THE OXFORD ENGLISH Dictionary says vision is “the ability to conceive what might be attempted or achieved.” In his book, Leading Change, John Kotter refers to vision as “…a picture of the future with some explicit commentary on why people should strive to create that future.” If you have been following this series, you know you need to create a sense of urgency and build a guiding coalition to effect lasting change. So, why bother with visioning? What good is having a vision anyway?

Kotter says “getting the vision right” can:

1. Clarify and engage

   The visioning experience can help people sort out issues about direction or the necessity for change.

2. Motivate

   It can help people overcome concerns about doing what's necessary to accomplish change, and motivate them to take actions beyond short-term self interests.

3. Coordinate

   It also can provide a coordinating motivation for the people who will be involved at many levels in the change process.

Vision Development Strategies

It's tempting to go right to planning where you want your organization or your office to go, and how to get there. But if you skip the visioning step, you're left with little that will inspire action or direct an effective change process.

While it's usually begun by one individual, visioning can be a teambuilding opportunity that will engage your guiding coalition. It allows you to mix dreaming about how your CME enterprise might look in the future, and practical thinking about how you might get there by doing a pilot project with select opinion leaders among your physician learners. But don't expect it to be easy: You will make progress in one dimension and lose ground in another.

There is a creative tension going on here — you need to build a sense of urgency to get it underway — but you need to allow ample time in order to produce an effective vision. Your coalition-building process is a good locus for these deliberations. Allow for consideration and exchange about vision in the context of your work for change with this group. The leaders that you convene can be very insightful. They also can be a powerful voice for its consideration and eventual adoption.

Sound like a lot of work to craft some charming and catchy saying that you can put on your letterhead or hang on the wall? Developing a vision that is no more than some well-meant but poorly conceived platitude is a dangerous waste of time. As Kotter and others point out, you need to get the vision right. If you ignore this step or breeze through it, you not only lose credibility with stakeholders, but you and your effort for change will appear to be confused or insincere.

In the words of American social philosopher Eric Hoffer: “The leader has to be practical and a realist, yet must talk the language of the visionary and idealist.”

Robert E. Kristofco, MSW, is associate professor and director, Division of CME, University of Alabama School of Medicine, Birmingham, Ala.; Joseph S. Green, PhD, is associate consulting professor, Department of Community and Family Medicine and associate dean of CME, Duke Office of CME, Duke University Medical School, Durham, N.C.; James C. Leist, EdD, is interim director, Alliance Center for Learning and Change, and associate consulting professor, Department of Community and Family Medicine, Duke University Medical School.

An Effective Vision Should Be

1. Imaginable
2. Desirable
3. Feasible
4. Focused
5. Flexible
6. Communicable

Source: Adapted from Leading Change