Educating health professional heroes of the future: the challenge for nursing.

WHETHER THE TOPIC is evidence-based care, patient safety, continuous quality improvement, or the drivers of future change described earlier in this issue by Dr. Stefl, our ability to "cross the chasm" from the present healthcare system to a preferred future is limited if our prevailing strategy is to do more of the same with fewer resources. But when and how will the learning occur to stimulate a different response? In the education of healthcare professionals, the primary focus is the transmission of disciplinary knowledge. In healthcare practice, we function in disciplinary teams, knowing and caring little about the work of other professionals who provide services to patients (except, of course, when their work impedes our own efficiency or quality of work life). As a result, healthcare professionals are ill-equipped to provide leadership for the new health system and quality agenda described by Detmer (2001) and the Institute of Medicine (ioM) Quality Chasm (2001) report. During the 7th Annual Summer Symposium, "Building Knowledge for the Leadership of Improvement of Health Care," at Dartmouth led by Paul Batalden (July 2000), participants challenged each other to consider how health professions education might need to change to better prepare healthcare professionals for the future. Participants began by sharing stories of heroes in nursing, medicine, and healthcare administration during two periods: 1850 to 1950 and 1950 to 2000. We worked first in single discipline groups to answer the questions: What values were important to the professionals in your discipline during this time period? What behaviors were needed to perform the daily work with the values stated above? What key aspects of professional preparation were needed to achieve the work, values, and behaviors? Members of each discipline discussed the characteristics of heroes in each time period and how they related, if at all, to the values, behaviors, and methods of professional preparation of the period. We then formed multidisciplinary groups, presented our summaries to each other, and looked for themes across professions. During other parts of the symposium, we learned about the projected effects of genomics, robotics, and nanotechnology on the future of the health professions and spent time imagining what would be required of the health professional hero of the future. The results of the group exercises were enlightening. The characteristics of heroes across disciplines were more alike than different. Furthermore, the characteristics of heroes of the past, present, and future were similar as well. Abilities possessed by heroes across disciplines and time periods included: Ability to identify the human elements of need and keep that vision central to any enterprise Ability to use information for learning, as an individual and within systems Ability to function as a member or leader of an effective team * Ability to create and be part of a learning community Ability to sustain a commitment to service, always demonstrating a moral and ethical compass Ability to listen, communicate, and manage conflict These abilities often made the difference between people referred to as heroes, and other professionals who may have had an equal or greater mastery of traditional disciplinary knowledge. If the above behaviors have been associated with professional heroes in the past and present, and we need heroes in healthcare today, then the question is: What ought we to be doing within our professions to induce learning about these behaviors? The nurses at the symposium (to whom I am indebted for the development of the basic ideas but who are not accountable for the examples elaborated below), wrestled with the question: What would it take in nursing to better educate health professional heroes for the future? The following ideas emerged. INCREASE THE AVAILABILITY OF CLINICAL ROLE MODELS Learners are most likely to develop the values and behaviors they see demonstrated in the context of clinical practice. …