Have any of you ever had faith, as I have, that just hearing about a compelling new evidence-based practice would be enough to motivate practice change among clinicians and behavior change among patients? I used to believe that if I just told clinicians about new evidence-based practices, I could inspire them to adopt them. I became very good at thinking up new and creative ways to tell clinicians about these new best practices: imprints on pens, posters hanging from the agency ceilings, and even custom-made fortune cookies with “best practice” messages inside. But practice still didn’t change! New best practice recommendations seemed to stay on a metaphorical shelf (or in an actual cookie), gathering dust.
That was until I recognized how top down my approach to clinical practice change was. When telling clinicians or patients about a new practice, I was expecting them to be passive, grateful recipients of compelling new information. Who wouldn’t resent that!?! My excitement (and possibly, my arrogance and maternalism) prevented me from engaging them in learning, and, therefore, from putting the new idea into practice. Oh, this was tough to admit!
Yes, I am an expert with lots of knowledge to share. But clinicians and patients are experts too. We all have a different realm of expertise about care. My work has been so much more effective since I recognized this. I learned to stop telling, and start asking questions that engage others in problem solving and the application of new skills. Most importantly, I learned to really listen to how others work through the problem and apply the evidence, so we can identify goals and learning needs together.
I now believe that whenever I use a clinical coaching approach with clinicians (asking more, talking less, really listening, and being supportive as they integrate new skills into their practices), I am also demonstrating a coaching approach that clinicians can use with their patients. Their patient teaching becomes less prescriptive, and more collaborative and coach-like.
The techniques covered in CHAMP’s new course Techniques for Improved Clinical Coaching will help you develop, refine, and practice new skills for motivating clinical practice change among clinicians and patients. Adopting these skills requires behavior change from you, so I’d suggest working on one technique at a time. Also, don’t be shy about asking a trusted peer for honest feedback. It may be hard to hear, but it can help you become a more effective manager, educator, clinician, and communicator!
Adele Pike
Director, Center of Excellence & Education
Visiting Nurse Association of Boston & Affiliates
