(re)Designing #MedEd, Part 1

Author: Rob Cooney, MD, MSMedEd (@EMEducation), Geisinger Medical Center, on behalf of the CORD #iMedEd Track


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At CORD16, a small group of participants was able to participate in a workshop that introduced the principles of design thinking to educators. Their overall experience was documented as one of Academic Life in Emergency Medicine’s MEdIC cases. In this series of posts, we wanted to introduce you to the principles of design thinking so that you may also benefit from this approach to solving thorny problems within your educational program.

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As educators, have you noticed that the needs of our learners are evolving? New technologies, new mandates from the ACGME regarding work hours, competency, and the clinical learning environment, perpetual boarding of emergency department patients, and many other factors stretch educators to their limits to keep up with these new demands. As educators, we are positioned optimally to be able to address and solve these concerns. As the quote above alludes to, however, to solve real-world, complex problems we need to adopt new tools and perspectives for success. Design thinking is one such approach.

What is Design Thinking?

Design thinking is a mindset and an intentional process used to discover and implement innovative solutions to complex problems. The process begins by developing a deep empathy for the “end-user.” In our case, the end-user is often the teacher or the learner. Design thinking uses a collaborative and experimental approach. Having a team with multiples perspectives fosters creativity. Experimentation, and the permission to fail, learn, and then iterate leads to better solutions in the final “product.” This process may be used to approach almost any problem that you are facing. Curriculum, learning environment, processes, and even systems are all fair game for design thinking improvements. Design thinking relies on an iterative approach to solving these types of problems. The iterative cycle moves through the following phases:

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From: Design Thinking for Educators, page 15

As the graphic above illustrates, design thinking relies on moving between the concepts of divergence and convergence.  The objective of divergent thinking is to create many choices. In this phase, no idea is viewed as a bad idea, they are simply collected and shared. The convergent thinking phase focuses on deciding between all the choices generated in the previous phase. Convergence can be viewed as a funnel through which all ideas must pass and either be filtered out or adopted.

When utilizing design thinking, it is necessary to first define the challenge that you want to solve. Every institution has its’ problems. These problems can be refrained as opportunities to solve. Converting a problem into a “How might we…?” question can be a helpful way to define the challenge. For example:

“How might we better supervise our residents?”

“How might we improve resident reporting of adverse events and near misses?”

“How might we improve resident attendance at conference?”

As the above questions demonstrate, the “how might we” questions are simple enough to understand yet broad enough to allow for creative solutions. Design thinkers was also keep in mind the existence of constraints. Constraints allow the design thinker to be very specific about the problem as well as possible solutions. These constraints must be managed for the project to be successful. As the challenge is defined, and goals and measures of success can be determined as well. All of these factors can be incorporated into a brief. The brief becomes the guiding document for the team addressing the challenge.

Once the challenge has been designed, it is time to begin planning the design project. Our time is a precious resource that also can make it very difficult to complete a design thinking project given the competing demands from our clinical and academic work. It is possible, as demonstrated at CORD16, to utilize design thinking to quickly solve problems. We used a daylong experience in which participants moved through the above phases over the course of 24 hours. You could easily implement a similar workshop at your own institution. In that example, it was very important to predetermine the challenge and provide the teams with materials ahead of time. More likely, you would prefer to use design thinking over time. Spreading out the project in small increments allows teams to go deeper. The more complex the problem, the more time should be allowed to complete the project.

Discovery

Discovery is the first phase of the design process.  In order to create meaningful solutions, the design thinker begins by developing a deep understanding of the problem. When working to solve educational challenges, we often have in-depth knowledge about the problems. As part of discovery, sharing what we “know” about the problem with her teammates can help define the problem further. As this occurs, it may also become clear what we don’t yet know about the problem. The gap between the known and unknown becomes an area for further research in later phases of the design challenge. Defining the “end-user” is also essential. Is your design challenge directed that your learners? Teachers? Medical students versus interns versus senior residents? These end-users become possible sources of inspiration and perspectives that you should obtain.  You may also wish to identify experts  with experience in solving the problem that you’re facing.

Design thinking often utilize qualitative methods to discover the best insights. The qualitative approach may involve interviewing the end-users, i.e. Other faculty or students, direct observation in their environment, and even discussion or observation in unrelated environments. For example, what can you learn about resuscitation team performance from watching a NASCAR pit crew? It is important to capture your observations. It is very common to see Post-it notes everywhere when watching people engaged in design thinking. This is because the ubiquitous little notes limit the amount of information that you can place on them and are easily reorganized at a later date as the discovery process unfolds.

Discovery is only the first phase of the design thinking process. In our next post, we will explore the following phase: interpretation.

Have you utilized design thinking in the past? Share with us your experiences in the comments below.

References:

Brown, T. Change By Design. HarperCollins, 2009.

Design Thinking for Educators, version 2, available at: http://www.designthinkingforeducators.com/

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