The opportunity to learn from a successful leader is worth its weight in gold. This past week, a team of educators with whom I work had a chance to visit a learning space that represents the impact of change agency within a large system.

Dr. Canterbury

After discussing what we would see in new learning spaces, we participated as a team in instructional “rounds” with a key leader in medical education to discuss innovations in the School of Medicine at the University of Virginia. Dr. Randy Canterbury serves as Associate Dean for Medical Education and he’s had direct responsibility for leading significant changes that, in essence, transformed the University’s medical education curriculum, pedagogy, learning resources, assessments, student work, and learning spaces. Teams of medical educators worked with him in designing new foundations for learning that transform the nature of medical education. They used a focus on Scientific Teaching (Jo Handelsman et al.) to inform research-driven decisions to make changes in educational practices and learning spaces. This work happened in a relatively “brief history of time.”

If you would like to learn more about the transformative work that’s occurred, I’ve written about specific changes in the School of Medicine at the Cooperative Catalyst and A Space for Learning.  However, this post reflects upon leadership within the change process and what Dr. Canterbury describes as important for leaders to consider when making changes of significant magnitude in the work that occurs inside an organization.  Here’s his perspective on change agency.

• Be respectful of people. A respectful learning environment is an absolute necessity for success. All people need to respect all people, students, faculty, peer to peer, across the hierarchy.

• Don’t be one who uses the words “I and me” a lot. “We and ours” are much more important because those bring us together. Little things like that become very important when working with colleagues.

• You must have the ability to smile and wave, and continue to push.  Be empathic and listen to people and their concerns. You must listen to naysayers – and in big changes you’ll find plenty of them. Validate their concerns without being steered off course.

• Begin with Steven Covey’s “end in mind” and decide where you’re going and continue along that path. If you have moves from side to side in direction it should be because there’s a reason to move that way.

• You’ll find hundreds of research studies on change process. There seems to be two types of change when it comes to ways you can change a big system.  One is a gradual and transitional change in which you move things a little bit at a time and eventually you can get there, but it’s asymptotic.  This doesn’t work so well in large systems. The other is a disruptive or transformational change that occurs with agility. When faced with the need to make radical changes, moving quickly gets ahead of resisters.

• When you tear everything down you will get resistance from people whose work has occurred in the same way for decades or even a hundred years. This kind of change is distressing to people.  People needed to hear “we really do need you. We need your expertise, but we’re reconfiguring and we want you to play with us, be a part of the team, and help us do this.”

• Leadership support for change is essential “from the top.” Responsibility “from the top” also is critical. That means if a key team member doesn’t make the needed transition, the leader owns that. At the same time, the message must be that nobody is important enough to stop the team from making changes they need to make.  Have backup systems for how you will get the work done. No one can hold you hostage then.

• Tear down silos and get people working in teams. But, remember silos love to form. It’s amazing to see one of those things sitting out in a field someplace. You think that must have taken a lot of work to build those silos, but then they just drop out of the sky and there they are. You have to keep fighting against silos getting built.

Dr. Canterbury illustrates qualities of natural leadership in the work he has led to transform the last 100 years of medical education into 21^st century learning to “create physicians who serve patients well.” He realizes that change occurs best when a leader can relate with and to people he or she serves.

Natural leaders create compelling stories of why change is critical and those stories weave together observations, study, discussion, and data.  Stories become a teaching tool that pulls people into the process of determining why change is needed, what’s possible, and how the community will work together to make changes together.

Natural leaders such as Dr. Canterbury engage community members in the change process by working across the hierarchy to gain people’s investment in the change, ensuring those in both positions of formal and informal leadership help facilitate the process.  They care for community members throughout the change process, even those who resist change.  Key to their success, natural leaders do not give up in the face of resistance, but rather work to ensure that resisters can’t hold the community “hostage” by creating barriers to change.

Learning Studio

In the School of Medicine, innovations didn’t occur as a result of a drawn out series of plans for incremental change. Rather, leaders used information to create dissonance about success of past practices that had been educational program traditions since Abraham Flexner brought structure to medical education.  From this, the decision emerged to create disruptive innovation, literally and figuratively tearing down medical school walls. The success of these changes resulted from Dr. Canterbury’s work across the hierarchy to build ownership for the needed changes.

Natural leadership skills trump those of the scientific manager when it comes to leading for transformative change. Natural leadership skills predate the shift to scientific management advanced by Tyler in manufacturing and Cubberley in education.

There’s a place for elements of scientific management in the work we accomplish as leaders.  However, I’ve come to believe that we need to learn from natural leaders and use what we learn to create a new curriculum of leadership that draws upon the knowledge and skills of those who lead naturally.

Dr. Canterbury attributes the medical school’s story of change to the power of a team of “we.” That’s an essential quality of natural leadership.