The opening plenary session of the Alliance for CME conference today was a really comprehensive discussion of what's needed to move from individually focused continuing professional development to education that will help an entire organization become better able to provide improved care and enable better outcomes for patients. At its heart was a presentation by Marijke Thamm Kehrhahn, PhD, University of Connecticut School Neag School of Education, who introduced the TRIO model of adult learning. This model is based on the idea that there are individual learner attributes, environmental factors, and key experiences that all feed into optimal adult learning.
I loved this quote: "Learning for information is not the same as learning for performance." Ain't that the truth? And she went on to outline for us how she took an issue in her work (feeling grumpy after schlepping tons of stuff up five floors in the morning) and very scientifically went about finding a way to make it better (aka, take the elevator for her first trip up to the office).
She also outlined a model for levels of change that was right on: we start off not even thinking about making a change. Then we may begin thinking about it. Then we may actual try it out--which starts off feeling mechanical and weird, which can make you abandon the change at this point. If you stick with it, though, the new way of doing things begins to feel comfortable and routine, and gets integrated into practice. The last stage is where you own the change by refining it to make it fit your situation better, and getting others to buy into the change as well.
Have you ever made a change that didn't go through those stages? The thing that really got me thinking, though, was when she asked the audience to reflect on something we learned that we put into practice. For all the talking we do about this, I haven't spent a lot of time thinking about what has prodded me into making changes. It's really worth taking the time to work through what made you go from not thinking about it to considering making a change, and from thinking about it to trying it, sticking with it, and finally making it your own.
Another big moment for me was when she said that, for real learning to occur, there needs to be an emotional connection that leads to a change in your actual physical state. I think we all kind of hesitate to go there, because no one enjoys getting pushed out of their comfort zone, but when I think about when I've learned something I then put into practice, that's been the case every time.
But the tricky part is taking that from an individual level to an organizational one: Building a learning culture in the organization that enables individual learning to trickle up, and organizational learning to trickle down.
Another great quote, this time from response panelist David Price, MD, Colorado Permanente Med Group/The Permanente Foundation: "Co-located learning is not interdisciplinary learning." It's not enough just to have different disciplines in the room -- it has to be designed to meet each discipline's educational needs.