Solvay Conference

In 1927, a small group of Physicists and Chemists were invited to Brussels to discuss larger problems in both physics and chemistry. The first conference was held in 1911 and scientists attended by invitation only.

I was not aware of this conference until a few years ago but it has been on the top of my mind ever since. One interesting perspective about those who attended (made by Seth Godin) is that people weren’t invited because they won’t a Nobel Prize – no, people won a Nobel Prize because they were invited (attended).

Within most Pharmacy conferences, you sit and listen to a speaker. Occasionally, there is interactive learning but often this is limited to pressing a button to answer a question, disguised as interactive learning. There isn’t a framework similar to Solvay currently.

A significant gap is finding a place to work on the big problems, to brainstorm and test. While there may not be a Nobel Prize at the end, you just might be able to improve healthcare along the way.

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Cooks in the Kitchen

In any collaborative effort, there is a chance that several people want to lead. The important part is identifying a leader and creating a team who will work together.

The challenge is when different groups do not want the same leader and communication is stifled as a positioning tactic to gain authority. You can navigate this by listening to the group, making sure everyone is heard, and ultimately making a decision with the best intentions for the collaboration in mind.

In the end, some people might not be happy and if you have done your due diligence as the leader, accepted mistakes, you can rest easy knowing you did your part.

Smart Recombinations

From a 2010 HBR article, The Four Phases of Design Thinking, you are introduced to the idea of “smart recombinations” and the work of John Thackara (In The Bubble and others).

The idea of combining unseen concepts (or groups) is very interesting. For example, you could combine difference disciplines at a health care conference:

  • Pharmacy and Social Work
  • Nursing and Occupational Therapy

You can also combine different learning methods and types.

What combination of didactic, interactive, and peer to peer learning can you create?

What combination of visual, auditory, and hands on learning can you incorporate?

The challenge is taking the time to look – but when we do, lots of unique combinations show up.

Happy Combining!

Interesting Questions

A recent and favorite purchase has been a book by Warren Berger, called The Book of Beautiful Questions.

It is broken up into five parts:

  1. Decision-making
  2. Creativity
  3. Connecting with Others
  4. Leadership
  5. The Inquiring Life

There are too many questions to list here but I’ll write a separate post soon with my favorite (new) questions.

A gem to take from the book so far is a quote from Elizabeth Gilbert, who says to stop telling people to find their passion. Many people do not not know what it is and it can create unneeded pressure and anxiety. Gilbert suggests advising people to “follow your curiosity” – which may lead to a passion.

Have a curious day and keep asking questions.

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Critical Thinking

If I had a nickel for every time a co-worker has said “where was the critical thinking” I could buy a lot of things at the dollar store. 🙂

Joking aside, this is one of the most common (and recurring) themes of feedback I hear about our colleagues in healthcare.

Unfortunately, the type of education and teaching we provide often reenforces this lack of thinking. While there are organizations (think “bigger”) with more technology and virtual learning spaces, the vast majority of healthcare facilities cannot afford this type of resource.

The alternative is to be creative and create learning that will test critical thinking. Learning that empowers Nurses to make decisions and see what happens next, with the safety of being wrong. Learning that allows Pharmacists to see the whole picture and think quickly to solve a problem.

You all have the ability to build this type of education. Our workforce will be better for it.

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“But my doctor ordered it.”

Please enjoy a brief digression from the usual focus on learning. This is a great anecdote and illustrates some of the confusion in our current healthcare system.


The healthcare system is like a giant jigsaw puzzle and it can be very confusing to put all the pieces together.

A friend was talking about prescription insurance challenges she is engaged in when working in a community pharmacy. Occasionally, a patient is unable to get a medication because the insurance does not cover it. The misperception is that Pharmacists in the community are the cause of this limitation in access – this denial of something that can be of great importance to us as a medication.

However, Pharmacists are in the middle…of a few systems. They get the prescription from the doctor – but – that does not mean the insurance will cover it. That medication claim is submitted to the insurance and the insurance decides if they will cover it. This second interaction is with the insurance. The last is with the customer and if the medication is not covered, it’s the pharmacist or pharmacy technician who tells the customer the insurance is not paying for it. It’s a frustrating place to be, on both sides.

The (very) basic process is:

Doctor/APRN/PA -> sends prescription to pharmacy -> pharmacy submits to insurance

From there, the insurance accepts or denies the claim, based on a pre-approved list of medications, called a formulary.

Some doctor’s offices have begun to get realtime coverage of medications, which helps to reduce the risk of a medication not being covered but the majority do not use this technology yet.

From a patient’s perspective, there are important questions you can ask. Setting aside questions related to interactions and side effects with new medications, one question is “will the insurance cover this medication?” If not, the doctor will find an alternative. Better to figure this out earlier and save yourself frustration later on.

Repetition

98,000 scripts a year.

That’s a rough estimate for how many prescriptions a community pharmacist checks in a “busy” store.

400 scripts a day; 2,000 a week; 98K a year (with vacations).

How many heart rates and blood pressures does a Nurse check in a day?

We are good at something because of experience and innate talent.

We are great at something because we practice.

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Ultralearning

A good mix with the idea of infinite learners is how we learn. One such strategy is ultralearning.

A new book from Scott H. Young, titled Ultralearning is available now and discusses key concepts for how we can learn new ideas quicker.

Here are a few of the key principles:

  1. Design your project well – set enough time aside and limit what you are trying to learn
  2. Train Focus and Productivity – limit distractions and create a system for your learning
  3. Learn actively – in addition to some required passive learning (lectures, etc.) find opportunities to practice what you are learning
  4. Get quicker, deeper feedback – find ways to get feedback and create quicker cycles (repetitions)
  5. Space your practice out – add more practice spread out over time
  6. Practice more deeply – process what you’re learning (Feynman technique)
  7. Overlearning – continue to practice even after where you feel you’re no longer seeing any improvement

As is everything, there are various degrees of how much time you’ll spend on each of these. It also depends on what you’re trying to learn.

The best plan is to start today and monitor what works for you – then it becomes an iterative process and you can learn more efficiently…and effectively over time.

The last idea which is very interesting is meta-learning. Part of this process is to reach out to other people who have done what you are looking to do and ask them questions. You may find that there are parts you thought were important to focus on, that aren’t, or parts you hadn’t thought of that you should add to your list to research further.

The book Ultralearning is worth a read, either at your local bookstore, library, or wherever you get your books (audio, e-, or otherwise).

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Infinite Learners

Infinite learners are those who not only enjoy learning but feel a constant need to acquire new skills.

Contrast this with lifelong learners who have an on-going and self-motivated pursuit of knowledge. The nuance is the acquiring of new skills.

Another subtle, but important difference is how we continue to build and leverage those new skills.

The first opportunity is the using idea of meta learning and thinking about what skills you want to learn. Then start today. The next step is to help others identify which skills (or combination of skills) they need or want.

When thinking about healthcare, gaps of knowledge is a frequent area you focus on when creating courses. This is only one layer – the knowledge piece. Another important layer is what skill sets are required to create the changes need to close the gap. What if we spent more time on building these skills?

How can you inspire and engage learners to become infinite learners?

Read more about this topic, infinite learners, in a short post from Reid Hoffman on LinkedIn.

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Improving Continuing Education

I am inspired by a recent podcast episode of Akimbo, from Seth Godin – titled Systems Thinking. The topic can push us to think more deeply about the industries we work in and how we can improve them.

Systems thinking is basically identifying how parts are connected.

You don’t necessarily have to create the system; there are many systems in place already. The question is what can you learn about the system(s) to help you create more value for the audience you seek to serve?

A way to apply this idea is seen with Jim Collins’ Flywheel effect. Here we see a cumulative process – drip by drip, step by step, with a bias for action, and it all adds up to create effective results.

Taking the lens of continuing education for health care professionals, here are the pieces of the system:

  • Accreditation organizations (those who approve accreditors and those who accredit programs/education providers)
  • Speakers
  • Learners

Part of the idea of a system is that if one of these components is removed, the system would not exist.

Without learners, there would be no one to educate. Without speakers (or SME), there would be no one who teaches, etc.

[I’ll carve out continuing professional development and self directed learning for now but we’ll cover that in a future blog post. At least for pharmacists, we are required to take accredited courses for those “hours” to count towards annual requirements.]

Bringing back the Flywheel Effect, you can focus improvement on what you want the system to look like and build changes in one part, while knowing how it’ll affect the rest of the system. It is important to remember your changes depend on how each part fits with the other parts.

You can improve the quality of your speaker(s), but if the type of learning for attendees doesn’t match what learners are looking for, then you will see limited improvement in the system. If one thing moves, they should all move.

One area I’m most interested in developing further is changing the types of learners (and disciplines) who are attending meetings. Many conferences implicitly promote silos as they are created for one discipline and are primarily didactic lectures.

One way to combat this while looking at the system is to create more interdisciplinary conferences with interactive sessions and create ways to bring the content back to where attendees work (their own organization). Changes include adding different disciplines, different types of speakers who are engaging and maximize how to promote participation. Lastly, the education provider would need to provide accreditation for all the disciplines who attend. Potentially, one organization could do this but more than likely (and preferably), a collaboration of groups is what you would see.

It’s a new way forward, using the current system, and making small changes, course by course, to create a more effective way to improving continuing education.

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I have three assumptions to note:

  1. Accreditation is required to provide education to health care professionals
  2. What’s it for – continuing education is to help maintain competencies and expand on knowledge to improve patient care. What’s it sometimes for – meeting mandatory requirements.
  3. I’m starting a deep dive on systems thinking and the ideas here are subject to change…in fact, they probably will.