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Saturday, August 18, 2018

Professional Development for the Whole Team

by Karla Washington (@comokarwash)

I entered graduate social work education in 1998. St. Louis Cardinals first baseman Mark McGwire broke the single-season home run record that year. Hearings were held regarding the impeachment of President Bill Clinton, and CĂ©line Dion released a duet with R. Kelly, forming a collaboration that probably sounds preposterous to most people younger than 25. On the technology front, social media as we know it today was years away (Mark Zuckerberg was only 14). Google itself was less than a year old. Its corporate headquarters were in a garage.

Fast forward to 2018. I used Google to obtain 100% of the facts I presented in the paragraph above; the search engine is now so ubiquitous that the term itself is used as a verb. And just this morning, I read a Twitter update supposedly posted by a celebrity cat. Professionally, in my work as a palliative care researcher, I recently completed a pilot study of a problem-solving intervention delivered entirely via technology, and I’m developing a mHealth (mobile health) tool to support rural family caregivers of hospice patients with cancer.

I asked you to join me in that walk down memory lane to make the following point: Like me, virtually everyone on every healthcare team in every health system everywhere needs continuing education. On my first day of graduate school, Google did not exist. This afternoon, I’ll be reviewing data analytics from a Facebook support group for family caregivers of people with advanced cancer. And unless it’s possible to win the lottery without actually playing, I’ll be working for at least 20 more years. I need periodic tune-ups, and so do your colleagues from all disciplines and professions represented on palliative care teams.

Below I’ve provided a few questions to consider when thinking about the professional development needs of palliative care professionals. Because I’m trained as a social worker, many of the examples I provide are discipline-specific, but the underlying concepts are more broadly applicable. If you’re in a leadership position on your team, I encourage you to give the questions below some thought. If you’re not, feel free to use this list to facilitate a conversation with those who are.

Which individuals on your team have access to professional development opportunities?

I learned long ago that worrying too much about who is getting paid what, who gets credit for what, and who is getting free lunch is a recipe for resentment, burnout, and bad patient care. At the same time, consider the message leaders send when they allocate virtually zero resources for some employees’ professional development while sending their colleagues to week-long conferences in some of the most expensive cities on the planet. There will likely always be inequities in how resources are allocated, but there may be ways that existing resources could be reallocated (or additional resources identified) to improve access to professional development for members of the team who tend to be less tangibly supported in their growth. In graduate school in the 1990’s, I learned that grief occurred in five predictable stages and that stressed out caregivers should punch pillows to relax. We now know that grief is much messier than previously thought, and research has shown that it’s a fairly terrible idea for people to rehearse violence when they are angry or frustrated. I’m sure pharmacists, chaplains, nutritionists, and others would be able to weigh in with examples of how the knowledge that informs their practice has expanded and evolved since their formal education. Patients and families receive better care from well-trained teams. We need to support all team members in access to professional development.

What are the continuing education requirements of the members of your palliative care team? How can you help?

In Missouri, where I work, it’s expensive to get licensed as a clinical social worker. I won’t bore you with the details, but the cost for someone starting out with no financial support from their employer is at least $5,000, which is a very low estimate if they pay out-of-pocket for weekly meetings with a qualified supervisor. That’s a lot. The good news is there are tons of ways to support these new professionals. Is someone on the team already licensed? (Possibly.) Can that person get trained and credentialed to provide supervision as an employment benefit for licensure candidates? (Pretty easily.) Would leadership allow them to receive licensure supervision during regular working hours? (Lots of leaders do.) Can training approved for continuing medical or nursing education also be approved for social work contact hours? (This is probably easier than you think.) The list goes on. I’m sure there are similar lists for other professionals on the team or for social workers in later stages of their careers. Palliative care professionals tend to be great problem solvers. Get them involved in brainstorming low-cost ways to support their acquisition of new knowledge, skills, and credentials.

Can you more meaningfully engage team members in shaping their own professional development?

I love conferences. I go early and/or stay late. I find conferences intellectually stimulating and return from them energized with lots of new ideas. Some people prefer to get their professional development needs met with less face-to-face socialization involved. They might prefer online trainings or access to books or journals. There are sometimes valid reasons to nudge team members toward an educational experience others know to be excellent, but often a more effective strategy is to engage team members in crafting their own professional development plan. This very importantly includes planning the logistics of how their plan will be executed. If you attend a conference, there’s a good chance you’ll need to stay in a hotel. Do I have colleagues I’d be happy to share a hotel room with? Sure. Bodies do weird things in the middle of the night, and we all look different when we first wake up, but I can name a dozen people I’d be willing to navigate that with. Is that true of everyone? Absolutely not. And the list of colleagues I’d even consider sharing a bed with is in the low single digits. I’m guessing most people would just pass on that entirely. We can’t always know what people will want, and we should avoid making blanket policies when it’s not necessary to do so. It’s probably an all-around better idea to just be transparent about available resources and let people make decisions like the professionals they are. And if they have to miss work for a professional growth opportunity – no matter how terrible it actually was while they were gone – they should not have to endure a guilt trip upon their return.

If our friend Google can be trusted, someone named Harvey S. Firestone once wrote, “The growth and development of people is the highest calling of leadership.” Even if that’s not a real person, that’s still a great quote. I am fully convinced that professional development is a vital ingredient in high-quality palliative care, and I’m so grateful to get to be a part of this vibrant, innovative, and growth-minded community. To thank you for reading this post to the very end, I looked up Harvey S. Firestone. He founded the Firestone Tire and Rubber Company in 1900. He is also the author of Men and Rubber: The Story of Business, which I hope we can all agree is a horrible name for a book, even if it is focused on professional growth.

Karla Washington, PhD, LCSW is an Assistant Professor of Family and Community Medicine at the University of Missouri where she researches interventions to support patients and families receiving hospice and palliative care. When not working or spending time with family and friends, Karla enjoys several British television shows including The IT Crowd (her all-time favorite) and, more recently, The Great British Baking Show (or, as they refer to it across the pond, The Great British Bake Off).

Photo composite created by Christian Sinclair and includes photos from Jonas Jacobsson and Tyler Callahan on Unsplash

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