By Daniel Cabrera (@CabreraERDR) and Felix Ankel (@felixankel)
This is the final post in a three part series. See here for Part 1 [The Frog] and Part 2 [The Fox]
Health care and health professions education environments are changing in three dimensions. First, the value of a clinician is moving away from being a vessel of knowledge towards being a facilitator of collective wisdom. Second, a clinician’s professional identity is evolving from binary (you are either a physician or not a physician) to quantum (you are both a physician and informaticist or even a new identity yet to be created) Third, the center of gravity for innovation in health care and health professional education is moving from the core of historical hierarchical institutions to the periphery of non-hierarchical trust, communication, and personal learning networks.
How do we navigate this environment? What language do we use? What are some of the mental models we can apply to help in sense-making? This is a three-part about the future of medical education using the frameworks of The Frog, The Fox, and The Electric Sheep. Welcome to Part 3: The Electric Sheep.
The Electric Sheep
“Do androids dream of electric sheep?“
We live in a rapidly changing environment. The jobs we are training for may not exist in the future. The skills we need for the future may not have been imagined yet. It is challenging to prepare to be something that doesn’t exist yet while continuing to acquire the competencies for work in the present. Organizations and people are challenged in building ambidextrous systems: able to prepare for a new business model or market while keeping the old business running and feeding the new project. For example, an ambidextrous health system may be one that continues to maintain its current successes in managing episodic illness while preparing for a future focus on continuous health, well-being, and social determinants of health.
Teachers and students should not wait to see what is out there to adapt, all of us should focus on imaging and creating our own version of the future, that is the only way to remain relevant. This advice implies that the future looks nothing like the present. Innovation and change are influenced less by how quickly we create new paradigms, but more by how quickly we let go of old ones. They key competency for future clinicians is how quickly we let go of assumptions as truths to facilitate disruption and innovation.
We understand that this is difficult and creates a big amount of anxiety towards change, but like any other task, the skills necessary to create the future can be taught. Tips to create ambidextrous career development competencies include:
- Acquire the most diverse and transferable set of tools. It is important to acquire and master your discipline and credential (e.g., NICU RN or hematologist) but simultaneously investigate an obtain knowledge and tools from non-HPE industries. Examples of these are data analytics, AI systems, entrepreneurship, business development, user system interphase creation, philosophy, design, etc.
- Focus on learning more than in outcomes. Healthcare professions are built on an architecture of the outcome; from the next exam in school, to the next surgery or the next TPS report. We commonly forget the importance of the learning (growth) process, where the ability to learn from failure is paramount. Maybe the eMBA you enrolled did not guaranteed you the promotion you were looking, but the new tools and learning certainly will help with the next steps in your career. Learning and growing are activities that should never be deprioritized and that create an evolutionary advantage.
- Maintain a Fox and Beta approach. It is important to learn from multiple and diverse disciplines, while being able to amalgamate and coordinate the knowledge. The ability to synthetize and apply knowledge to different settings is perhaps the single most important trait for innovate and successful work. Simultaneously, it is important that Industry 4.0 is focus on rapid development and adaptation, it not necessary to have a product of project 100% debugged, the key is to make it work enough to learn from it and subsequently improve it. Keep a permanent beta mindset.
- Health professions has a significant benefit in career and life planning: almost certain job security. This is true today and likely for the short-term future, but longer trends don’t appear as reassuring. With the advent of new financial models, increase in the supply side of the market and changing jobs descriptions, there likely will be decrease of compensation among clinicians. We may need to pivot intra-industry and likely extra-industry. Pivoting is difficult, however we are not the only industry who have faced these challenges and there are frameworks that can help with the movement.
The future is coming and will look different than today. How different is the critical question. Anxiety about change is a good thing, panic and paralysis is not. Teachers and learners need to reimagine their identities, roles, and disciplines to successfully adapt to the changes that are coming. What are the keys to face the future: moving into a constant mode of improvement (perpetual Beta), focusing in acquiring non-clinical transferrable traits, building fusion skills, being ready to pivot to different industries and roles, and above all, the ability to imagine, create and spring into new ideas. The world is changing and the future may not be made of androids and electric sheep, but perhaps it will be made by the projects we start imaging and creating today.
- How the Healthcare Industry Will Change. How The Healthcare Industry Will Change | George Washington University (gwu.edu).
- Actor-Network Theory. Actor–network theory – Wikipedia
- American Medical Education 100 Years after the Flexner Report. N Engl J Med 2006; 355:1339-1344 DOI: 10.1056/NEJMra0554.
- The Role and Importance of Knowledge Economy as a Platform for Formation of Industry 4.0. Industry 4.0: Industrial Revolution of the 21st Century | SpringerLink
- Liminality. Liminality – Wikipedia
- Human + Machine. Human + Machine | Reimagining Work in the Age of AI | Accenture
- Living in Permanent Beta. How To Overcome The Fear Of Failure: Living In Permanent Beta | by Louis Chew | Medium
- The Clinician and Dataset Shift in Artificial Intelligence. N Engl J Med 2021; 385:283-286 DOI: 10.1056/NEJMc2104626.
- Superintelligence: Paths, Dangers, Strategies. Superintelligence: Paths, Dangers, Strategies – Wikipedia
- The Ambidextrous Organization. The Ambidextrous Organization (hbr.org)
- The Blind Spot of Institutional Leadership. Otto Scharmer.
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