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Untangling workplace challengesSayra Cristancho, PhD | Western University, Canada

Untangling workplace challenges:A case for a new way of thinking in

professional complexity

Sayra Cristancho, PhDCentre for Education Research & Innovation (CERI)

Western University, Canada

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Extracted from “Effectiveness in Complex Organizations”

Complex Workplace Situations

Complexity

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Force/TorqueSensor

What does complexity meanin THE WORKPLACE?

Three lessons:

• Complexity emerges when feeling out of control

• Complexity calls for a multidimensional mindset

• Complexity requires awareness that problem solvingis a process, not an event

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Systems Engineering:perspectives & interactions

Drawings

Interviews

Observations

Seeing in different ways: Introducing “Rich Pictures" in the study of expert judgmentCristancho S., Bidinosti S., Lingard L., Novick R., Ott M., Forbes T., (Qual Health Res. 2015)

Rich Pictures

Objects

Ideas

People

Feelings

Prejudices

Conflicts

Armson, 2011; Guillemin, 2004

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• Simplification of descriptions

• Focus on procedural dimension

• Alternative language (visual metaphors)

Crandall, Klein, & Hoffman, 2006; Ericsson, 2006; Klein, 1995; Klein, 1997

Settings

• Surgery• Intensive care

• Neurology

• Neonatology

• Clerkship

• Surgery• Intensive care

• Neurology

• Neonatology

• Clerkship

Participants

• Surgeons

• Intensivists• Neurologists

• Nurse practitioners

• Neonatologyresidents

• Medical students

• Surgeons

• Intensivists• Neurologists

• Nurse practitioners

• Neonatologyresidents

• Medical students

Situations

• ~ 100 situations• High-risk, high-

difficulty asreported byparticipants

• ~ 100 situations• High-risk, high-

difficulty asreported byparticipants

Lesson #1

Complexity emergeswhen feeling “out of control”

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“… but that’s what it feels like!”

Note: Participants have given permission for audio clips to be used

“… but that’s what it feels like!”

When being out of control…

Maintaining control of teamdynamics

Balancing care vs. emotional impact

Ensuring standard of care

Negotiating internal uncertainty

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What’s the price of “not being incontrol” in your workplace?

- What’s the equivalent of “standard ofcare” in you industry?

- What disrupts team dynamics in yourworkplace?

Lesson #2

Complexity calls for amultidimensional mindset

Complex and frustratingComplex and exciting

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“Help, I’m out of control!”: Students’ emotional and behavioral responses to complexityHelmich E., Diachun L., Joseph R., LaDonna K., Poel N., Lingard L., Cristancho S. (MedEd 2017, submitted)

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“We were destroying them but we wouldn’t give up, as if it was soimportant for us to finish the discussion that you keep on going andgoing and going…I know it’s medically important that we tell them allthe facts but I think we lose the distinction of doing what theyneeded and covering the ten points...” Participant 4

Biomedical Social Organizational

What's behind the scenes? Exploring the unspoken dimensions of complex and challenging surgical situationsCristancho S., Bidinosti S., Lingard L., Novick R., Ott M., Forbes T. (AcadMed 2015)

What are the “complexitydimensions” of your workplace?

- What’s the trade-off between thosedimensions and team dynamics?

- What’s the role of “empathy” in yourworkplace?

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Lesson #3

Complexity requires awarenessthat problem solving is a process,

not an event

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Problem definition

Problem solving

From problem solving to problem definition: scrutinizing the complex nature of clinical practice.Cristancho S, Lingard L., Regehr G. (PerspMedEd 2017)

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Putting the puzzle together: the role of ‘problem definition’ in complex clinical judgement.Cristancho S., Lingard L., Novick R., Ott M., Forbes T. (MedEd 2017)

Why do competent individuals notalways make a competent team?

Beyond technicalities of work

Prepare people for‘Being out of control’ ‘Being on the same page‘,

not always the goal

Summary

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Homework:

• How would YOU define the problem?

• How would THEY define the problem?

• What would be points of contention you wouldhave to deal with if you hadn’t consider THEIRversions of the problem?

Thank youSayra.Cristancho@schulich.uwo.ca

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