Coaching for Success in Medicine: Initiative

Coach Woodenism for the Week: "Stay the course. When thwarted, try again - harder, smarter. Persevere Relentlessly."

In this series, we're applying Coach John Wooden's Pyramid of Success to medical education and leadership. We began by discussing the foundation of Attitude, Effort, Friendship, Loyalty, and Cooperation. The second focuses on the mind, beginning with Self Control, followed by Alertness, and this week Initiative.

Initiative is defined as the ability to begin and follow through energetically with a plan. In the clinical arena, the teacher first demonstrates Initiative by arriving on time, always jumping to help, and staying to finish each day's work. As a coach, we need to expect this same level of professionalism from our trainees. 

Beyond the bedside, we model Initiative by becoming a solution tester, instead of just another whining problem identifier. Is your nurse backed up on discharges? Avoid the fundamental attribution error by asking him why. If he is the only nurse for eight beds for an hour, then provide the discharge paperwork and education yourself. Why are the crash carts a mess? Ask your Resus Nurse. Brainstorm together on solutions and test one for a week. Plan, Do, Study Act. Observe, Orient, Decide, Act. Whatever you call it - Ask Why and then Just Try It.

Back in the classroom, Initiative is likewise imperative to our success. Medical education today needs to be transformed, not simply reformed. Traditional techniques of knowledge acquisition, such as endless powerpoint lectures to sleeping students, or reading a 2000 page text book once during a residency filled with 70 hour work weeks, have never been more ridiculous than in today's dynamic online world. As educators, we need to take the Initiative by effectively integrating social media, the FOAM movement, positive psychology, and technology into curricula that meet the needs and objectives of all our students and patients.

This week, work first on being an example of Initiative for your trainees by demonstrating the ability to start and finish every shift with enthusiasm and effort. When a problem arises, encourage the team to ask why and test a solution. Try out new educational methods such as an In Situ sim cases, or quickly locating online the latest articles and decision aids. Always have the courage to to Fail Forward Fast.

Make it a great week!

Where to Learn More:

Wooden on Leadership: How to Create a Winning Organization, by John Wooden and Steve Jamison

Coach Wooden: The 7 Principles That Shaped His Life and Will Change Yours, by Pat Williams and Jim Denney.