Thesis Progress: Scaffolding

My thesis work has been progressing well as I have joined forces with a team of nurses who are currently going through a performance improvement course. This is quite a departure from some of my previous aspirations of helping an Academic Health Center define there innovative process. Since the beginning of my thesis work, the healthcare organization has defined there process (quite well). The healthcare center’s innovation team has been able to effectively communicate what innovation is but the challenge still remains that employees are not applying their learning. Here, the issue of sustaining cultural change surfaces.


After months of research, coupled with personal experience, it seems evident that you can teach any process to anyone in a powerpoint presentation or within a 2 hour bootcamp. The issue is that participants are being taught new methodologies (in this case innovative thinking) that are meant to be applied to their work. Facilitators seem baffled when participants are able to regurgitate the information that has just been presented to them but are unable or unwilling to apply the learning to their work. This can be attributed to the huge jump from learning and applying learning.

In bootcamps, participants receive all types of scaffolding. This is in the form of agendas that schedule your every move down to the minute; a space that is safe from the common interruptions that might be faced otherwise in daily work; tools and resources like post-its, sharpies, whiteboards, and dry-erase markers; a facilitator to direct your every move. When participants return to their routines, all of the scaffolding has been removed. It’s like trying to ride a new rocking horse without letting the glue dry.


Think of my new roll to act as scaffolding outside of the bootcamps. As I have been working with a team of nurses, I merely help guide them and provide support when needed. They are responsible for the agenda, they run the meetings, but when they get to a hiccup along the way, I provide support.

A perfect example is when they were trying to move from quantitative data to quantitative data without abandoning their original interest. The team of nurses wanted to address issues around inaccurate, inconsistent information being communicated to patients in a cardiovascular clinic. As they explored this issue through administering surveys with patients, they were able to identify that patients need clarity around what to expect during treatment, what is the  model of care, and how they are progressing through their care.

As mentioned earlier, these themes were discovered from the nurses administering surveys. However these surveys asked patients to rate the communication from different members of their care team. Despite the high ratings, many patients still expressed issues around how there care was being communicated to them. Once the nurses identified their three themes they were hesitant to pursue these topics because it did not translate to their initial surveys. This is where I leant guiding support.

I explained to them that their information was extremely relevant and that they were exploring the more specific issues around inaccurate, inconsistent communication. I continued by reminding them that this was their first survey and encouraged them to just look at it as a way to refine their focus. Once they understood this was just part of the process, I helped them craft new questions that would allow them to gather data on their new topics.

I think this was a critical part of the process of developing an innovative culture. Support for the nurses’ project was extended outside of the classroom, and allowed them to refine their focus appropriately. This helped them pursue their discovered interest without feeling like they were abandoning their original focus. My collaboration with them will continue into early April and I look forward to finding out what other ways I can support their work.


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