In addition to the In Beta podcast that I host with Ben Ellis (@bendotellis), I’m also involved with a podcast series on health professions education with the South African Association of Health Educators (SAAHE). I’ve just published a conversation with Vanessa Burch, one of the leading South African scholars in this area.
You can listen to this conversation (and earlier ones) by searching for “SAAHE” in your podcast app, subscribing and then downloading the episode. Alternatively, listen online at http://saahe.org.za/2019/06/8-building-a-career-in-hpe-with-vanessa-burch/.
In this wide-ranging conversation, Vanessa and I discuss her 25 years in health professions education and research. We look at the changes that have taken place in the domain over the past 5-10 years and how this has impacted the opportunities available for South African health professions educators in the early stages of their careers. We talk about developing the confidence to approach people you may want to work with, from the days when you had to be physically present at a conference workshop, to explore novel ways to connect with colleagues in a networked world. We discuss Vanessa’s role in establishing the Southern African FAIMER Regional Institute (SAFRI), as well as the African Journal of Health Professions Education (AJHPE) and what we might consider when presented with opportunities to drive change in the profession.
Vanessa has a National Excellence in Teaching and Learning Award from the Council of Higher Education and the Higher Education Learning and Teaching Association of South Africa (HELTASA), and holds a Teaching at University (TAU) fellowship from the Council for Higher Education of South Africa. She is a Deputy Editor at the journal Medical Education, and Associate Editor of Advances in Health Sciences Education. Vanessa was Professor and Chair of Clinical Medicine at the University of Cape Town from 2008-2018in health and is currently Honorary Professor of Medicine at UCT. She works as an educational consultant to the Colleges of Medicine of South Africa.
There are standards that professionalise teaching and standards that simply manage teachers. While standards which professionalise create cultures of collegiality, expertise and pride among teachers, standards that manage can leave them feeling brow-beaten, untrusted, and demotivated.Robinson, N. (2019). Why South Africa will find it hard to break free from its vicious teaching cycle. The Conversation.
While the article refers specifically to the primary and secondary teaching context in South Africa, the principles are relevant for a wide range of international higher education and professional contexts as well. The article differentiates between two types of standardisation; professionalisation and management.
Standards that aim to professionalise an activity invariably lead to virtuous cycles. From the article “…teaching [in Finland] is a prestigious and attractive profession which recruits the brightest and most motivated school graduates, who don’t require continual monitoring and oversight. Teachers instead enjoy professional autonomy; they are trusted in key decisions about their teaching and professional development.” You can easily see how this applies to any other profession as well when professionalisation standards are being applied i.e. the standards open up spaces and encourage autonomy as part of trusting relationships.
In contrast, management standards (especially when presented under the pretext of developing professionalism), can lead to vicious cycles. In these situations “…governments take it upon themselves to hold teachers accountable. Standards are used to manage teachers, and to protect students from the worst educators through supervisory surveillance and control. Invariably, the relationship between teacher unions and governments becomes antagonistic and generates feelings of fear and mistrust.” You can see how this could play out in the context of professional organisations tasked with developing cultures of professionalism. Instead of opening up spaces by trusting and supporting people who can make their own choices, organisations may use management standards that aim to close down space and control the people within them.
We need to ask if the standards we’re being asked to meet are aimed at developing cultures of professionalism, or whether they’re simply being used to manage us. One way of determining which standards are being used in your context is to ask how much autonomy you have to make decisions about the work you do.
I just finished a meeting where I realised that the incentives provided for academics are all wrong (if you assume that having an effective department is a goal). If we want departments to be excellent (however you define excellence) we must accept that they can only get to that point if the staff work together as a team. However, academics are not incentivised to work as a team within those departments unless they happen to all be working on the same research project. While it’s true that academics are expected to work on larger projects in larger teams as they progress through the system, those projects and teams are typically not within the same department, or even institution.
The reason for this is that we have to keep expanding our sphere of influence, looking to work with colleagues from other institutions and then in other countries. As I grow as an academic all of the reward structures direct me to look for collaborative opportunities outside of my home department. If I ever actually manage to develop a high performing, excellent team in my own department, there is no way for me to be rewarded or even recognised in any meaningful way for that. OK, maybe I can tick the “Administration” box with a really big tick but there’s no way it’s going to give me an edge over someone else who is working on an international collaboration. All things being equal, “internationally recognised researcher” trumps “has developed a culture of excellence in home department”. And yet, many of the problems we experience in higher education can be traced back to poor / weak learning cultures within departments.
The more I see myself and my colleagues progress in our academic careers (through promotions and attaining higher degrees), the more I see the institution pressurising us to look beyond our own departments. This has implications in that we have fewer people committing to the responsibilities that are necessary for departments and faculties to run effectively. We need to coerce (sorry, encourage) each other to accept seats on committees because the time we spend on committees is time that we’re not working on a collaborative proposal. And even though the criteria for promotion does include wording to the effect of “Participates actively in faculty committees“, I doubt that my lack of engagement on those committees is going to impact my promotion, when I’m working on international projects and publishing fairly regularly.
I worry that the pressure from the institution on “senior” academics to increase their sphere of influence is going to have the following (unintentional) side effects on departments:
- A reduced emphasis on the success of individual departments (because individual academics are rewarded on the basis of their collaboration outside their departments)
- A lack of attention being paid to the undergraduate curriculum (because postgraduate throughput leads to income generation and publication)
- Fewer staff willing to participate in department and faculty committees (because it takes time away from what really matters i.e. research)
- Allocation of first year modules to staff with the least experience, when the reality is that our best teachers should focus their attention on the newest cohorts. But in fact, we are seeing a withdrawal of experienced staff from the undergraduate curriculum entirely (because experienced staff can’t afford to devote time to a process that won’t advance their careers i.e. undergraduate teaching)
- Departmental processes gradually dissolving until the department limps along, with everyone doing the minimum necessary to avoid completely closing down (because “being part of an excellent department” doesn’t fit anywhere on my CV)
I’m sure that there are more but this is how far I’ve gotten in the time I allocated for this post. I don’t know what the answer is. We want our staff to progress in their careers but that progression comes with pressure – through the institutional incentives – to spend less time on ensuring that the department functions as a high performing team. In reality, departments just need to get by because as long as the wheels keep turning and the department doesn’t actually fall apart, there is no incentive on academics to build the internal relationships that allow for excellent teams to develop.
“And every day you must decide whether to put your contribution out there, or keep it to yourself to avoid upsetting anyone, and get through another day. You are right to be cautious. Prudence is a virtue. You disturb people when you take unpopular initiatives in your community, put provocative new ideas on the table in your organization, question the gap between colleagues’ values and behavior, or ask friends and relatives to face up to tough realities. You risk people’s ire and make yourself vulnerable. Exercising leadership can get you into a lot of trouble. To lead is to live dangerously because when leadership counts, when you lead people through difficult change, you challenge what people hold dear—their daily habits, tools, loyalties, and ways of thinking—with nothing more to offer perhaps than a possibility. Moreover, leadership often means exceeding the authority you are given to tackle the challenge at hand. People push back when you disturb the personal and institutional equilibrium they know. And people resist in all kinds of creative and unexpected ways that can get you taken out of the game: pushed aside, undermined, or eliminated. It is no wonder that when the myriad opportunities to exercise leadership call, you often hesitate. Anyone who has stepped out on the line, leading part or all of an organization, a community, or a family, knows the personal and professional vulnerabilities. However gentle your style, however careful your strategy, however sure you may be that you are on the right track, leading is risky business.”
Ronald Heifetz & Marty Linsky: Leadership on the Line: Staying Alive Through the Dangers of Leading
I found the excerpt above on Gardner Campbell’s blog.