In early November 2011, I attended the American Association of Medical Colleges’(AAMC) Annual Meeting in Denver, Colorado as a part of a yearlong fellowship program with the Association of Academic Health Sciences Libraries (AAHSL). The fellowship program is jointly sponsored by the US National Library of Medicine and the AASHL to prepare emerging leaders for the position of library director in academic health sciences libraries. This was the first opportunity for the 2012 cohort to meet one another and our respective mentors. While I’ve attended and presented at multiple national conferences, my attendance at the AAMC was very different in that the content focus was outside of my discipline and I attended the meeting as a simple attendee not a presenter. From this perspective, I was able to absorb meeting content without having to focus on preparing for a presentation.
Now that I’ve had the opportunity to reflect, absorb, and process the information that I learned during the meeting, one of the common themes in several of the presentations that I attended dealt with issues related to organizational culture. It was apparent that issues relating to organizational culture are playing a significant role in medical education and health sciences libraries alike. At the meeting, medical educators and librarians alike were engaging in deep conversations about the anticipated challenges in the next few years. From my perspective, many of these challenges center around organizational changes brought on by the declining budgets and shifting priorities. This idea makes total sense to me as I can see it happening in my own discipline. You see, I’m just like many people in that I sometimes have a self-centered view of the world. At work my primary focus, lately, has been assessing the impact organizational culture has in my environment and developing strategies to work-around and through any resulting issues that arise because of culture. So I don’t often think about how the same issues that I deal with daily affect workflow in disciplines and areas such as medicine and medical education. So attending AAMC gave me the opportunity to hear presentations about culture and climate change in medical education. What I learned at the meeting is that health care reform and dwindling budgets are affecting health care tremendously. I also attended several presentations that talked about shifts in medicine due to healthcare reforms. The impact of healthcare reform is that it will change how medicine is practiced and taught in the future. Medical educators are grappling with this issue in the classroom and the clinics. I imagine that this is a huge organizational shift for physicians and medical educators.
Another presentation that I attended spoke volumes about organizational changes and environmental shifts affecting health sciences libraries. This presentation discussed the evolving relationship between health sciences library directors and university library deans. To understand the nature of these relationships one must understand how health sciences libraries work in the grand scheme of an academic medical center. While every health sciences library is unique in its own way due to institutional constraints, service offerings, and collection scopes, many of health sciences libraries bare similarities when it comes to reporting structures within a given university. From an organizational standpoint, most health sciences libraries report to the School of Medicine or the VP of health Sciences. In addition, while several are part of a larger university library system they still operate as autonomous entities with their own budgets, collections, staff, and resources. This is very different from how we operate at my current library. Our structure supports one system with multiple libraries. We have one consolidated budget, library catalog, website, and technical services. Even though we sometimes wish we had complete autonomy to make our own decisions, the organizational structure works there are huge financial savings by operating in this fashion. We often joke about succeeding from the Union even though we know that this will never likely happen. This structure has its advantages and disadvantages. My library has operated in this fashion sense the 80’s while several health sciences libraries in the Mid-Atlantic region are moving towards this structure. Major reasons for the change were leadership changes at the university level, library administrator change, and financial/cost savings, consolidating campus units, and consolidation of services. Some of the issues that resulted from these changes were budget and finances, communication, recognition of priorities, lack of understanding, no recognition of differences, and concern over visibility. These things are indeed significant organizational changes. The problem with migrating to this organizational structure after having full autonomy is that it will require a complete change in practice. For instance, final decisions at a library with full autonomy are made by the director who understands the external pressures and organizational priorities of the health sciences campus. This process will change dramatically if the director now has to consult with another entity before a decision is made.
At the meeting, I also attended a presentation by from the Khan Academy by Salman Khan. The Khan Academy is a not-for-profit educational organization. The Khan Academy is a fascinating organization because it makes these amazing educational resources available to the world free of charge. The Academy offers over 2,700 videos covering topics from arithmetic to physics, finance, and history and 253 practice exercises to help people learn about a variety of topics in a self-paced environment. One of the most fascinating aspects of his presentation was the demonstration of the Academy’s Map of Knowledge that shows all of the concepts for each of the educational exercises that they have created. The map that he showed was way more extensive and complex than what we created in class but I got the point after watching his demonstration. The basic purpose of a concept map is to learn a concept.
You made an interesting declaration when you referenced having a self-centered view of the world. Don’t we all, and isn’t this part of what Schein discusses truth and reality in chapter seven?
It seems like budget reductions are always on the forefront of an organization’s list of issues, whether they are inside or outside of the private sector. Perhaps budget reductions influence culture as it introduces an element of fear. It may contribute to a “scarcity mentality” in that resources are limited and may even be running out. I would expect to see behaviors that include people competing for power over resources, distrusting others on how resources are being used (wisely, selfishly, or foolishly), and fear that cutting costs equates to cutting jobs. I do not see this sort of fear creating unity within a culture. I can see is causing a survivalist mentality.
Cost cutting or budget reductions may also bring a sense of frustration into an organization’s culture. Take medical research for example. How frustrating it must be when trying to pursue new medical treatment breakthroughs or researching possible cures, only to have such work put on hold while fighting for the money to continue the work. This would most likely have a demoralizing effect on the members within the organization, and from there filter in such emotions into the truth versus reality dynamics of the culture.
By: Steve Tyler (@rstyler12) on December 11, 2011
at 8:24 pm
Yes, that’s exactly what Schein meant. I agree with you. Budget reductions certainly influence culture. At least it does in my environment. In my environment, we are in the business of spending money while generating very little if any revenue at all. So the budget is always on the forefront of our discussions. In the past we’ve not been funded at optimal levels which resulted in us operating in scarcity mentality”. We I first started my job over 8 years ago the scarcity mentality was prevalent in all our discussions. I’m glad we’ve moved away from this line of thinking. For years, the staff would rise to the occasion and just did more with less but those days are gone. We had to move away from doing more with less because it sends a bad sign to the people who hold the purse strings. If we are able to sustain services with less the assumption is that we didn’t need the more to begin with. Fortunately, budget discussions don’t strike fear amongst my coworkers. While we’ve been faced with making hard decisions about drawing back some of our service offerings we haven’t had to face layoffs. One of the things that I am happy about is that my senior leadership has made a commitment to sustain people over resources. We would not be able to sustain business operations without the people.
By: shdejones1 on December 12, 2011
at 1:20 pm
I really like this post, Shannon, and your conference experience sounds fascinating. I would like some more info on your presenter from the Kahn Academy. Is he an educator (as in PhD or EdD?) focused on adult learning? This sounds like one of the growing resources of open educational content on the Web and I’d like to know more about the quality of the content, how they produce it, who they are affiliated with, etc. if you know any more about this gentleman, please do let me know, or if you have his contact info, I would be most interested in it.
I’ve been to a medical education conference before, too, and they are fascinating. I’m glad to hear that so many folks were wrestling with the cultural issues that are currently affecting needed changes in how we train the next generation of doctors. These issues loom large in our own context within this University.
You’ve done a beautiful job capturing your “memorable moments” in our organizational learning class and in making your thinking visible so we can learn from your meta-analysis. The Army’s AAR was a great class presentation of a true learning organization, and your final paper exploring in-depth the cultural components of TML has been fascinating to read. Thank you for the excellent ideas that you contribute to your fellow students’ learning. tjc
By: tjcarter on December 19, 2011
at 1:05 pm