thinking design - eggplant.orgthe thinking design approach is recommended for the whole organization...

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: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


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.


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


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


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?


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


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


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?


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


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


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.


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.


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


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.


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.


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.


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.


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)


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


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


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


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


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


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

Tree MapClassificationTheTreeMapisforclassifyingorsortingthingsandideasintocategoriesorgroups.Undereachcategory(group)thereisalistofdetails.

Our Community: Tree Map

community important things

detaildetaildetail

detaildetaildetail

detaildetail

detaildetail


1 2 3 detaildetaildetail

detaildetaildetail

detaildetail

detaildetail


1 2 3


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


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



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

anevent

causeeffect

effect

effect

cause

cause

cause


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

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