Leveraging Cognitive Diversity in Addressing Complex Healthcare Problems

Good afternoon everybody so welcome to today's health system science open forum session on leveraging cognitive diversity in addressing complex health problems dr megan seibel is the inaugural director of the virginia tech valor program which stands for virginia agricultural leaders obtaining results the associate director for the center of cooperative problem solving ccps at virginia tech and an associate fellow of the occupational research center in the uk dr seibel's background and expertise in healthcare career and technical education and outreach educational programming invigorate her passion for community development and considering complex issues that incorporate all three of these paradigms so a co-author on numerous publications related to leadership and community programs dr seibel uses scholarship as a way to bring ideas to life through practical application so please join me in welcoming dr megan seibel and uh feel free as we go through today's session if you have questions or comments throughout the session uh feel free to type them in the chat and we will convey them to dr seibel or you can feel free to also unmute yourselves and convey them directly thank you welcome dr seibel thank you so much for having me i'm really excited to be part of this series and seems like the invitation came in so long ago and um has been long anticipated and then boom here we are so it's exciting to be with you all and um again welcome questions as we go and it's um great to see a couple of familiar faces sarah i can actually see you on camera so that's wonderful um but anyway thank you all for being here i'm really excited to be part of this series so um the topic today is thinking through cognitive diversity and how we can address that in times of complex change which is everywhere it seems especially i think in a context like healthcare when um we are at the forefront of just unending changes before us across society and across our communities so i'm gonna go ahead and just sort of think through some different things um one of the things i'm really curious about from you all if you can just drop it in the chat but if you think about the work that you do perhaps as an individual or as a content expertise practice expert whatever that is in the context of work what types of teams are you also a part of and obviously no right or wrong and the kinds of teams you're on may not even be represented on this list but i'm just really curious because we will be talking about impatience for cognitive diversity and team dynamics and may be able to incorporate some of that back in as we move forward so great educators others thanks they're starting to come in the chats we've got teams of educators medical education leaders well-being patient experience administrative yes at research committee's work groups regional clinical advisory teaching and administrative grade these are all wonderful examples so you can certainly continue to keep dropping them in there and i will um kind of watch those as i speak um thanks for sharing those and patient care was another one that was new that was that was there that hadn't seen so just put this word cloud up not to spend a lot of time on it but these are different words when today we're going to use the a theory of change adaptive innovation adaption innovation theory related to problem-solving style what is innate to us what our cognitive preferences are around the ways in which we generate ideas the ways we utilize structures in order to get those ideas implemented and into play and the ways we respond to groups and rules based on our innate preferences inside of cognition so these are just some different words that kind of come out of the theory made a little word cloud out of them and also to sort of exemplify this thought that around the way our brains process and ideate um it's this convergence of things that are happening inextricably so decision making creativity problem solving all sort of run together in the cognitive spaces um but we do know there's some some ways to sort of flex out what's innate and then what parts of it are flexible and so let's talk about that with the context of kind of moving through change today there are several objectives for this series um the course today as you all know um based on the requirements for carillion but we're going to discuss adaption innovation theory as it relates to cognitive problem-solving preference and again this is your preference for that um i will have you sort of think through where you think you are in that space and there'll be a chance to weigh in on that as we move forward we obviously there are other ways to actually measure it using an assessment but since we are taking that as part of this that'll be more of a discussion point we can talk later if you really do want to take it or have your team take it um but we're going to differentiate between cognitive effect and affect as part of cognition and the difference between style or the style in which we solve problems and our abilities and capacity we're also going to compare adaptive and innovative preferences of individuals relative to task and team so your preference is your preference it might be more adaptive or it might be more innovative but it is always going to be relative to the people that you're working with and the things you're working on and so discussing that relativity while you have this stable preference across your lifetime we're defining cognitive gap and aspects for coping and bridging across those gaps so it is natural and expected that there are cognitive gaps in the way two individuals for example working on the same project might be coming to the table to define the problem and that causes stress and there's opportunities for individuals to play social roles of bridging as they help close those gaps in teams and then we'll also be examining implications for leadership and management of cognitive diversity and health systems so you put a number of teams in the chat box but thinking through how those teams are part of larger health delivery systems and what that means when we think through how we have to work through those so i'm going to give you a little bit of leadership food for thought just to sort of start out this first piece is thinking through the implication of values so all of these different factors that we have and providing motivating factors for us to decide on how we're going to engage and i'll show you a cognitive um kind of function scheme we call it that goes with this theory but it sort of thinks through the things that are around us things we know to be true the things we believe in the things we were raised to understand and the values we place on those via motive are a lot of times the way we take information and and then choose to do something with it a vision is obviously a desired ideal or expected outcome pending barriers communication is really critical especially in systems like carillion and all of its affiliates you know the importance of communication outwards to the communities inward to our personnel and what that looks like as far as making sure that we are actually talking about the same thing on the same page and being able to have some clarity around that so we can move forward and then the value of trust we would not be healthcare practitioners if trust was not an essential thing that we believe in and ascribed to so that we can build that those relationships internally and externally i did go ahead and pull the institutional core values for both curling clinic and virginia tech curling school of medicine and i know there may be others represented in the room but these were the two that i wanted to look at and just sort of flank through because there um is some distinction and difference in the way that they're presented and might be perceived by our external stakeholders but at the same time there's a lot of overlap in them as well so um curling clinic obviously um according to the use of the seas collaboration courage commitment compassion and curiosity um interestingly inside of those are some of the things that then show up in the um kind of dual purpose statements of the school of medicine collaboration and excellence innovation and discovery diversity equity inclusion and humanism and compassion um namely in that compassion obviously shows up in both collaboration jumps out in both curiosity in korean clinics values includes words like innovation which is in the school of medicines and then when we're talking about something like adoption innovation theory how we frame innovation and advance innovation perceive innovation uh is really critical in that sort of piece where we're thinking through new discoveries and improvements upon current systems and then i think in both of them is this desire to do whatever it takes at um without question what our patients need from us so i'm just going to kind of throw out this uh starting place i'm going to posit it with a question about to you about what we know about you or what you know about yourselves and then sort of what we know that are the key elements of the theory that tell us we know about people in general so there's a little poll question i'm gonna launch and um it simply asks do you consider yourself creative if i were to just run into you on the street and say hey do you consider yourself a creative individual would you say yes or no can everyone see the pole i can see the pool you see you can or cannot sorry ma'am i can it looks good i'm going to close it so we can see the uh results okay great all right 71 said yes and 29 said no um that to me is a question that i ask of a lot of groups and i'm always interested in the results depending on the audience it's interesting to see what those where those fluctuations are very often it's only a quarter to a third of people in the room that really consider themselves creative i think that um and i expected it to be a little bit higher in this audience i think primarily because um when we think about the kinds of work that we do and the ability to um think critically react and adapt in times of uncertainty and respond to things that that creativity that it takes to respond and that is is pretty profound so that's great thank you so as human beings one of the things that we know to be true is that all people are creative so every single one of you are creative and all people solve problems and if we think of create creativity as the ability to um generate novel ideas and then resolve those ideas then by nature of being human beings we're all creative problem solvers we just do so differently and part of what we'll be talking about today is our innate preferences for the way in which we work through those uh processes in order to get those ideas generated and implemented so in this idea that all people are creative one of the other things that we know um in this work and that we're actually able to measure and and show equivocably is that the way in which we are creative the style with which we create bring things to the table um the manner in which we solve problems is in no way shape or form correlated it's orthogonally correlated with how how creative we are our ability to be creative um the intellect or ability or experience or education that we have that allows us to do those things now there are level measures of creativity and i'm sure a lot of you are probably aware of those and those do measure creativity in alignment with iq but the way that we are looking at the creation from the preference for being more adaptive or more innovative is not correlated at all with level where level comes in though is the ability to handle um more complex problems multiple problems at a single time it's just that they might be more in paradigm or more out of paradigm or one at a time subject matter wise versus all sort of confluence together uh the theory itself adoption innovation theory is based on the work of dr michael curtin who actually just passed away this past year at age 94 in the uk and he started the occupational research center there and began his theoretical study of this back in the late 60s when he had access to a number of companies and just was able to go in and observe them the work that came out of that then and then his study of psychology and biology and a number of other fields led to the development of this cognitive function schema we call it in our practice and i understand that it's a very simplified version of it and the cognitive theorists in the room and neuroscientists and those of you that are in your in your worlds can probably realize or know that cognition is much more complex than this but very simply speaking and i'm not going to spend a lot of time going through it but part of what it does is take what happens internally is that kind of purple blobby cloud at the top of cognitive affect that is feeling driven preference driven sort of any things that we decide that we should be doing flanked by cognitive effect which in this case is at what level so iq and inborn traits that way and the way in which we try to do things so our cognitive style and the separation of those two um based and then with cognitive resource what we've learned what we've accumulated over time so those kinds of things are separated as far as what's happening internal to our heads implications of environment and what we take in and then the behavior that we exhibit as an output are external to ourselves but because that's all we can see amongst each other that's usually what we will respond to in a given given time so our innate preferences for problem solving and what we'll talk about as we move through this and get some input from you all do not change over time but our behaviors are flexible and the circumstances of our environment as stressful as they may be really do have some implications there so one of the other things that we all know every single one of us to be true is that change is constant and one of the things that we think about with change is whether or not the change that's in front of us is paradigm consistent for example or paradigm cracking how we manage and lead through that change is the variable because it is perception based what might be just really catastrophic or seemingly impossible to one person may seem um tangible and doable to somebody else in the same room in the same situation based on the way they are hardwired and based on the experiences and things that they bring to the table the other piece of it is when that change comes in front of us and what we would call a precipitating event or something that comes in and is the impetus for whatever the change is at hand we can think of that as was it something that was anticipated or is it a bombshell type of an event and so there's a number of things obviously we know of that we've all been dealing with regularly and as we sort of move through space and time but because we're talking about the context of healthcare delivery health systems we'll just go ahead and use the big kovid as an example and thinking through what has happened over the last two years so we can think of the how we responded to knowledge of the virus what we learned about it as we went through the scientific discovery um development of vaccine technology responses of the public policy implications there were so many pieces of this and it has a lot of opportunity to parallel it with the work of that we're talking about today with thinking through definition of the problem and getting people on the same page which we'll get to in a minute but sort of thinking through the perception of people any given person us as an individual our ailing parents our immuno-compromised neighbor our um legislators our bosses at the hospital our co-workers who were in the trenches whatever that looked like to different people the perception of what was going on at any given moment was different so i just went through kind of did a quick google search using terms like ambiguity and just have three little things to show you just kind of about this reinforce this idea of perception so um if ambiguity is a fear uh multiplier then um we can think of ambiguity as a fear amplifier covid has laid bare the public's discomfort for that clinicians and scientists sometimes like ambiguity right it's part of the scientific process we're going to delve into the great unknown and figure out what it is we can know about it now there may be some bumpers on the sides of the aisles of that what what is it that we've tried before what protocols are already in place what experiments can we leverage for information or we have no idea where this is going we need to think completely differently than we have before and develop a radical new technology we've never seen and figure out where to go from there but this acceptance that ambiguity is sometimes part of the process is a little bit more familiar to us and clinicians think about that acceptable risk but the public might for example desire a more definitive stance whether or not they like the rules that were being imposed on them um there was this need for information right so where do we fall in something like that when we're faced with something as big as a pandemic um that was in 2021 2022 early just a few months ago there was an article on npr when facing loss embrace change and don't force closure a therapist urges so we think about change and what goes with it and the ambiguity that goes with that and where people are in that space so a lot of us were raised to think through going through a trauma or a loss and needing closure um and yet now they're saying maybe there we have to have something called ambiguous closure and this idea of ambiguity is much more comfortable for some people than others and then a another one case example out of the proceedings for the national academy of sciences an article about rational policy making during a pandemic and a word like rational and even the perception of a word like rational it implies structure it implies guidance um it implies some sort of sound decision making and reasoning that goes into it but again there's probably some hypothetical um interpretation of what a word like rational means so this is all over the place this is was three seconds top three hits off of a google search there are a number of factors influencing outcome of change and when we think about any change that's before us maybe it's a change in the way we want to do our service delivery a change in the way we want to structure our infrastructure and physical facilities that we're bringing patients to maybe it's a change in the way we want to leverage the skill sets within our personnel or do continuing education whatever it is anytime there's a change thinking through the things that influence it um there's three primary ones so opportunity is the need for there to do something about it it can be something that is sought it can be something that's perceived it can be something that presents itself but there is an opportunity to engage in some way shape or form around the process and progress of this change motive is absolutely critical intrinsic or extrinsic whatever those motivating factors are motive will drive the processing of that information and the influence of our own desires and our own preferences for how to engage in that space solve that problem but sans motive a whole lot's probably not going to get done and then resource is the other critical piece thinking through not only things like uh you know huma um resources like cash capital physical infrastructure and those kinds of things and even human capital but as an aspect of human capital the diversity that we each bring with our own personal cognitive preferences for the way in which we want to engage in that coupled with the level which i said is not necessarily statistically correlated with our preference for the way in which we do things but we'll determine how well we do them or how successful we might be so we need all of these things to be successful throughout change processes one other thing and sort of thinking through and we've talked about problem solving style as the topic um du jour but the way in which that's defined is is pretty simple it's three components and like i said if we were actually using the assessment to measure it there would be these three pieces that are actually a part of that but it looks at the way in which we generate ideas our innate preferences for ideating um the number of ideas the types of ideas and what those look like the way in which we utilize or leverage structures to implement ideas so some people want a lot of guidelines what are the expectations the timeline the rubric how will we know if we're successful how will be evaluating this um all of those pieces of it that they need where others will loosen those structures as much as possible uh who says we have to do it this way why are these the rules we've never viewed this seen this thing before that's really exciting and so how people tighten or loosen those structures or put those structures in place in order to get their ideas implemented and then the third component is the way in which we respond to rules and group norms so what are the expectations um what does the engagement with other people look like what are the guidance guidelines and the guiding principles or the policies that we need to to go through our style is stable throughout our lifetimes and we know this from um being able to measure it and and do so with multiple data points but that preference that we have we can see anecdotally and by observation in small children all the way up through and then we can measure it as people get older but we know that it's it's stable our behavior is what's flexible so the way in which we respond in a particular situation because we're motivated to do so where we have the skill and ability to do so is the part that is external and so that's where we end up making judgment sometimes about how other people are engaging but all we're really viewing is their behavior and not necessarily fully understanding potentially what's going on inside of their minds so megan when you when you refer to if you don't mind flipping back when you refer to style being stable as opposed to behavior are we referring to mainly internal cognitive style exactly exactly behavior is the manifest the external manipulation the behavior is the external piece of it and the reason i always throw that out is sometimes um i did a workshop one time for example with an administrator at the university who's in charge of a lot of compliance reporting and you know all of the pieces that get reported to the federal government et cetera et cetera really really good at their job had done it for years um their his style was actually not at all in alignment with job that he was doing on a daily basis and it was causing a lot of stress but because he was good at his job and he liked people that he was working with and he was close to retirement he just sort of stuck with it but then when we did this and people realized that he had honed that behavior but it was not necessarily the way he preferred to operate um it was absolutely thrilling for him to sort of have that out in the open and it was a really big aha for other people to think through the fact that um you know maybe they could have taken some time to learn a little bit more about what he enjoyed or didn't enjoy about the work that he was doing as a valuable member of the team so yeah our style is internal to us and unless we have an opportunity to leverage it in a way that makes sense um all we can observe is behavior but thanks for asking that question sharon because when we get into sort of implications for team dynamics around problem solving it becomes really critical then to be aware enough of the cognitive diversity that's around the room that we can actually do something with it so i'm just going to move on so that we don't um have that i'm going to make sure we've got enough time for questions at the end and again if you've got anything throughout the middle just go ahead and unmute like sherry just did i'm only going to throw this out there not to go over the different stages of it but process of problem solving as used theoretically in this instance and um throughout this body of work for the last several decades these six steps that you see in front of you so much like scientific process there's a lot of pieces with it right but this one's based on perception of the problem and then how we analyze it work through solutions agreeing to the change that we're about to embark on accepting the process of change and then implementing it and i put two asterisks by two of those because they tend to be the two stages that most people get hung up on when there's a discrepancy in our cognitive styles that create some tension or some gap because sometimes we think we're talking about the same thing and we're talking about different layers of it and i think covid was a big example of that right people might be thinking that they're talking about that same issue but they're but they're looking at different uh examples of it and then emotion gets in the way and we start talking about different pieces of it the other um there's a couple of other components that i just want to make sure that i address because it really impacts how we individually leverage our own cognition for ourselves in the way that we're doing things and then move forward but one piece when we're talking about the outward utilization of this and engagement with others is this idea of paradox of structure and essentially it is that all structures rules policies expectations whatever it is evaluation rubrics the analytics that we use to collect performance or to evaluate whatever that is all of those structures are enabling to some people and limiting to other people people who have more adaptive preferences will continue to ask questions and look for those structures because that information provides guidance that empowers them to get out of the gate and be more successful in the problem-solving process for people on the more innovative end where they don't need all of those structures they may disregard the ones that they don't need loosen ones that can be loosened um but they can work through ambiguity in different ways and so having too many constraints too many check boxes actually prevents them from doing the work that they need to do cognitively style and behavior again like i said are we've talked about so i won't spend any more time on that but as we go through different experiences it helps us develop insight and foresight as we move forward into other situations so that we can have some predictability about what might happen if we're in a situation again that we've been in before what it was that we learned about what did or didn't work and how we might apply that moving forward so that helps us build our cognitive resource in order to solve the problem we have to agree on the problem and that requires some management of cognitive diversity so if we think of problem a as the task at hand taking the time to make sure that we are out actually talking about the same problem and that we're working on the same piece of it is is essential and it may be that the problem is so complex and so big that we have to break it down and there's multiple sort of sub problem a's if you will so that we can work on one piece of it at a time without it all getting really muddy problem b is cognitive diversity among other things that keep us separated from ourselves and as a result keep us separated from the task at hand so it may be that depending on where we are in the problem-solving process one style might be more appropriate or needed than the other so for example maybe we're faced with something we've never seen before and we've decided that we're going to have to come up with some completely out of the box approach try something that we never would have even fathomed that we would have tried five years ago but now we're here and so we maybe need more innovative problem solving individuals to think of what that completely different radical thing is going to be but then in a different phase and a different stage when we're thinking through um testing and implementation and budgets and timelines we maybe need more adaptive people around the table to make sure that we're not missing some details there so thinking through what that is but we've got to agree on the problem in order to even get going so i mentioned to you these preferences from being more adaptive or more innovative what we do know from thousands of data points from all over the world out of decades of research is that there is a continuum that we call the adoption innovation continuum um interestingly this the stats support a kind of a bell curve demographic on it in the middle of it the majority of the population um so you know two thirds with a normal bell are somewhere around the mean the population mean and i'll give you some numbers for these in a little bit um to the one side or the other um out one direction is a higher stronger preference for adaption which is described by individuals who want to solve problems by making things better uh more evolutionary types of changes looking through things we've done before how can we improve these systems or tweak this or tweak a couple of things um they will utilize structures in order to facilitate problem solving and put structures in place in order to do that they can see um chaos inside of that order on the other side are stronger preferences for more innovation more innovative approaches and so those preferences for innovation are more revolutionary in nature solving problems by making things different um being able to um take things that are totally chaotic and see enough structure in them to figure out how to move forward but will alter structures in order to facilitate problem solving more so i'm just going to give you kind of some characteristic terms and these are more extreme descriptors for so if you think about that being bipolar um with a starting point not anyone better than the other but differences on out out on those ends and when i give you some numbers i'm going to talk about you know minuscule percentages of the populations that are um more adaptive more innovative depending on how far out on your on the pole you are but i want you to think about these characteristics i'm going to ask you in a minute about where you think you might fall on that continuum if you had to think through the way you prefer to do things comfortably over a period of time so more adaptive individuals prefer structure they like to know what the expectations are what the guidelines are they'll produce really targeted ideas and so for example they might be um less prolific in a brainstorming session but the ideas that they present they've probably thought through in their mind thought about the effectiveness of it what the implications for um for it you know things that could go right go wrong or whatever so as a result when they ideate and share their ideas they expect a higher rate of success for those ideas taking those three things on the counter of that then more innovative individuals prefer less structure and they'll either overlook or move aside some structures if they don't need it in order to work with things proliferate lots and lots of ideas the thrill of generating a lot of ideas that may seem very different different or potentially not as related in nature but there's a lot of ideas to pick from and so they'll they're also more tolerant of um the effectiveness of those ideas if something doesn't work then there's another idea in the ready to try more adaptive individuals improve systems by being by making things better that's their role as a change agent um where individuals on the innovative side are more radical change agents making things stuff um different adapters are precise in master details they're consistent seen as disciplined and reliable they're sensitive to people in groups so sometimes you need to make sure you've checked in with them to make sure they're in agreement with what they're seeing or hearing or the action that we're taking moving forward because they may not be speaking up of sensitivity to others where on the innovative side they tend to shed details and which can make them seem very visionary but at the same time a little bit undisciplined but it might be that they're just unconventional in their approach they challenge rules and assumptions you know why do we have to do it that way and why do we have to start at that point and challenge the problem definition they may start at an unconventional point in the problem to begin with and both groups will take risks but adaptive individuals will be more prudent thinking through the pros and cons or implications of that risk that they're about to take where innovators will tend to just take the risk and see what happens as a result no again no better or worse and you can probably think of a number of instances where one or the other or both could be really powerful in a given situation so i'm just going to um have we're going to give you i'm going to give you one more example then i'm going to ask you where you think you might be so differences are a really good thing neither adapters or innovators are better than the other and using their creativity when it comes to problem solving and decision making in particular situations different degrees of adaption or innovation may be judged as more appropriate and sometimes this is where it takes some guidance or some management leadership within a team to sort of think through the appropriateness of those things and adapters and innovators may disagree about what is best in a given situation but we might also end up confusing differences in style as a difference in ability which we know is not the case so an example that i'll share with you actually comes from a colleague that um lives outside of the u.s and has been using this for 30 years or more um and it has a podcast and does a number of different things with it but interestingly enough knowing what he did about this theory he was needed to have brain surgery um several years ago and so he had two different surgeons that he was thinking about working with they both knew him well and they knew what his work was he gave both of them the kai as an assessment and told them that they could have the results when he got off the table and um he knew both of them were stellar well-published well-researched years of experience brain surgeons but you i would love to have somebody just unmute and tell me which one they he think did you think he went with the more adaptive one or the more innovative one innovative why do you think you went with more innovative uh i think you would value the flexibility when you get in the situation of that pivot once you're inside yep interesting um he actually went with the more adaptive one because his rationale was he didn't want them experimenting inside of his brain right he want but i think he took an extreme example because i actually think that um yes depending on which to apply so one of the things that i'll share sometimes when i teach this class because again you can see one or the other right and what's appropriate or different sometimes i'll talk for example um think through an or example um surgery that maybe is something that's been done a thousand times over at x hospital because they're you know one of the premier centers for whatever that is things may be going along just fine and then another time you may get somebody on the table and open them up and you see something that's unexpected or something ruptures or um vitals something happens to vitals that that wasn't expected or whatever it is right and so we have to have the ability to think inside of those things now interestingly do we need an in paradigm response um this thing is happening we've seen it before even if it's rare but we know what to do because of what we know that's in paradigm or is it something that is we've never seen before this is the stuff that ends up becoming examples in textbooks and we need a completely different approach so how do we leverage that cognitive diversity if we don't necessarily happen in the room at the time and bring it in so there's a number of different examples so i love charles you put in the um chat bar sarah said she thought more the more adaptive one um and charles but it would seem to me that one needs to be both adaptive and innovative and distinguish when to apply and i'm going to actually say yes to that so your preference is stable over your lifetime and it's innate and we can consider it hardwired even but as you develop um that insight we're talking about the cognitive resource and the skill set you can flex your behavior in a given point in time because you know how to that doesn't necessarily mean that it's going to be easy and it may come at a cost psychologically and cause some coping for you but that just you're right absolutely right it does not mean that you cannot be that you don't behave in one or the other way um that's maybe out of preference and if you have more of a mid-range preference then you could um really have the ability to flex different ways depending on the task or the situation so where might you be on the continuum and i'm going to go ahead and ask sandy to put the other pole up and but i'm going to go ahead and put this this piece back up for you so you can kind of think through where you might be so based on what we've discussed do you feel your cognitive problem solving preference is highly adaptive moderately adaptive mid-range moderately innovative or highly innovative again no right or wrong this is your preference and your behavior can be whatever you need it to be based on your expertise i'm going to go ahead and close that all right great so um you can see that there is a more it will kind of in that mid-range moderately adaptive higher percentages of individuals but just as we would expect smaller numbers 12 out each on either of the two poles right so with high preferences for adaption or innovation and in sometimes inside of different groups we'll see a slight skew so the population mean is uh 95 but for this group that's on on today it's probably closer to a um 85 or so if we were to actually run the numbers based on where you think you are and then we again have a way of actually measuring this but it's pretty solid as far as space validity goes so thank you for taking that little poll i love the results of that all right so i'm going to talk about um sort of think through types of gap and forgive the fuzziness of this picture but i mentioned that there can be cognitive gap so a difference between you and your preference your cognitive preference and the task you're working on or the problem you're trying to solve you and another individual you in a group between two groups group and a problem so cognitive gap can happen all over around us in the in situation related places things we're working on our preference doesn't change so for example that that bulk of you that put that you feel like you have a moderately adaptive preference your preference is for that but if you're working on the great unknown thing that's before us you're going to potentially feel and and there's different people that are in there right so that problem to you is going to feel potentially fairly daunting because you have that more adaptive preference where in another group that you might go into work with where it is very detail-oriented very data-driven very adaptive in tasks and the types of people that engage with that space you even as a moderated actor might be the one that they're all looking to for the next greatest big idea because you might be the most innovative person on in that team at that point in time and that's why i asked you about the different teams you're on and thinking through um what that looks like potentially because in any given day you may be working on a dif with a different task or with a different team or go home and be in a completely different environment cognitively speaking than in your work environment and so even though your preference doesn't change the ability to flex your behavior based on what's happening around you um sometimes becomes necessary because we may not be able to operate in that space where it's our preference most of the time so we know that gap and i um we'll give you again like i said there's going to be some numbers i'm going to show in this next example but at 20 points between individuals we start noticing the differences so 20 point gaps sometimes will inhibit communication how well we work together how much we trust each other those three sub bullets have to do with where those differences occur and like i said before we've got um you know we as we dig down the way we had put systems in place in order to implement our ideas and engage with other people we can look at those more specifically if we um ever so desired but it has to do with the way i see this problem before us compared to the way you see the problem before us and some of those things that have to get sorted out before we can move forward so i'm going to show you um some of the things that i'm talking about using this sort of normal distribution as an example right so i've got a kind of a bunch of people plotted along the continuum um i probably should have put an a on the left hand side for more adaptive one um i on the right side for more innovative it there's you know numeric balances there typically people will fall between 45 and 145 when we when we have because we have a number of items on an assessment so statistically there has to be some numbers 95 is the population mean and um i want you to each think of yourselves as agents of change so if each individual can be an agent of change that at any given point in time as individuals were operationalizing in different groups so for example what we'll call the agent of change 2 group is going to be a group of individuals that are within 10 points of the group mean so in this case example population mean of 95 our agent of change group is going to be between 85 and 105. it tends to be the largest number of individuals in the group and there can be some ability to have some consensus in there so that's what we call an ac2 group outside of that more 10 more than 10 points from the mean more innovative or more adaptive so this there's more adaptive ac3 group and a more innovative ac3 group they're the ones that depending on where the leadership is or where the decision-making is happening could potentially um need to be brought in or need to be referenced or may have to work a little bit harder to get their voices and their ideas heard so hypothetically speaking i just want you to think through if the positional power right the person in charge happens to also be in this ac2 group where the bulk of the individuals are the ideas and different things are happening pretty easily and quickly because it's fairly homogeneous you can see pretty quickly how there could be a lot of movement in that space but potentially the more adaptive or more innovative ac3s could potentially get left out of a conversation what would happen if you put your positional leader out in the more innovative ac3 group then potentially you've got a big bulk of people in the group or the team or the organization and also the more adaptive voices and ideas that may have a harder time getting connected in because there's some decision making power at the other at the innovative end or likewise we could have a similar thing where the decision-making power um the authoritative power whatever it is is down on the innovative side i mean the adaptive side and so they're pulling in those ideas and thinking through those individuals and thus sometimes bleeding others out so there ends up being these implications for what it looks like when we have to cross those gaps so how in this example would the most innovative person for example have to get his or her ideas heard by even somebody in the middle of the range let alone on the far end and vice versa so that ends up sometimes causing a situation where people may potentially have to cope it causes stress because they're having to present themselves in a different way in order to um be in the box so to speak or be a part of that in group um they may potentially just get left out they may not may or may not even notice that that's going on because they're so in tune with the work that they're doing and they need somebody else to come along and help bridge that gap so bridging ends up becoming this social role that individuals can play where if they have the ability and the interest and are motivated enough to do so they could potentially help close that those gaps bridging can happen by anyone at any point in time um like i said if they have the skill set of the motive to do it but the logical places where we might find individuals who would be willing to help um reword something translate something close a communication gap um figure out what what maybe what structures are too tight or maybe what structures are too ambiguous would be those that straddle the two groups and so there you may be that if you can pinpoint those individuals that would be a likely starting point for those things so we think through really what the implications are then so that none of us have to change our style but if we know enough about what those styles are then from a leadership management perspective we can have those heard and brought in so i'm just gonna share one more slide with you and some food for thought and then open it to questions and we can go back and revisit any of these slides if you like so in applying your style um i like to encourage everyone to use their what we would now call your problem solving acumen to promote communication and uh inside of an inclusive organization by a couple of different ways monitoring the effects of your own preferences effectively managing differences to best engage others and strive to manage differences in a way that meet the task and i might suggest to you that it has to do with practitioner practitioner or inside of a research team or an education team and those kinds of things but i also always encourage people to think through where it might be that you're the patients that you're engaging with or the community that you're trying to communicate with or whatever that looks like has a very different preference than you so that the things that you're explaining to them maybe seem too ambiguous or maybe there's so much detail coming at them that if that's not the way that they're hardwired and they're already under stress they're missing some of those details and then ending up falling short on something that they need to come to come back with as far as how we're explaining things i think healthcare sometimes is really good at thinking through utilizing different individuals in that continuum of care so that we have the ability to have individuals in place who might take a detailed set of lab results for example or a test um test output that goes with a diagnosis and then repackaging and explaining in a way that's understood so we have the ability sometimes to do those things and move up and down those chains of communication within our different areas of expertise and different practice specialties but i think sometimes we need to be pretty intentional about it and then i would also throw out that even though covid was the example here obviously that's like just a cute boom it's in front of us we have no idea what it is but we do know what it is we don't know how to respond but we think we can come up with a way that works and we need to follow these rules and put out this psa versus something else and um i was in peru in march actually and looking at the different way that they communicated there compared to how we were communicating it here was really interesting um but sort of also then thinking through the fact that we are in these chronic crisis states of having an aging comorbidity heavy population and what it is we maybe need to think through as we're moving through those paradigm shifts and pendulum shifts inside of those things so that we can best meet the needs of our communities as well and acknowledging the stress and coping that that puts on the people that are in our systems is really a huge move in figuring out how best to help them feel that they're being heard and get their ideas to the table so that we can leverage them so with that i will open it to questions there's my contact information if anyone wants it and i would love to hear from you all don't be too quiet so megan when we're considering uh communication with whether it be with patients or with team members etc and so if you recommend if it's just doesn't seem to be getting through then just try a different approach because there are no key indicators to say oh well this person is more adaptive as opposed to innovative so maybe i should approach them in this way it's just sort of testing it out testing it out and taking a different approach what i will tell people is um err on the side of more detail more structure more instruction the people who need it will appreciate you for it and the people who don't need it probably won't won't notice it in the first place right it's not going to offend them that it's there or get in the way um but sometimes when things aren't explicit enough and i you know think about you know examples over the years of you know where people will be in a patient ed situation for example and and show them something and potentially ask for it to be demonstrated back but there's you know such a direct translation i i mean i was probably 10 my my mother was a um uh naval nurse and i can remember her you know just simple example of um you know diabetes control and they taught the person to put the um insulin they can do their injections with an orange because the tension on the orange peel was pretty similar to skin tension and could not figure out why the sugars were under control asked her to come back in and demonstrate how she was giving herself her insulin so she whipped an orange out of her bag injected the orange peeled it and ate it and they thought oh my gosh like how did we miss that that was going to be the way this was translated when this patient got home and so it's i mean some of us think about like what why in the world would somebody even do that right and it can be something as simple as that or something as major as saying this is the way you need to do things because we told you so or this is the way the instructions say to do it and not necessarily explaining why to help recontextualize it in a way that meets the needs of of their value system or whatever that looks like but so that it helps them situate their own ideation around that so thanks for that question um excuse me another question in the um yeah yeah so there's a question that says in some ways can't the structure stifle innovation yes short answer is yes let me read the second part and then even the college system of education has been criticized as being constraining um yes and yes so when we talked about all structures being enabling and limiting um i think over time things like higher ed and um even the way we do healthcare delivery because of insurance compliance and reporting and data points and whatever has almost gotten more structured and or structured in tighter ways in different ways and the ways that those get implemented then in some ways constrain they constrain innovation in the sense of if we really need to be dancing in spaces where we are coming up with the next technology that we've never even seen before or never conceived of before how do we know how do we feel like we have the ability to just push the envelope and get there and so without and then it almost seems like we've created and then we create another system right we create a center for innovation or we create a special lab where people can test those things out utilizing other things that we already have access to from the standpoint of resources or knowledge um and so the kicker then is figuring out which of those systems we can best leverage and potentially loosen or alter in order to create that space for innovation and thinking through what that innovation needs to look like and then keep in mind that there is a spectrum of innovation right so even on that more innovative end so say if you've got somebody who falls out they have a preference for being more innovative even on that end of it you're still there's still room for things that are even more innovative or slight perceived as more structured innovations within that space um efficiency is another interesting piece of it because people will think through what that looks like so there definitely are adaptive efficiencies and innovative efficiencies and the way people um put those things in place in order to be able to do them and like i said adapters will create structures where there aren't any in order to to best serve the needs of the problem at hand and innovators will loosen or disregard them um or alter them in order to facilitate the problem-solving process so great question every problem likely has one or more best solutions but acceptance by other humans often usually require some form of moderation absolutely and i really appreciate that that comment um it it in managing and leading others through that change process that's the part that sometimes takes the most time but gets short changed in thinking through how to make sure that people are on there so one we have to agree that there is a problem to solve we just probably have to agree on the solution that we're going to use and then people have to buy into that solution and so figuring out how to reframe it um in a way that makes that meets that need is really really critical so thank you charles for pointing that out excellent point there's a question do i ever do this lecture as workshops for teams yes actually that's where the bulk of my work lies working with organizations and especially teams i will say when you have the ability to offer the assessment or take the assessment it has the most profound impact inside of intact teams inside of organizational teams because then people can really look at where they are positioned on that continuum and dig deep as far as how best to leverage each other in different situations and then think through implications for that so um pretty much you name the field or you name the group and there's there's an ability to use it and apply it there and are there measurable generational differences coming from a gen x i'm also a gen x so thanks for this question adaptive versus innovative thinking okay i love this thought so interesting when you look at the age stats sometimes people will say that um some people will look at the kind of statistical tables in the manual that supports the theory and they'll say oh it looks like older people are more adaptive they tend to potentially be more conservative in the way that they do things right so they might be less likely to rock a boat where they might have rocked a boat more easily earlier in life or something like that um but interestingly there's not a lot of differences across the generations um because but the behavioral output looks a little bit different but we still have those preferences so um all three of my kids are in their 20s so they're at the upper end of gen z for example but i will say that um from a level ability thankfully they're all awesome scholarship award you know where breakers but at the same time there are huge gaps my two daughters that are 15 months apart in age are almost 70 points apart on the continuum as far as their overall preferences and um it caused a lot of problems until they figured out that that was what the problem was and then they then they started going at things collectively um bringing those different perspectives to the table and and started operating as a team when they were doing different things and it was pretty pretty powerful in that the other place that we don't see differences and some people will ask is across cultures so um speaking of you know looking at data sets from other countries for example um it there again is a pretty um good spread across that bell curve where we will see some sort of shifts or skews internally are among occupations um in different places that are maybe more science and number driven versus um uh you know chartering unknown territory driven or thinking through those different pieces of it too as far as what that looks like so that seems to be where we see the skews but populationally speaking no those generations and cultures hold on the bell okay thank you dr seibel this has been wonderful very informative um i do have a feeling that this slide in particular will become very useful as individuals contact you to perhaps come and help work with their teams um to uh to explore how they might work better together so thank you all for having me and as you um if you're if you've got colleagues that end up watching the video if anyone's got questions or if you all think about this and have questions afterwards please do not hesitate to reach out wonderful thank you so much everybody have a wonderful day and i hope you all get to enjoy uh the outside a little bit today because it is gorgeous enjoy thanks.