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The Paradox of Experience: How It Can Both Help and Hinder Us

Summary

  • Experience can be helpful. But experience can also fool the best of us into thinking we do not have much more to learn. As seasoned professionals, we may not realize we are closing our minds to important new ways of looking at our work.

Juli Maxworthy, DNP, PhD(c), has sometimes seen this among the adult learners — often high-level professionals — in her classes over the years. “They’ve been there and done that,” she explained in a recent interview with the Institute for Healthcare Improvement (IHI). “They have a lot of experience, so they don’t always realize they have anything else to learn.” Maxworthy is an Associate Professor at the University of California, San Francisco, teaching in the Doctor of Nursing Practice (DNP) program.

Maxworthy recalled that she has had students who were unhappy about the perceived course workload that the IHI modules added. Like many others in the program, they work full-time while being full-time students. Instead of seeing the linkages between the coursework and their current role, their relationship to the degree program struck Maxworthy as more transactional than educational.

However, a section on quality improvement (QI) and patient safety proved eye-opening. The student had initially balked at how long it would take to complete the multiple IHI Open School modules required for an assignment. Maxworthy assured her that the time and effort would be worth it. She also noted that the paper would count toward a significant part of the final grade.

Initially, this student rushed through the Open School courses. But Maxworthy had required each person to engage in reflective discussions with other students about what they were seeing in their own organizations. For their final paper, the class had to synthesize these reflections with what they learned during classes and the Open School modules.

The student reviewed the QI and patient safety lessons and came to appreciate their value. “They came back to me and said, ‘I thought this was just going to be busy work, but this makes more sense to me now. I see how important this is,’” Maxworthy recounted.

New Ways of Thinking

When they start in Maxworthy’s course, the adult learners in her class can have a task-oriented attitude toward health care quality and safety. “They often have an opinion that quality is just one of those things you have to check off the list,” she explained. “Hand hygiene? Check. Data? Check.”

“Many of them haven’t been trained to connect the dots as well as they should,” Maxworthy said. “The work gets focused on tasks, and we forget that the reason we do any of this work should be about the patient. It's not just about counting falls and needle sticks.”

Maxworthy expressed appreciation for the patient-centeredness and realistic scenarios in the Open School modules. She assigns them to her students because they allow learners to consider how they might manage a range of common challenges. “The [Open School] gives them ‘the why’ and ‘the how’ to help support [health care improvement] work,” she remarked. “They open up all kinds of new ways of thinking.”

In addition to the value to individual students, Maxworthy sees the following benefits to organizations that use Open School subscriptions to reinforce and expand their improvement and patient safety work:

  • Spreading a shared language. “I’ve had several students go back to their organizations [after taking my course] and get [Open School subscriptions] to make it part of the expectations for their leadership,” she said. “They’ve told me that the value added for them organizationally is having a common language and shared model to do their work.”
  • Supporting a multidisciplinary approach. Maxworthy noted that Open School courses are worthwhile for more than nurses and physicians. “I believe strongly in interprofessional education because we all have something to contribute,” she said. “We have to value everybody's contribution because that's how we avoid duplicative care and miscommunication. All kinds of patient safety issues arise because of a lack of communication.”
  • Expanding horizons. “The Open School helps you see your organization and your role in it in a new way,” said Maxworthy. She added, “The courses are practical and concrete, but they also offer a more global view of the health care world we are all trying to improve every day.”

As a committed lifelong learner herself, Maxworthy is excited by the idea of longtime health care professionals like her students and others making the effort to push beyond the boundaries of what they think they know.

“My hope for any learner taking the Open School courses is that they help you see the world through a different lens.”


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Photo by Courtney Hale

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