If someone asked me for a word I would associate with “innovation,” I would answer: “fast.” And yet I attended a session recently at the Annual Conference of the Professional and Organizational Development Network that upended my thinking. It turns out that in order to spread change, slow may be the best approach.
The session, led by Milton Cox of Miami University and Laurie Richlin of the Western Michigan University School of Medicine, focused on why some health science breakthroughs spread more quickly into policy and practice and others do not. We began with an excerpt of a July 2013 New Yorker article by Atul Gawande, entitled “Slow Ideas.” Gawande contrasts the relatively short amount of time it took for surgical anesthesia to catch on as a practice, versus the relatively long time it took for the use of antiseptics to catch on, at a cost of countless lives.
As Gawande notes, both practices, when they first came on the scene, violated surgeons’ existing beliefs about how and why patients died. Both practices involved some economic investment. And both practices had a level of technical complexity that needed to be worked out. Why, then, did one come about quickly and one much more slowly? He continues,
“First, one combatted a visible and immediate problem (pain); the other combatted an invisible problem (germs) whose effects wouldn’t be manifest until well after the operation. Second, although both made life better for patients, only one made life better for doctors. Anesthesia changed surgery from a brutal, time-pressured assault on a shrieking patient to a quiet, considered procedure. Listerism, by contrast, required the operator to work in a shower of carbolic acid [where even] low dilutions burned the surgeons’ hands….This has been the pattern of many important but stalled ideas. They attack problems that are big but, to most people, invisible; and making them work can be tedious, if not outright painful” (p. 2).
This is often the situation that exists in figuring out what makes a difference in improving student learning – most of us only see a tiny portion of the student experience (my course, my advisees) and the rest is often invisible. Furthermore, new pedagogies and new structures can be difficult to implement, with the faculty member and the students left feeling unmoored by the change.
Gawande goes on to describe one of the most compelling strategies for spreading new medical breakthroughs, and it requires no particular technology: useful information and support provided by mentors to practitioners. The key to this strategy is that mentors take the time to learn about the impediments to change and to help foster new habits over time in an atmosphere of trust. That’s what we’re hoping to do with CELTT and with the new Office of Academic Innovation – provide a context where faculty can test out research-based practices in the company of thoughtful and supportive colleagues.
Gawande concludes: “To many people, that doesn’t sound like much of a solution….But, to combat the many antisepsis-like problems in the world, that’s exactly what has worked.”