Avoiding “Eduspeak”: How to Build Effective Interprofessional Communication in CME Planning
Jack Dolcourt, MD, MEd, Professor of Pediatrics; Associate Dean for CME, Medical Graphics, and Photography, University of Utah School of Medicine, shares the lessons he’s learned about how to build effective communication with physicians and teams to facilitate CME planning, in a conversation with Steve Singer, PhD, Vice President for Education and Outreach, ACCME. (13 minutes)
>>SINGER: Hi, my name is Steve Singer. I'm the Vice President for Education and Outreach of the Accreditation Council for Continuing Medical Education.
>>DOLCOURT: Hi, I'm Dr. Jack Dolcourt. I'm Professor of Pediatrics at the University of Utah School of Medicine and Associate Dean for Continuing Medical Education, Medical Graphics, and Photography.
>>SINGER: Welcome, Jack. Thanks for joining me.
>>DOLCOURT: Good morning, Steve.
>>SINGER: Tell me a little bit about what your role is at the University of Utah School of Medicine.
>>DOLCOURT: Well, I do two things. I'm a neonatologist in the Department of Pediatrics and I spent my entire career in continuing medical education and now I'm Dean, Associate Dean for CME at the University of Utah School of Medicine.
>>SINGER: And you've been there in this role for how long?
>>DOLCOURT: I've been Associate Dean since 2008, so that's about seven years, and I've been in Utah since 1980, so that's a lot of years.
>>SINGER: That's a lot of years. Okay, what we're going to talk about today is the opportunity for Accredited Education to bring value to change and improvement in an institution and you have a story to share about sort of how your approach to doing that sort of changed over time?
>>DOLCOURT: That's right.
>>SINGER: And why don't we start with sort of, start with the beginning. Let's introduce the characters and we'll talk about sort of what happened, what you learned, and hopefully what others who are watching can take away from the strategies that you've come to.
>>DOLCOURT: Well, the story for me that was so enlightening was when the Chief of Surgery came to me and said, "I don't understand. You gave me the form to fill out, I couldn't do it. I didn't understand and I went to what I think is the smartest person I know, another surgeon, and went over with him and he didn't understand it either." And I was amazed by that because here is somebody who is really bright, she's an authority in one particular area of surgery and she couldn't get it. That was an "A-ha" moment for me because I realize that I was giving her edu-speak; that I was giving her language in an area that she didn't know anything about. It had nothing to do with her needing the smartest person, we were just in two different cultures. I was in the education culture.
>>SINGER: Yeah, so to just sort of back up a step. So you were in pursuit of planning educational activities. You had provided her with some sort of a tool, a form to get information from her about planning the activity. Was that what she was reacting to?
>>DOLCOURT: Right. She had this form that we had given her and she was cooperative. She wanted to do it, but she just couldn't do it. So that was when she came back to me really asking for help.
>>SINGER: Okay, so we're – what happened next?
>>DOLCOURT: So that was when I realized that I was speaking edu-speak. I said, "Okay, tell me what's going on? So what's your diagnosis of the problem?" And because she's a clinician, the word diagnosis, she knew what that meant and she immediately started laying things out and then said, "Okay, so what's root cause?" And this is another one of those "A-ha" moments when there was a difference in the communication because she said, "Well, the problem is that surgeons don't know how to do this procedure." And that struck me as being really odd too because how could a surgeon not know how to do a procedure? So I just dug a little bit more and said, "Does that mean they've never heard of it, that is that they don't have any knowledge of it?" And she said, "No, no. They don't know how to do it right." I said, "Ah, we're on two different levels. You're thinking of performance as being, 'Know how to do things right and get the job done.'" That is where I was at. So here is another one of those moments where I realized that we were talking past each other and simply just discussing things all of a sudden brought out what she was trying to accomplish, what the issues were, and it made the planning just go very smoothly from that point. And in the process, instead of having somebody who I'm arm wrestling with, she became an ally.
>>SINGER: Okay. And how long ago was this interaction, this first interaction?
>>DOLCOURT: This was probably about five years ago or thereabouts.
>>SINGER: So something that's interesting for people watching is that as a CME leader or sort of as the education leader within your institution, you're sort of a service provider, right? Because you're being utilized as a resource to provide methodology and assistance to develop educational interventions of some sort to help people change or get better at – to take a problem like she described about a performance that they're not doing a particular surgery or a particular procedure in the best way or in the right way and to take those educational needs and to help them improve. So with regard to that though, you said you're a neonatologist and you're in pediatrics. So it's interesting to me that you're in that area. And was this a neonatal surgeon, or is this like a totally different domain?
>>DOLCOURT: She was a pediatric surgeon, but certainly, we were not... What she was talking about was not...
>>SINGER: Is not something that you do.
>>DOLCOURT: No, not at all.
>>SINGER: Yeah. So there's an opportunity there, I think that as an educational... It's almost, you said edu-speak and I almost think like a translator, as a way to say to anyone in your institution whether they're from your particular area or an area that's sort of remote in practice from what you do, and say, "I, Jack, don't have to be an expert in your particular discipline," but I could say the educational methodology of well, "What's the problem that you're trying to address, and why is it a problem?" And then going through that sort of learning cycle to help people plan is an opportunity. So you work with other areas of the hospital as well?
>>DOLCOURT: Oh I do
>>SINGER: In the medical school, I'm sorry.
>>DOLCOURT: I do. And it is a medical school and there's hospitals and there is actually very specialty areas, like a cancer center. And adult cancer is not something I know anything about from professional medical side, so I have to be able to deal with those folks, and actually not being an expert in the field's helpful because I can ask naïve questions, and actually it's the naïve questions which oftentimes bring out the, "Here's what I'm really going for," on the part of the planners. The planners are experts and they sometimes assume that everybody else is on the same plane as they are, so my naivety helps because they now have to step back and really dig down and say, "Here's what it really is."
>>SINGER: So I would assume that business is good from the standpoint of, that you're in demand, now that people have gotten wind of the opportunity for you to help them in different ways and with this sort of educational methodology.
>>DOLCOURT: Absolutely. Since 2008, we've basically doubled the number of RSSs and probably a 25% increase in the number of courses. So it has been helpful, prior to the time that we sort of changed our approach, I was hearing things like, "Well, CME is just hoops that I have to jump through." It's no longer that. I think part of it is because the value is being perceived by the folks I'm dealing with. They see this as, I think, they're getting some educational coaching. This is not an area that they necessarily have so much expertise in, and so they appreciate sitting down and discussing things that they can do, and usually they end up changing after a conversation by adding something on. So right now social media is one of the things that we at least hold a conversation about, and this is not something that any of them have thought about, so they actually are getting some value when they walk out of the room that they didn't even expect.
>>SINGER: So it's interesting. Tell me more about one of... You said social media, what... About social media, or what's the focus with regard to that?
>>DOLCOURT: We just bring it up. Is there any opportunity for extending the learning beyond the actual time that the instruction is going on, and so oftentimes there's sort of this blank expression and you say, "Well, have you ever done a Facebook page?" And then you find out, "Oh yeah, we do have a Facebook page." "Well, you're doing it, and is there any way you can use that Facebook page to carry on the conversations afterward?" Or, "Anybody twittering, doing Twitter? Is there any tweeting that goes on at the meeting?" So that reinforces, here's something that somebody said was very valuable to me, maybe somebody else would pay attention to that. So those are things that the planners oftentimes haven't thought about.
>>SINGER: Right. So it's really, there's no magic bullet here, but it's sort of incrementally finding opportunities for you to sort of interview and act as an educational consultant and add value where you can with these folks that you're interacting with. As a physician, you have been involved in education for a long time. Not all physicians are coming from that same background or have that same sort of experience. What would you... If you're talking to the physicians out in the audience or to CME planners out in the audience who would like to engage physicians like you, what advice would you give them?
>>DOLCOURT: I think there has to be some cultural competence, and that is realizing that every specialty has its' own culture, and that education office has its' own culture as well. And so the cultural competence, to me, means being able to walk across that bridge between the education and meet the physician or other members of the team. And it's not just physicians. I mean, there are advanced practice nurses, physician's assistants, there are a lot of people out there that make part of the team. Being able to walk across that bridge and talk to them in a language they can understand, and frankly, the language that all of them are familiar with is diagnosis, underlying path of physiology, treatment, evaluation, and surprisingly enough that lines up very well with good planning of education. So by being able to translate medicine and education, there is now an understanding of what the goal is, and instead of having resentment, have the perception of hoops to jump through, all of the sudden it becomes, "Oh, yeah, I understand," and these folks are now better planners.
>>SINGER: We meet them where they are.
>>SINGER: Thank you very much, Jack.
>>DOLCOURT: Thank you, Steve.
This is a transcript of Avoiding “Eduspeak”: How to Build Effective Interprofessional Communication in CME Planning.
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