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Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 1
Thinking Design:Models and Methods for Patient Centered and Healthcare Student Centered Practices
grass roots critical thinking tools are a human right
For Healthcare Professionals, Support Staff, Health Sciences Faculty and University Students
International Trainer: Robert Seth Price Ethiopia Country Trainers: Atsede Tsehayou, Dagim Melese
website: www.eggplant.org
November 2016Mekelle, Tigray, Ethiopia
Mekelle UniversityCollege of Health Sciences
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org2
Table of Contents•IntroductionandBackground•ObjectiveoftheConsultancy•LearningOutcomes•TrainingOutcomes•Consultants•TrainingMethodology•CollaboratingCommunities;QuestioningforInquiry:ThinkingEnvironmentsVisualTools–ThinkingMaps;Dispositions
•GuidingQuestionsforImplementation•Resources
Thinking Maps"': A Language for Leadership; A Language for Learning© 2006 by Thinking Maps, Inc.401 Cascade Pointe Lane Cary, North Carolina 27513 USAAll rights reserved. No part of this book may be reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording,or by any information storage and retrieval system, without permission in writing from the publishers, with the exceptions of those pages clearly identified within this text for duplication and use within individual classrooms.Inquiries should be addressed to:Thinking Maps. Inc.401 Cascade Pointe laneCary, North Carolina 27513(800) 243-9169ISBN: 1-884582-25-7
The term “Thinking Maps~ and the term Thinking Maps® with the graphic forms of the eight Maps have registered trademarks. No use of the term “Thinking Maps” with or without the graphic forms of the eight Maps may be used in any way without the permission of Thinking Maps, Inc.Thinking Maps, Inc. © 2006-2012 All Rights Reserved
Thank YouThank you Geoffrey Suddreth, General Manager of Thinking Maps®, Inc.; Chris Yeager, Consultant Director for Thinking Maps®, Inc.; and David Hyerle, creator of Thinking Maps® and founder of Thinking Foundation for providing use of Thinking Maps® with professional development by Thinking Schools Ethiopia (Part of Eminence Social Entrepreneurs, Ethiopia) for school leaders, NGO leaders and educators in Ethiopia. Thank you to Corwin Press and the author David Hyerle for permission for reprinting excerpts from Visual Tools for Transforming Information into Knowledge (second edition).www.thinkingmaps.com www.thinkingfoundation.org www.corwinpress.com
Systems Thinking“The word organization is a product of how we think and how we act; [it] cannot change in a fundamental way unless we can change our basic patterns of thinking and interacting.”—Peter SengeThe Learning Organization Made Plain
The BrainThe globalization paradigm emphasizes the fact that information can now travel 15,000 miles in an instant. But the most important part of information’s journey is the last few inches — the pace between a person’s eyes or ears and the various regions of the brain.
• Does the individual have the capacity to understand the information?• Does he or she have the training to exploit it?• Are there cultural assumptions that distort the way it is perceived?
—David BrooksThe Cognitive AgeNew York Times • Friday, May 2, 2008
www.thinkingschoolsethiopia.com • www.thinkingmaps.com • www.thinkingfoundation.org 2
Thank YouThank you Geoffrey Suddreth, General Manager of Thinking Maps®, Inc; Chris Yeager, Consultant Director for Thinking Maps®, Inc.; and David Hyerle, creator of Thinking Maps® and founder of Thinking Foundation for providing use of Thinking Maps® with professional development with Thinking Maps® in Ethiopia for schools, school leaders, educators, NGOs and NGO leaders in Ethiopia. Thank you to Corwin Press and the author David Hyerle for persmission for repring excerpts from Visual Tools for Transforming Information Into Knowledge.www.thinkingmaps.com www.thinkingfoundation.org www.corwinpress.com
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 3
Thinking Design:Models and Methods for Patient Centered & Student Centered Practices For Healthcare Professionals, Healthcare Educators and Students
Mekelle University College of Health Sciences
Introduction and BackgroundThinkingDesignisasystemsapproachthatusespracticalresearchbasedmethodstoassureahealthyorganizationsupportingandgrowingeffectivecommunicationwithandbetweenleadershipandthewholeorganization.Itusestoolsthatthoughtfullyandeffectivelycommunicateideaswithinandoutsideorganizationtocreatecollaborations.Ithonorsandunderstandstheabilitiesandgiftsofallmembersofanorganization.
ThinkingDesigntrainingusestheThinking Design researchbasedmethodsthatinclude:
•Collaborating Community:collaborativethinking;collegialcoachingandcommunitybuildingmethods;
•Questioning for Inquiry:highqualityuseofquestionsandsharedinquiry;•Visual Tools:theuseofvisualtoolstomapoutideas;•Designing a Thinking Environment:howthephysicalspace,humaninteractionandresourcesareorganized,integratedandused.
•Developing Dispositions:characteristics,dispositions,habitsofmind;
Tolivefulfillinglives,peoplebenefitfromtheknowledge,skillsanddispositionsshapingthelivestheycanimagineforthemselvesprofessionallyandpersonallywiththeirfamilies.Criticalthinkingtoolsareinstrumentalinguidingandknowingoneself,connectingwithothers,andexploringideasandmethodsofsuccessfulcollaborations.Thissupportsahealthyandproductiveorganizationincludingleaders,professionalstaff,supportstaff,volunteersandthegreatercommunity.
Thetraininghassequentialstages:Introductionforlearning,practicingformastery,andmasteryforsustaining.
Objective of the ConsultancyTheobjectiveofThinking Design: Methods for Patient Centeredconsultancytrainingistoprovideaparticipant-centeredapproachtolearn,shareandthinkbestwithone’spersonalcapacitywhilesupportingqualitypracticesforthewholeorganization.Thespecificobjectivesinclude:
•knowingourselves;•understandingthinkingindividuallyandasacollaborativeorganization;•introducingtoThinkingDesignmethodsincludingcollaboratingcommunitymethods,inquiry,dispositions,visualtools,thinkingenvironment;and
•developingasustainablesequentialplanthatsupportsthehospitalandmedicalteachingcollegewithimplementationofthethinkingorganizationapproachwithintheorganization.
TheconsultantswillsupportthewholeorganizationimplementationincludingdevelopingateamofTrainer of TrainerstoassuresustainabilitywiththeThinkingDesignsmodel.
Thinking: The Most Important
Human Resource for Life Long
Visioning, Problem Solving, and
Decision Making
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org4
Learning OutcomesTheThinkingDesignapproachisrecommendedforthewholeorganizationincludingtheorganizationsleadership,teachingfaculty,professionalstaff,supportstaff,students,andvolunteers.TheThinkingDesignmodelarelifelongtoolsandskillsforcommunication,understandingeachother’sperspective,problemsolvinganddevelopmentofaqualitycollaborativesharingandlearningenvironment.TheThinkingDesignapproachisconcurrentlystudentcentered(medicalcollege)andpatientcentered(hospitalprofessionalsandsupportstaff)thatpromotesactivecriticalthinkers,thoughtfulcollaboratorsandproblemsolvers.
Training OutcomesTheThinkingDesignstrainerswillbuildunderstanding,masteryandcapacitywithinthehospitalandmedicalcollegewiththemethodsofthinking.Thiswillinclude:
•personalmastery•buildingasharedvision•teamlearning•developingmentalmodels•creatingasystemsthinkingorganization
ConsultantsRobert Seth Pricehasexperiencewithwholeorganization(NGOs,universities,foundations)andschoolchangethroughatransformationaldesignprocess.Simply,howcanwecollaborativelyandthoughtfullyaffectlearningoutcomesasaprocessindividually,forourwholecommunityandcreatingourvision.Robert’sworkisbuilduponthebelief:‘grassrootscriticalthinkingskillsandtoolsareahumanright’.www.eggplant.org•www.thinkingschoolsethiopia.org
Atsede Tsehayou hasabackgroundthatincludesclassroomteaching,facilitatorofprofessionaldevelopmenttraining,coaching,andtutoringstudentsatdifferentlevels.Shehasgiventrainingsextensivelyoncomparativeanddevelopmentaleducationtopicswithanemphasisonhigherorderthinkinglevels.www.thinkingschoolsethiopia.com/?page_id=1474
Dagim Meleseishighlymotivatedtobetterunderstandhowthehumanbrainlearnsandtoputthattopracticalusehelpingchildrenandstudentslearnmoreefficientlywhichhebelievesisfundamentallyimportantintermsofcreatingathoughtful,healthy,prosperous,caringandsustainablesociety.Hisexperiencesincludeteaching,facilitatingprofessionaldevelopmentnationallyforThinkingSchoolsEthiopia.www.thinkingschoolsethiopia.com/?page_id=1680
GuideTheparticipantswilluseaguidethatincludes:
•ThinkingDesignImplementation•TheModels:CollaboratingCommunities,QuestioningforInquiry,VisualTools,ThinkingEnvironments,Dispositions
VideoVideowillbemodeledandusedtodevelopalibraryattheuniversityofbestpractices.
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 5
doing reflecting
consideringchangebasedonsuccesses
andneeds
creatingsolutionswithpartswhile
seeingthesystem
makingdecisionsonsolutionstoimplement
implementingaplantobuildsuccesstowardsmastery
change thinking
systemsthinking
exploringthinking
implementing thinking
connectingdeciding
Change
Change Process
Kotter’s Change Model ProfessorJohnKotter,HarvardBusinessSchool.
Institutionalize new approaches
Build on the change|
Create short term wins|
Empower others to act on the vision
|Communicate the vision
|Create a vision for change
|Form a powerful coalition
|Create urgency
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org6
Training MethodologiesTheThinkingDesigntrainingisparticipant-centeredlearningwithhands-onapplicationusingcontentthatisrelevanttotheparticipants.Onemodelofthetrainingisvisualtools:Thinking Maps®whichisacognitivevisualmappinglanguageprovidingaconcretefoundationtoorganizeone’sthinking,understandeachother’sthinkingandeachother’sperspectives(frameofreference).Thismaximizesanorganization’scapacitytothink,understand,andperformeffectivelytosucceedindividuallyaswellascollaboratively.
Thinking DesignsModels and Methods
Visual Tools Thinking Maps®
DispositionsOpen Minds
Collaborating Communities
collaborative learning
collegial coaching
community building
Questioning for
Inquiryguiding questions
guiding thinking
Thinking Environments
interacting withintentionality
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 7
TrainingMethodology:VisualTools•ThinkingMaps®
ThinkingMaps®areconsistentvisualpatternslinkeddirectlytoeightspecificthoughtprocesses.Byvisualizingourthinking,wecreateconcreteimagesofabstractthoughts.Thesepatternshelpthewholeorganizationreachhigherlevelsofcriticalandcreativethinkingindividuallyandcollaboratively.ThinkingMaps®establishaconsistentlanguageforcriticalthinkingindividuallyandcollaboratively..
CircleMap
COMPARING and CONTRASTING
DESCRIBING QUALITIES
DEFINING IN CONTEXT
CLASSIFYING
SEQUENCING
CAUSE AND EFFECT
SEEING ANALOGIES
PART TO WHOLE
BubbleMap
BraceMap
FlowMap
Multi-Flow Map
Bridge Map
TreeMap
Double BubbleMap
Guiding Questions Thinking ProcessesThinking Maps as
Visual Patterns
How are we defining this topic? What is the context? What are our frames of reference which influence our points of view?
Let’s describe the topic. Usingadjectives and adjective phrases, what are the sensory, logical and emotional attributes present?
Let’s compare our ideas. Where are the similarities? and differences? How does the present situation compare to our identified goal?
How could we classify theseideas into groups or categories? What are the main ideas, supporting ideas and details this information?
Are there any physical, component parts and subparts that we need to analyze?
What do we think happened?What is the sequence of events? Let’s prioritize our solutions and then create a sequential plan of action.
What are the short and longtermcauses and effects of this event?What are the feedbacks in the system? Given our solution, let’s predict what will happen over time.
How is this situation related to other experiences we know? What analogy is guiding our thinking?
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org8
Training Methodology: Thinking Maps® and Frame of Reference
Aframeofreferencecanbeusedwithanymap.Itisameta-cognitiveframeaskingparticipantstothinkabouttheirthinking.Theywillbeaskedtostepbackfromthemaptheycreatedtothinkaboutwhatinfluencedtheirthinking.
Thefollowingquestionscouldbeaskedtoknowtheframe.•Howdoyouknowwhatyouknowaboutthetopic?•Didyourinformationcomefromaspecificsource?•Isthisinformationbeinginfluencedbyaspecificpointofview?•Whocouldusethisinformation?•Whyisthisinformationimportant?
defining in context
classification
describing
analogiessequence
whole / part
compare & contrast
cause & effect
1. What is needed to build a plan?
2. What are desired outcomes?
Reflective Frame of Reference:What are sources of information you can access to assist you?What is each person’s role in the organization?
Building Your Organizations
Plan
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 9
Note Detailselaborate;identifyattributes;notetheparts;importantfactors
Identify The Rulesstatetheexplicitorimplicitfactorsthataffectanareaofstudy;thestructure;theorder;thehierarchy;theelementsthatsetthestandards
Observing Patternsidentifyreoccurringelementsandevents;determinetheorderofevents;predictwhatcomesnext
Recognizing Trendsnotefactorsthatcauseeventstooccur(social,political,economic,geographic);identifypatternsofchangeovertime
Identify Ethical Considerationsdetermineelementsthatreflectbias,prejudice,discrimination;stateobservationsandargumentsintermsofethics
ReflectiveQuestionsusequestionsto:identifyunclearideasormissinginformation;discussareasyettobeexploredorproven;noteconclusionsthatneedfurtherevidenceorsupport
What is the Generalization, Principle, Theory or Big Ideaidentifyaruleorgeneralstatementthatsummarizesinformationordrawsconclusionbasedonevidencedrawnfromacollectionoffactsorideas
Relationships Over Timedescriberelationshipsbetweenpast,presentandfuture;relationshipswithinatimeperiod;howorwhythingschangedorremainedthesame
Multiple Frames of Reference (Perspectives)discussmultipleperspectivesrelatedtoareaofstudy;exploredifferentviewpoints;reflectondiversitywithinasociety
Interdisciplinary Connectionsrelateandintegratetheareaofstudytoincludethemethodologyofotherdisciplines
Training Methodology: Depth and Complexity with Frame of ReferenceTheDepthandComplexitymodelprovidesdepthofthinkingasathinker,asaproblemsolverandwithcollaborations.Thefollowingprocessiseffectivelyusedaspartofourthinkingwithreflectivequestioning,visualmapping,collaborativenetworking,dispositionsandstructuringathinkingenvironment.DepthandComplexityisveryeffectivelyusedwiththeFrameofReference.
ethical considerationsidentify the rules
recognizing trendsmultiple framesreflective questions
recognizing patterns
an event
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org10
Training Methodology: Questioning for InquiryPowerful Questions ThePowerfulQuestionstechniqueisusedtobuildunderstanding,inferentialthinking,listeningskills,understanding,andinterest.Eitheranobjectorimageareusedasthefocalpointforquestions.Aftertheobjectorimagehavebeenrevealed,theparticipantsinitiallyobservetheobjectorimage,thensharequestionsfromtheirobservations.Thistechniquedevelopsinquiryskillswhileenhancingobservationabilities.Itisimportantthatnoquestionsareansweredduringtheexercise.Ultimatelyqualityquestionsframedeeperanswersandunderstanding.AnextensionisQuestions in Depthasusedbyjournalists.
Object or ImageEitheranobjectoranimageworkwellforthisexercise.Thisstimulatesenhancedobservationskills,especiallywhenanobjectmightbeseveraldifferentthings.Withanimageorphotograph,itisbesttochooseonethatstimulatediscussionanddialogue.
Order of Technique1—Stateyou will be shown an object (or image) which we’ll ask questions about.Initiallytheywillbeshowntheobject(orimage)andquietlyobserveit.Theparticipantscouldcloselygatheredaroundtheobject,thefacilitatorcouldbewalkingaroundtheroom,oreachsmallgroupcouldhaveoneoftheobjectsorimage.
2—Iftheobjectorimageissomethingtheyaredoingfurtherresearchon,thequestionsmightberecordedonposterpaper.Theperson(s)whoaskedeachquestionmightalsobenotednexttotheirquestiontohonorthemwhenusingthequestionsduringalaterstudy.
3—Thefacilitatorneverprovidesanswersanddoesnotaskquestionsthemselves.Theymightreferenceaquestiontoofferanewdirection,differentframeofreferenceoradeeperextension.e.g.the perspective of who took the photographorhow an object was designed.
4—RereadallthepresentedquestionstothatpointseveraltimesduringPowerfulQuestions.Thisrecaphonorsthepresentedquestionswhilestimulatingideasfordeeperinquiry.
5—PowerfulQuestionsarealsoexcellentusedwithvisualmappingtosee,reflect,andassessthethinkingofthegroupandparticipants.
Questions in DepthTostartQuestions in Depththetwoparticipantsmustinitiallydecideonatopictoquestion.Onepersonstartswithanopenendedquestion,thentheotherpersonrespondswitharelatedopenendedquestion.Thiscontinuesbackandforthwiththetwoparticipants.Theprocesscanstartfromanobject,atopic,oraphotograph.Anexampleisanobjectintheroomsuchasalightbulb:
•Questioner A: How does a light bulb work?•Questioner B: Who designed the current light bulb?•Questioner A: Who invented the light bulb?•Questioner B: Why would someone invent the light bulb?•Questioner A: How can we improve the light bulb?
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 11
Training Methodology: Questioning for Inquiry
Questioning for Collaborative Questioning for Inquiry
•brainstormingquestions
•organizingquestions
•refiningquestions
•decidingquestions
•collaboratingwithdiscussions
Shared InquiryWhenproblemsolvingand/orvisioning,itisimportanttoaskinterpretivequestionsthatbuildupononeanother.Interpretivequestionsareeffectivebothwithwellplanneddiscussionsandinspontaneoussituations.Interpretivequestionsstimulateideas,communication,understandingandproblemsolving.
Types of Questions•Factual-Afactualquestionhasonlyonecorrectanswer.•Evaluative-Anevaluativequestionaskstheparticipantstodecideifs/heagreewiththeideasorpointofview(frameofreference).Theanswertoanevaluativequestiondependsontheperson’spriorknowledge,experience,andopinions.
•Interpretive-Aninterpretivequestionhasmorethanoneanswerthatcanbesupportedwithevidencefrombackgroundknowledgeandresearch.Interpretivequestionskeepdiscussionsgoingandrequiretheparticipantstorefertoexperiences,knowledgeandresearch.
Writing Interpretive QuestionsDevelopingqualityinterpretivequestionstoguidevisioningandproblemsolvingbeginswithunderstandingthethinkingprocess.Thisguidespracticeandmasteryofinquirytocreateinterpretivequestionsthatguideeffectiveandproductivediscussionsforproblemsolving.
Testing the QuestionsIfaquestionisopentodifferentpossibleanswerscollaboratorswillbewillingtosharetheirinput:
•You should have genuine interest in the question.Collaboratorswill‘read’yourinterest(orlackof)inthequestion.
•The question should stimulate discussion.Thequestionshouldcreateaninterestinrevisitingthevisionand/orproblemsolvingforfurtherunderstanding.
•The question should be clear.Thecollaborators(orpatients)shouldeasilyunderstandthequestion.
•Thequestionshouldbespecific.Thequestionshouldfitthetopicandnotgenerictoanyidea.
Q u e s t i o n i n g fo r I n q u i r y
brainstorming
organizing
refiningdeciding
collaborating
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org12
Training Methodology: Collaborative Community Collaborative Learning, Collegial Coaching, Building Community
Collaborative Thinking Learning MethodsCollaborativeThinkingLearningMethodsisarelationshipamongco-workersthatrequirespositiveinter-dependence(asenseofsinkorswimtogether),individualaccountability(eachofushastocontributeandlearn),interpersonalskills(communication,trust,leadership,decisionmaking,andconflictresolution),face-to-facepromotiveinteraction,andprocessing(reflectingonhowwelltheteamisfunctioningandhowtofunctionevenbetter).
Collegial CoachingCollegialCoachingisa model that focuses on healthcare professionals and health sciences educators regularly observing each other to learn, understand, and improve their patient centered methods and pedagogy (the art of teaching). This model works best in groups of three or more - one professional demonstrating while two or more professionals observe. The observed demonstrations are generally in the 15-30 minute range to provide a focus on a particular method(s). The model includes a briefing, demonstration and debriefing.
This model is a multi-directional process: everyone has gifts and skills to share and learn from one another. This differentiated process allows everyone to progress at a rate consistent with their skills. The model is an ongoing process for both new and experienced professionals, staff and health sciences educators.
Systems Model: This model is equally effective with administrators coaching administrators; facilitators coaching facilitators, support staff coaching support staff.
Ongoing Development: Professionals regularly participant with the Collegial Coaching model throughout the year.
Building CommunityBuildingCommunityisdevelopingauthenticrelationshipsbetweenpeopletobetterunderstandeachother’sgifts,respectcollaborationsaspartofthegreatercommunity,andlearnfromoneanothertodevelopagreaterwhole.Buildingcommunitybeginswithspecificmethodsandexercisesthatthewholegroup(andsub-groups)regularlyparticipatestogether.
TheabovethreemodelsofCollaborative Learning, Collegial Coaching, Building Communityarefocusedon:
•personalmastery•buildingasharedvision•teamlearning•developingmentalmodels•creatingasystemsthinkingorganization
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 13
Collaborative Thinking MethodsCollaborativeThinkingisarelationshipamongco-workersthatrequirespositiveinter-dependence(asenseofsinkorswimtogether),individualaccountability(eachofushastocontributeandlearn),interpersonalskills(communication,trust,leadership,decisionmaking,andconflictresolution),face-to-facepromotiveinteraction,andprocessing(reflectingonhowwelltheteamisfunctioningandhowtofunctionevenbetter).
Think-Pair-Share•Theinstructorposesaquestionortopic,preferableonedemandinganalysis,evaluation,orsynthesis,andgivesapersonaboutaminutetothinkthroughanappropriateresponse.This“think-time”canalsobespentwriting.
•Onepersonthenturnstoapartnerandsharetheirresponses.•Duringthethirdstep,aperson’sresponsescanbesharedwithinafour-personlearningteam,withinalargergroup,orwithanentirehealthteamormedicalclassduringafollow-updiscussion.Thecaliberofdiscussionisenhancedbythistechnique,andallparticipantshaveanopportunitytolearnbyreflectionandbyverbalization.
Three-Step InterviewCommonasateam-buildingexercise,thisstructurecanalsobeusedalsotoshareinformationsuchashypothesesorreactionstoafilmorarticle.
•Peopleformpairs;onepersoninterviewstheother.•Peopleswitchroles.•Thepairlinkswithasecondpair.Thisfour-memberlearningteamthendiscussestheinformationorinsightsgleanedfromtheinitialpairedinterviews.
Learning TeamsMembersoflearningteams,usuallycomposedoffourindividuals,countoff:1,2,3,or4.Theinstructorposesaquestion,usuallyfactualinnature,butrequiringsomehigherorderthinkingskills.Peoplediscussthequestion,makingcertainthateverygroupmemberknowstheagreeduponanswer.Theinstructorcallsaspecificnumberandtheteammembersoriginallydesignatedthatnumberduringthecountoffrespondasgroupspokespersons.Becausenooneknowswhichnumbertheleaderwillcall,allteammembershaveavestedinterestinunderstandingtheappropriateresponse.Theverbalizationandthepeercoachinghelpsalllearnersbecomeactivelyinvolvedwiththematerial.
Simple JigsawThefacilitatordividesanassignmentortopicintofourpartswithallpeoplefromeachLearningTeamvolunteeringtobecome“experts”ononeoftheparts.ExpertTeamsthenworktogethertomastertheirfourthofthematerialandalsotodiscoverthebestwaytohelpotherslearnit.AllexpertsthenreassembleintheirhomeLearningTeamswheretheyteachtheothergroupmembers.
Collaborative Visual MappingUsingvisualcognitivemapsasacollaborativetoolforthinkingandunderstandingconcepts,ideasandframesofreference.
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org14
BuildingCommunity•TeamBuilders•GettingToKnowYouMingleThegroupminglesaround,casuallytalkingtoeachother.Astheycontinuemingling,youcalloutanameofacategory,likepets.Theplayersthenhavetofindotherpeoplewhohavethatincommonwiththem.Othercategoriesyoucantryare:someonewiththesamenumberofbrothersandsistersasyou,someonewiththesamecoloreyesasyou,someonewithoneofyourhobbies.Letoneoftheplayerstakeyourplaceandbetheleaderwhocancalloutthecategories.
People to PeopleEverybodyminglesaround,greetingoneanothernormally(thusthetitle“PeopletoPeople”).You,astheleader,stopmovementbyproclaiming“elbowtoelbow!”or“kneetoear!”Thegroupmustformwhateverconfigurationyousaybyfindingsomeonetotouchelbowswithorakneetoputanearon.Whenyousay“peopletopeople,”theminglingandgreetingbeginsagain.Thegamebecomesmorecreativewhenyouannounceanimalconfigurations,like“Elephanttoelephant!”or“Snaketosnake!”or“Alientoalien!”Thesecanleadto“Trunktotrunk!”and“Tailtotail!”
InCommon•CommonalitiesParticipantsfacetheinsideofthecircleontheirindividualspots.Oneperson(startwiththeleadfacilitatormodelingseveraltimes,theneachpersonwilldoitonce)willstatesomethingtrueaboutthemselves.Anexamplemightbe“Ihavetakenballetlessons.”Theneveryonewhohasthis“InCommon”withthepersonwhostated“Ihave...”willleavetheirspotsandtradewithsomeoneelse.Thisisfollowedbyanotherpersonsharingsomethingtrueaboutthemselves.Theneveryonewhohasthis“InCommon”withthepersonwhostated“Ihave...”willleavetheirspotsandtradewithsomeoneelse.
I Love My NeighborParticipantsfacetheinsideofthecircleontheirindividualspots,exceptforoneperson,forexampleAshenafi,whois“It”andstandsinthemiddle.Ashenafistartsbysaying“Ilovemyneighborwho...,”finishingwithacharacteristicordescription,suchas,“Ilovemyneighborwhohasanolderbrother.”Thenalltheparticipantstowhomthisistrueleavetheirspotsandtradewithsomeoneelse.Ashenafithenscramblesfortheopenspaces,andwhoeverisleftwithoutaseatisthenew“It”andmustbeginagainsaying“Ilovemyneighborwho...”Eachpersonwhois“It”isnotallowedtorepeatanyoftheotherthingsprevious“Its”havesaid.
TrustParticipantsareinpairs.Theywillconnectwithhands(youcouldalsodoitwithelbows,fingers,etc.).Onepersonwillclosetheireyesandtheleaderwillkeeptheireyesopen.Theywillthenstartwalkingtogether.Itistheresponsibilityoftheleaderwiththeeyesopentoleadtheotherpersonwhoistrustingthemonasafepathwhiletheyarewalkingaround.Initiallydoforshortsegments(e.g.30seconds),thenhavethepairsswitchwhoistheleader.
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Briefing(deciding)The colleagues are led through a storyboard (flow map) of the demonstration to be observed. The person doing the demonstration might have requests for the observation, and the observers should have a focus to observe.
Collegial Coaching: Medical Professionals Coaching Medical ProfessionalsTheCollegialCoachingHealthcareProfessionalsmodelfocusesonprofessionalcolleaguesregularlyobservingeachothertolearn,understand,andimprovetheirmethodology(demonstrations,proceduresandpracticewithpatients)and/orpedagogy(teachingmethodswiththeCollegeofHealthSciencesfaculty).Thismodelworksbestingroupsofthreeormoreprofessionalcolleagueswithonecolleaguedemonstratingamethodwhiletwoormoreothercolleaguesobserve.Theobservedmethodsaregenerallyinthe15-30minuterangetoprovideafocusonparticularmethods.Themodelincludesabriefing,demonstration,anddebriefing.
Thismodelisamulti-directionalprocess:everyonehasgiftsandskillstoshareandlearnfromoneanother.Thisdifferentiatedprocessallowseveryonetoprogressatarateconsistentwiththeirskills.Themodelisanongoingprocessforbothnewandexperiencedhealthcareprofessionals.
SystemsModel:Thismodelisequallyeffectivewithadministratorscoachingadministrators;facilitatorscoachingfacilitators,healthsciencesfacultycoachinghealthsciencesfaculty,supportstaffcoachingsupportstaff.Thisisalsoeffectivewithamultidisciplinaryapproach.
OngoingDevelopment:HealthcareProfessionalsregularlyparticipantwiththeCollegialCoachingmodelthroughouttheschoolyear.
Process
Demonstration(doing + observing)The observing colleagues take notes, make sketches, and/or video tape the lesson.
Debriefing(reflecting)The participating colleagues including the person doing the demonstration and all observers meet to discuss the demonstration. The protocol is:1. something positive observed2. questions3. learning take away from the observation
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Open MindDispositions Model
ConnectingEmpathy
Interdependence
PersistingPatient
Continuous
FlexibleCreativeWonder
ReflectingQuestioning
Metacognitive
FocusingClarity
Accurate
Dispositions for Developing an Open Mind of Mindful Habits The Open Mind Dispositions ModelTheOpenMindmodelistheviewofofferingaparticipantcenteredmodelfordispositionslearningandunderstanding.Thedispositionsarecategorizedinto5keywaysofdevelopingandsustainingalisteningandcollaboratingmind.Hereisasummary:
Connectingiskeepinganopenmindtohowwe“connect”withotherpeopleaswellaswithideas.Connectingincludeslookingforinterdependenciesbetweenpeople,includingthedevelopmentofempathy.Italsomeansremainingopenmindedwhileconnectingpriorknowledgetonewinformation.
Persistingiskeepinganopenmindbynotgivingupwhenfacedwithadifficultorlongtermproblemorproject.Topersististoengagepatientlyintasksaswellasstayingopentonewlearning,ratherthanremainingstuckonyourideas.
Flexibilityiskeepinganopenmindtodifferentwaysofseeingaproblemandhavingaunderstandingofthegenerative,creativedimensionofthinking,problemsolving,anddecisionswithfutureeffects.Itisalsomeaningbeingopenmindedtoaworldthatisambiguousandfullofunexpectedevents.
Reflectingiskeepinganopenmindtoquestioningandinvestigatingyourthinking.Metacognitioninvolveslookingatwhatyouarethinkingaswellashowyouarethinking.Forexample,apersonmayrecognizethatheorsheisthinkingabouteatinganapple(what)andalsoseethatheorsheisthinkingusingcausesandeffectsreasonabouteatinganapple(how)!
Focusingiskeepinganopenmindaboutfocusingwhilealsobeingasaccurateaspossiblewhensolvingproblemsorcompletingwork.Thisdispositionisalsoaboutpeoplebeingabletodosystematicsearcheswhiledrawingupontheenvironmentaroundthem.
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Training Methodology: Developing a Thinking EnvironmentThinking Environments is an awareness, understanding and a process focused upon the design, interface and impact with the environment of the physical work and learning space. The healthcare professional and health sciences educator’s decisions — with intentionality — impact the organization’s and learning environments. The decisions are crucial to the quality outcomes of the whole organization. In the research about learning and the physical environment, three points stand out:
•Physical environments influence how we feel, hear and see. Those factors, in turn, influence cognitive and affective performance.
•Some variables exert a much greater influence on the professional’s achievement than others.
•Better awareness, smarter planning and simple changes can be made in every environment to improve communicating and learning.
The purpose of Thinking Environments professional development is for developing an appreciation and understanding of the physical environment’s impact while having practical interventions that can elevate the learning potential of the whole organization and learning community. Thinking Environments is a process of thinking through the development of specific elements that impact the learning environment. The goal is to understand the approach, outcomes and reflectively develop pathways of action that focus on mastery with environment impact.
Our ProcessThe approach and process recognize three key elements in regards to what, where, how and when they are used:
•Materials: the use and choice of natural and recycled materials•Objects: the design and human interface with furniture, lighting and other objects•People: how we as people interface with the environment including space, timing, communication
and collaboration
The above elements recognize the focus of using our ‘place in space’ in regards to local assets and intentionality respectful of local culture.
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org18
Areas for Reflection and Criteria
PatientCentered
Patient Centered Learning
Patient Fluency
Communicating Learning
InteractiveAssessment
Assessmentto Inform
Reflective Thinking
InteractiveAssessment
IntegratedProfessionalDevelopment
ProfessionalDevelopment
Differentiationfor Healthcare
Providers
Collaborative Inquiry
FacilitativeLeadership
Hospital Leadership Team
Implementation Plan
Learning Centered
Leadership
Hospital-WIdeEthos
Whole Hospital Culture
CollaborativeCommunity
Global Networking
CertificationandAccreditationAllparticipantswillreceivecertificationthroughparticipationofthevarioustrainingsasrecognizedbytheuniversity.Thiswillacknowledgetheirinvolvementwithprofessionaldevelopmentof,forandaboutthehospitallearningthemethods,skillsandapproachofThinkingDesign.
Thevarioushospitaldivisions(e.g.emergencyroom)andhealthsciencesdepartmentswillbepartoftheAreasforReflectionandCriteriaAccreditation.Thisprocesswillbefacilitatedbytheuniversitytoassurethewholedivision,wholehospitalandcollegeofhealthsciencesaredevelopingintoa‘ThinkingDesign’organizationthatbestprovidesforthepatientsandgreatercommunity.MekelleCollegeofHealthScienceswillbeamodelofthisprocesswithagoalofbecomingtheaccreditinginstitutioninEthiopiabothregionally and country-wide.
The Five Areas for ReflectionandFifteenCriteriaTheMekellehealthcarecommunitywillfocusonfiveareasforreflectionastheydevelopandthinkabouttheirowntransformativedesignforthejourneytowardsbecomingaThinkingDesignorganizationthatisPatientCenteredThinking(andstudentcenteredwiththemedicalcollege),FacilitativeLeadership,IntegratedProfessionalLearning,InteractiveAssessment,andHospital-WideEthos.Thereare15basiccriteriaandrelatedreflectivequestionsassociatedwiththesefiveareasthatareusedbyhospitalsand/orhealthsciencesdepartmentoftheuniversitytoengageinaprocessofself-studytoassesstheirprogresstowardbecomingathinkingdesignhospitalandCollegeofHealthSciences.Thesame15criteriaandreflectivequestionsareusedbyanaccreditingpartnertograntaccreditationtodivisionsinthehospital,thewholehospital,andthehealthsciencesthathavemettheirownvisionandobjectivesassetforthintheirtransformativedesign.
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 19
Guiding Questions for ImplementationWhoshouldparticipate?•faculty?professionalstaff?supportstaff?students?hospitalstaff?
Howdowebuild,growandsustaintheThinkingDesignmodel?
HowdoweassessoutcomesoftheThinkingDesignmodel?•successes?•needs?•asareflectiveprocess?
Wewilldevelopasetofquestionsthatareaskedpriortotraining,aftertraining,duringtheemerginguseofthetools,duringtheprocess,andsoforth---actionresearchWewilluseofvideointerviewstocapturethethinkingwhichcouldbedoneinsmallgroups.
Whatisapatient-centered(studentcenteredinthemedicalcollege)model?•looklike?•attributesofithappening?
Howdowesupporthealthcareprofessionalsandhealthcarefacultyeffectivelychangingfromamedical-centeredmodeltoapatientcenteredapproach?
Howwillthehealthcareleadership,faculty,supportstaffandmedicalstudentsbenefitfromtheuseof:•VisualTools(ThinkingMaps)?•QuestioningforInquiry(effectivelyandexpertly)?•understandingdispositions?•andknowingmethodsforcollaborativelearning?•thinkingenvironments?
Theframeofreferenceisimportantwithvisualmapping.Itisimportanttounderstandweallhaveaframeofreference.
•Whyisitimportanttounderstandeachother’s‘frameofreference’(perspective)?•Whattoolsdoweusetounderstandourindividualandcollective‘framesofreference’?
Theuseofvisualtoolsandinquirycanbeusedasameansofassessmentofourpractices.
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org20
Visual Mapping • Frame of ReferencePerspective, Point of ViewTheFrameofReferenceisthelensthroughwhichweviewthingsincluding:
•Howdoyouknowwhatyouknow?•Wheredidyougetyourinformation?•Whoareyourinfluences?•Whatareyourexperiences
Use the space above and draw a circle and frame. This process can also be done in sand with a stick.
Write and/or draw things that describe things about your life. Your frame of reference including important people, events, places, attributes and things about you.
Pair with another person to share your personal frames.
in pairswholegroup
1 2 3My Frame: Frame of Reference
personalattributes
importantevents
importantplaces
thingsyoudo
foodyoulike
importantpeople(family,friends)
influentialpeople(famous)
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 21
Visual Mapping - Connecting and Learning Of, For and About Each Other WewillcontinuewithavisualmappingprocesscalledaBridgeMap(ThinkingMaps®)withaFrameofReference.Thisprocesswillsupportusinbeingreflectiveofourpersonalexperiencesalongwithothersinoursmallgroup.
AfteryouandsmallgrouphavecompletedyourBridgeMapwiththeframeofreferences,gatherwithanothersmallgroupandshareyourideasbyasking:
Whataresomeofthesimilaranddifferentbitsofinformationinthemaps?
Wewillthensharethemostimportantinformationtothecollaboratingsmallgroups.
1.
2.
3.
•useaA4,orsimilarblankpaper,ornaturallyonthegroundinsoil
•constructaBridgeMapasmodeled•useapen,markingpenorstick•usewords(anylanguage),drawingsand/orphotos
•writeeachperson’sname(bottom)•writeacorrespondingfactorforeachpersonthat‘relatestooneanother1.eachperson’sname
relatingfactor:___________________________
2.relatingfactorforeachperson
traitname name name
traitname name name
ReflectiveFrameofReference:Howistherelatingfactorsupportandcontributetowhoyouare?
writewhattherelatingfactorforthe‘traits’is
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org22
For, Of and About Thinking Athinkinghealthcareorganizationisoneofamedicalcommunityinwhichallmembersshareacommoncommitmenttogivingregular,carefulthoughttoeverythingthattakesplace.Thiswillinvolvelearninghowtothinkreflectively,criticallyandcreatively,andtoemploytheseskillsandtechniquesintheco-constructionofmeaningfulimplementationandpractices.Benefitswillalsobeshownbythewaysinwhichallmembersofthecommunityinteractandshowconsiderationforeachother,andinthepositivepsychologicalwell-beingofbothpatientsandhospitalstaff,themedicalcollegestudents,themedicalcollegefacultyandthemedicalcollegesupportstaff.
Learning FOR ThinkingCreatingorganization-wideanddepartmentconditionsthatsupportthinkingdevelopment.
Learning OF ThinkingProvidingallleadership,professionalandsupportstaffintheskillsandstrategiesofthinkingdirectlyand/orimplementingthinkingprocesses.
Learning ABOUT ThinkingHelpingthewholestaffbecomeawareoftheirownandothers’thinkingprocessesanduseinreal-lifeproblemsolvingsituations.
Eachofthesebroadareasofdevelopmentcanhappenatthesametimewhileafocusmaybeondevelopingasequentialplan.Ifyouhadtoprioritizeastartingpoint,whichlearningareawouldYOUstartwith:FOR,OForABOUT?Whatwouldcomesecondandthird?
What wouldan effective
‘Thinking Design’ organization
be like?
commonthinkinglanguage
partofalongtermplan
infusedthroughouttheorganizationandthe
ethosoftheorganization
linkedtostaffProfessionalDevelopment
andPerformanceManagement
agreeduponmethodsofmodelsandstrategies
informedbytheoryofthinkingandlearning
rootedinresearch
explicitteachingofthinking
consistentwholeorganizationapproaches
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 23
our community
Write your name and draw a circle around your community name.
our community
facts
about
events
people
places
Write and/or draw things about your community around the circle with your community name.
Draw a circle around your information.
Draw a frame of reference around your community map. Writeinfluentialpeople,placesand events of your organization in the frame.
facts
about
events
peopleplaces
facts
about
events
peopleplaces
1 2 3 4
influences
influences influences
influences
Circle MapDefininginContext•BrainstormingTheCIrcleMapisusedforbrainstormingideasandthoughtsaboutatopicoraconcept.
Our Community: Circle Map
our community
our community
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org24
name
Write your community name and draw a circle around our community name.
Write and/or draw things that are descriptive words about your community in the bubbles around our community name.
Add a frame of reference around your map.Writeand/ordrawinfluentialpeople, places and events of our community in the frame.
1 2 3
Bubble MapDescribing TheBubbleMapisfordescribingusingadjectives;Identifyingthesensory,logicalandemotionalqualitiesofanytopicorconcept.
Our Community: Bubble Map
name
describe
describe
describe
describedescribe
influences
places people
influences
name
describe
describe
describe
describedescribe
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 25
community1
community2
Pair with another colleague, then write our community and another community with a circle around each of your names (or draw your faces with a circle around them).
Write and/or draw similarities in the middle, and identify how you differ with one another on the outside bubbles.
Draw a frame of reference around your community map. Write influentialpeople,placesandeventsfor each community in the frame.
1 2 3
Double Bubble MapCompare and ContrastTheDoubleBubbleMapisusedforcomparingandcontrastinganytwothings.
Our Community: Double Bubble Map
community
1community
2
differ
differ
differ
differ
differ
differ
similar
similar
similar
similar
community
1community
2
differ
differ
differ
differ
differ
differ
similar
similar
similar
similar
influences
influences influences
influences
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org26
Write our community’s Important Things on the top line.
Think of 2, 3 or 4 categories to classify important things about your community. Write the name of these categories on the next lines. Under each category, list examples of each favorite thing within that group.
Draw a frame of reference around your map.Writeinfluentialpeople,placesandevents for your community in the frame.
1 2 3
influences
influences influences
influences
Tree MapClassificationTheTreeMapisforclassifyingorsortingthingsandideasintocategoriesorgroups.Undereachcategory(group)thereisalistofdetails.
Our Community: Tree Map
community important things
detaildetaildetail
detaildetaildetail
detaildetail
detaildetail
community important things
1 2 3 detaildetaildetail
detaildetaildetail
detaildetail
detaildetail
community important things
1 2 3
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 27
Write ‘our community name’ on the line.
Write or draw pictures of the three physical parts of ‘our community’. Then write minor parts for each major part.
Draw a frame of reference around your map.Writeordrawwhatisinfluencingyour community and/or other peoples’s views in the frame.
1 2 3
Brace MapWhole Part RelationshipTheBraceMapisforanalyzingthecomponentpartsofphysicalobjects;identifyingthespatialrelationshipofpartstothewholeor“structuralanalysis.”
Our Community: Brace Map
community name
community name
hospital
minor
minor
minor
minor
minor
minor
college
?
community name
hospital
minor
minor
minor
minor
minor
minor
college
?
influences
influences other views
influences
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org28
Write and/or draw the history of your comunity. Write 3-6 historical events and sequence them in order.
For each step write any of the substages (s-s) for each of the historical events.
Draw a frame of reference around your Flow Map. In the frame write or draw who and/orwhatinfluencesyourcommunity.
1 2 3
Flow MapSequence TheFlowMapisforsequencingthestagesandsub-stagesofaneventincludingidentifyingthestepsinaprocessandorderinginformation.
Our Community: Flow Map
history 1
history 2
history 3
history 1
s-s s-s s-s s-s s-ss-s s-s
history 2
history 3 history
1
s-s s-s s-s s-s s-ss-s s-s
history 2
history 3
influences influences
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 29
Write and/or draw a community event or procedure that happened or will happen. Draw a rectangle around it.
In the left boxes write or draw ‘causes’ of the event. On the right boxes write the ‘effects’ of the event.
Draw a frame of reference around the map and write or draw the experiences of different people involved with the event.
1 2 3
Multi-Flow MapCause and EffectTheMulti-FlowMapisusedforidentifyingthecausesandeffectsofanevent.
Our Community: Multi-Flow Map
anevent
anevent
causeeffect
effect
effect
cause
cause
cause
influences
influences influences
influences
anevent
causeeffect
effect
effect
cause
cause
cause
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org30
Write or draw names of key people in the community on the bottom. Add a key attribute or descriptive for each person.
Write what the ‘relating factor’ (r-f) is for all the key people in regards to their common attributes.
relating factor ____________ relating factor ______________
Draw a frame of reference around your map. Write or draw examples for each person’s relating factor attributes.
1 2 3
Bridge MapClassificationTheBridgeMapisusedforidentifyingsimilaritiesbetweenrelationshipsandcreatinganalogies.
Our Community: Bridge Map
example
example
examplename name namer-f r-f r-f name name name
r-f r-f r-fname name namer-f r-f r-f
Thinking Design: Tools for Healthcare Professionals • www.eggplant.org 31
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