I’ve been thinking a lot lately about what constitutes a challenge, and why it’s important to listen when challenges come calling. I was cogitating especially heavily on the topic recently as I white-knuckled the guy-wires at the top of the SkyJump, a 630-foot-high platform atop the tallest building in New Zealand from which I was in theory supposed to fling myself in a controlled base-jump by wire. I knew logically that it was perfectly safe, but I’ve also had a deathly fear of heights as long as I can remember. That I was standing on that platform was pretty miraculous, but the thought that I was supposed to overcome the instinctual urge to respect gravity and jump instead of taking the elevator back down was, well, daunting. No, terrifying.
The operator counted down… 3 … 2 … 1 …
It was amazing. It only took about 11 seconds before I hit the target on the ground, but for those 11 seconds, I was flying. While I may still have a fear of heights, I’m stronger for having done what I thought was close to impossible. And I can’t wait to defy gravity again—skydiving, anyone?
Challenge, while sometimes scary, often painful, and almost by definition difficult, is essential. Without something that incites us to close the gap between what we do and what we need to do to be stronger and better, life would be a pretty tame thing, wouldn’t it? Comfortable for sure, easy even, but stagnant. Without push we don’t push back—and we don’t push forward.
We may learn new and better ways to do what we do, but without something that challenges us to play with what we learn, to find ways to make it work for our set of circumstances, to really use what we learn to grow and change—to get stronger--it will just gather dust on our mental shelf. As the eminently quotable George Mejicano, MD, professor of medicine, Department of Medicine, University of Wisconsin School of Medicine and Public health said at the 2012 CME Congress in Toronto this spring, “Learning is insufficient. Delta matters.”
I’ve written a lot over the years about the challenges of providing good continuing medical education, the challenges of engaging learners so they really learn, the challenges of learning to use new technology, the challenges of our ever-challenging healthcare system—pretty much everything you do in your professional life has some sort of challenge attached to it. At meetings such as the CME Congress, the Alliance for Continuing Education in the Healthcare Professions annual conference, and the Global Alliance of Medical Educators, we talk and talk about how to drive change in continuing medical education that will lead to professional development, improved practice, and better healthcare outcomes for patients. While a growing number do take what they learn and run with it, for so many, talk it remains.
I appreciate that the obstacles that get in your way of making those changes can look like a 630-foot drop: there’s just no way to take that first step. Cultural and institutional issues, regulatory requirements and operational issues, technology and funding problems—the challenges can seem overwhelming. But they’re not. All you have to do is take that first step.
Ready? 3… 2… 1…
P.S. If you haven’t seen it, check out this YouTube video of children on the hemoncology floor of Seattle Children’s Hospital performing the Kelly Clarkson song “Stronger” that sparked the title of this note. They’re taking the scariest leap of all. It’s up to you to ensure those who are there to catch them know how.
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