ADEA CCI Liaison Ledger

Fall 2017: Introducing ADEA CCI 2.0 at the ADEA CCI Liaisons Summer Meeting

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As most of you know, in September 2016, ADEA convened a community of stakeholders to relaunch the ADEA Commission on Change and Innovation in Dental Education (ADEA CCI) as ADEA CCI 2.0—a multi-institutional faculty development program. The commission now has an ADEA CCI Steering Committee composed of six dental educators who have been influential in promoting change—within their institutions and across dental education more broadly. 

Several of these individuals joined me in Baltimore this past June for the 2017 ADEA CCI Liaisons Summer Meeting. At that gathering, the Liaisons were tasked with assessing their readiness for change and understanding the change process on a theoretical and practical level. They were sent home with the first of several CCI 2.0 toolkits that are being developed to facilitate change.

We caught up with the Steering Committee members last month to hear their thoughts on the meeting and the work the Liaisons will be doing. This issue of the ADEA CCI Liaison Ledger contains excerpts from those conversations. As you’ll see, over the years, the members of the Steering Committee have gained a number of insights, which can inform all of us while helping to guide the Liaisons in their on-the-ground work to advance the goals of ADEA CCI.
Anthony Palatta, D.D.S., Ed.D., ADEA Chief Learning Officer  

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Ledger: The ADEA CCI Liaisons left the recent meeting in Baltimore primed to engage their campus communities in projects that support institutional change. How will you know that these projects are gaining traction? 

Cindy Amyot: We had a very robust discussion at the summer meeting—all the way from “I’m really freaked out about this,” to “wow!” The Liaisons are going back to their institutions to talk about change in dental education and ask, individually and collectively, do we feel prepared for change? Some folks spoke about broadening the discussion to include all their dental school faculty—beyond the CCI Liaisons and CCI Workgroups—administrators and staff, and I suspect some will be talking with students as well. So, I don’t expect one deliverable, given that everybody’s at a different place and doing different things. We have 76 dental schools in the United States and Canada, and they all bring to the table unique cultures.

Muhammad Walji: I will be looking for engagement. I think, essentially, it’s the faculty members on the ground who are going to make any change viable and happen successfully.

Denise Kassebaum: We’re going to be looking to see that the Liaisons are successfully catalyzing new conversations that haven’t occurred in the past, that they are helping to start new initiatives at their own institutions. This meeting provided great opportunities not only to hear about stories of change from different institutions, but also to talk about what change is and how to become a change agent. Some of the competencies discussed included handling conflict effectively, building new relationships and listening more actively, so I think we have a group that is eager to try these things out.

Nadeem Karimbux: What I like about this new CCI venture is the fact that it’s trying to engage people in creating pedagogies or assessment tools that will lend themselves to some of these changes. I sensed frustration among some dental educators at the meeting because we are constrained by certain external factors—our accreditation standards, our national board exams, our licensure exams—but it’s definitely early on in the process. My sense is that people are starting to get excited about the things they could potentially do. There was definitely that spark in the room.

Frank Licari: Using the existing resources and getting people to rally around an idea—that’s what change is all about. I think that people sometimes find more reasons why they can’t do something instead of trying to find out a lot of reasons why they can do something. They have more power to make a change than they realize. And so, when the Liaisons get stuck, we’d like them to bring those problems to us so we can help them work through them.

Denise Kassebaum: In my own institution, one of the things that I’m working on with the Liaisons and the rest of the faculty is creating what we’re calling an innovation agenda. This process allows us to prioritize change actions and track our progress on initiatives in our different mission areas. 

Nader Nadershahi: It’s always important to bring a diverse group of constituents together early in the conversation around change. It’s also important to define some metrics ahead of time. We could measure increased discussions in our schools about excellence in education, what that means, and how we continue to evolve our curricula. Another approach may be to quantify the number of curricular innovations that are happening, or the number of ADEA meeting presentations related to the conversations that are occurring with the Liaisons. Of course, these would include use of the toolkits that are coming out.
      One other potential metric could be the changes or trends we may start seeing in the survey of dental school seniors—the consumers of this work that the Liaisons and faculty in each of our campuses are putting in. How are the students viewing their education, or are they viewing it any differently from the way previous student cohorts did? 

Ledger: What are your long-term hopes for this initiative?

Denise Kassebaum: ADEA CCI 2.0 is about creating a learning community where we can inform each other’s road to change. While recognizing always that individuals at one institution may have a set of opportunities and resources that someone at another institution may not have, we all can contribute to sharing best practices, influencing each other as part of a learning community and informing the future as we’re moving forward.

Muhammad Walji: I hope that CCI 2.0 will provide a framework for how dental institutions change and innovate. Many of our institutions are very focused on educating the students, which is obviously one of our main missions. But because we have clinics, it’s equally important that we provide great experiences to our patients as well, not just in the clinic, but also in their communities.
      I hope that going through this process and methodology will help move our dental institutions to become more person-centered in the care they deliver, and I believe that if we focus on providing high-quality and high-value care to our patients, we will also create great learning opportunities for our students.

Frank Licari: I think it’s very easy to change when there’s a crisis. I think it’s very hard to change when people think everything is okay. Too often we have really looked only at the status quo, as if dental education operates in a vacuum with nothing else around it. It’s sort of like, the world could change, but dental education really should remain the same. Our hope would be that the schools begin to say, “There are some issues that dentistry needs to start moving on now.”

Cindy Amyot: I think we are painting a pretty compelling picture that shows—whether we choose to engage or even acknowledge it—change is happening all around us, and it’s going to influence what we do. So, as we move forward with CCI 2.0, I hope we are developing the kinds of tools and strategies that will help the liaisons to have more global conversations when they return to their institutions.

Nader Nadershahi:
Ultimately, I hope that we’re creating and evolving an educational system that’s graduating professionals who are going to change the world. They’re going to make our global society healthier, and they’ll be the leaders in making those changes. Whether in policy or the direct care that they provide, or the conversations that they’re involved with, I hope they will be equipped to have that kind of a broader impact on the world.

Ledger: Dr. Kassebaum, What lessons from your experience as a pioneer in interprofessional education can inform the Liaisons’ work to transform dental education?

Denise Kassebaum: My recommendation would be to take an inventory and value the local expertise that you have no matter what institution you’re in. In our case with interprofessional education, we had amazing partners from different professional schools on the campus. If you listen closely to them, you can begin to define shared values and create an excitement and direction that you can move forward on, together. Each of you may start from a different place, but as long as you acknowledge what is unique about your situation while being open to considering changes others are making, you can work together to foster change in dental education.

Ledger: Dr. Nadershahi, What has your experience as a curriculum innovator taught you about overcoming resistance to change, and how might those insights assist the Liaisons in their work?

Nader Nadershahi: The biggest lesson that I learned over the years is that it’s important to be patient. It’s important to know when to press the accelerator, and it’s important to know when an organization needs to coast a little, adapting to changes and integrating new ideas so people are comfortable with those initiatives. If your vision is clear, and you have brought the right folks together to help develop that vision, be patient.

Ledger: Dr. Licari, As someone who has worked as a change agent at both established and recently opened dental schools, what advice do you have for the Liaisons on adapting their approaches to fit diverse institutional environments? 

Frank Licari: I try to first look and say, is this really the right thing to do? Is this the best option that we have? And if it is, then we need to do it, and we need to find ways we can be successful at it. You have to free your mind of all the political issues and other difficulties when you look at change, and start asking yourself a much bigger, broader question as to why you need to change and how that change will result in a positive impact once it is accomplished.

Ledger: Dr. Karimbux, As Editor of the Journal of Dental Education, what role do you envision the publication of ADEA CCI 2.0 resources playing in transforming dental education?

Nadeem Karimbux: ADEA CCI 2.0 will have a broad array of outcomes, so dissemination will occur through many kinds of environments: MedEdPORTAL®, ADEA weTeach®, posters at ADEA meetings and so forth. Research on the validity and reliability of CCI 2.0 tools could appear in the Journal of Dental Education. We might also want to share these tools in some kind of collaborative online environment.

Ledger: Dr. Walji, From your vantage point as an informaticist, what opportunities related to information science can advance the Liaisons’ work?

Muhammad Walji: One of the main opportunities will be to use data to drive decisions about which changes to adopt and how to measure the success of those changes. Dental schools already have a treasure trove of clinical, educational and research data, but we sometimes rely on anecdotes and gut feelings to make important decisions about what changes to adopt or not to adopt. By putting these data together, we can generate new insights.
      In addition, I think it’s possible for institutions to generate new data—to essentially run these micro-experiments to test their various change initiatives so we can learn from these experiments, even if they’re not successful.

Ledger: Dr. Amyot, As a faculty development specialist, what do you want the Liaisons to know about the value of a faculty-driven, grassroots approach to bringing change to dental schools?

Cindy Amyot: Change is not going to happen unless we develop faculty. Whether we’re talking about new technologies, new pedagogical approaches to teaching and learning, new assessment strategies, whatever the case may be. We can’t expect to move change forward in any of these areas without our developing as faculty. 
      So, to me, faculty development is like the big umbrella at the top of all of this. Change is not going to happen unless people are developed first to buy into the idea that change probably needs to occur and then to accept that change will likely disrupt the way we’ve done things up to now. So, the question becomes, how do we gear up and prepare ourselves to be the educators who move us into this new changing environment?

Ledger: Any parting thoughts?

Nadeem Karimbux: Like any new venture, I think there will be some anxiety, fear, trepidation, and I think we will see some schools that are a little more agile in the way they think about change and the way that they potentially embrace change and start to run with it.

Denise Kassebaum: It’s about listening; it’s about collaboration; and it’s about identifying shared directions forward that engage people in change. Adopt a belief that you don’t know what other people know; be willing to listen intently; and be open to creating the changes you want to see. 

Cindy Amyot: Talking about change raises all kinds of different feelings—from anxiety all the way to excitement. Everybody will be returning to the unique context of their dental school, and so having an awareness of that context and trying to understand the best approach to trying to move change…and then not being frustrated if School A isn’t moving as fast as School B because School B may have some unique properties that are allowing it to move in a more expeditious way. We shouldn’t let the context discourage us about what the future holds.

Nader Nadershahi: I’m excited to be part of this group, and more importantly, I’m impressed with our ADEA colleagues. Dental educators tend to be broad-thinking and innovative, and it’s really a privilege to be part of that kind of an organization.

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