment as a whole and the mere nature of continuous change that has become a standard in our settings.”
We are not an independent unit in the ecosystem. We are an exact replica of the highly mobilized community around us that tends to basically change with every single glimpse. The exact nature of change does not really make a difference as any kind of change generates the response of alertness and stimulates the fight or flight response even if it is for the better.
The main challenge with this is that higher education institutes are places where people learn and develop; and the hidden curriculum is the main influencer of the learning. Having a highly charged environment continuously, is a serious influencer on people behavior and on their capacity to act within their best nature which is a requirement when models are being set and when relationships are built.
Environmental factors tend to affect the hidden curriculum vastly and are the one challenge that has defied standard setting capacities of all professionals. It remains the only humane portion of education that cannot and will not be automated, tested, or standardized. The nature of an unsafe environment is nothing less than a disruptor of the educational innovation and promises a product that is most probably lacking competitiveness and any kind of appreciative nature.
In health professions schools, the challenge is bigger; fear is high. Furthermore, responsibility is an additional stressor that motivates a continuous process of self-improvement and self-monitoring. Faculty in these schools are burdened with the responsibility to build graduates who are willing to work under extreme stress and yet remain empathic and human. In addition to this they are burdened with the responsibility to offer patient care that abides with patient safety, human rights, and maintains the name and reputation of the school, its hospitals and the whole profession. With the growing area of limitations, creativity is held captive and changes start to follow hollow structures that rarely suit local environment or local needs. Clinical educators with all the stress of falling into ethical or legal dilemmas are without doubt themselves a large body of threat in the work environment. They mask their personal issues and fears with a superiority mask that renders them untouchable in the workplace.
Since health professions education and service are both areas that are not structured around clinicians alone and other elements and individuals exist to support both functions, it is rather debilitating to think that effective communication can be conducted in an environment with so many bottled emotions and distrust. All players in this work place are within the same circle of distress.
An alarming sign we see in our environment is people settling for mediocrity that does not equate to their potentials. Energy levels in institutions tend to drop when people function outside their comfort zones. We are social beings and the human interaction is by far the most important drive for a healthy functional day at work and when you see people retracting and refraining from actual meaningful engagement, this reflects a sense of distrust and lack of empathy as once stated by one of our school Leaders during a discussion around organizational culture.
A root cause analysis that we did to understand the nature of the viscous cycle we live in had us moving in circles of endless blame on everything around us and every player in the environment. This just signifies a trap we all fall in when we try to think of a cause effect model to take a corrective action when it comes to unhealthy work place environments.
The circle needs to be broken and breaking it comes usually from the weakest point. Many articles speak about the role of management in creating the organizational culture and monitoring it where actually I would like to offer a different approach.
Thinking of this issue as a cycle, offers some degree of empathy to everyone and assumes that everyone has the best intentions but maybe are trapped into an endless process of disappointment. Then it becomes a little easier to look for weak points in this cycle that can be broken; little initiatives that might help people recognize the potential of a coworker in a dysfunctional working relationship and thus empathize easier with them. Empathy is the core of all successful human interaction and since systems are alive and in a continuous process of change then they are nothing short of a living being that requires the same degree of empathetic nature.
It all starts with understanding the challenges we are all facing and when it is time to empathize we find common ground. Our physician culture that considers unmasking emotions a weakness that jeopardizes credibility in a clinical setting, is the main enemy to any genuine workplace interaction.
Actions taken can be as simple as a work monitoring chart that gives employees a visual of how much work is being undertaken by different personnel and departments and maybe gives people a chance to appreciate each other’s’ contribution to the system. This is just a thought but I do encourage people to experiment. I do not believe that we need to bring in someone from the outside to help us understand the system we have lived in for years. We know it more than anyone.
“We just need to think small and stop trying to shatter existing relationships and constructs in a demolition fashion. Big changes start with the smallest steps.”