Impact at the core receives both solicited and unsolicited council from its own advisory board. In this series, we will discuss impact-driven education with the members, starting with Anne Marie Weggelaar-Jansen. After having worked as a nurse herself for years, she now works as an assistant professor at the faculty of ESHPM. “For traditional research you observe the anthill from a distance. I prefer sitting in the middle of it.”
Can you tell us a little more about yourself and your education?
“Next to my life at EUR, I work as an independent advisor. This means that I am active in the sector that I myself am researching. That way, I stay up to date as concerns the questions from the field, which in turn helps me to ask the right research questions and to use the right examples in my education.”
“I am responsible for two master courses within ESHPM, both of which are truly practice-oriented. The first one is the internship, an elective in which students can gain practical knowledge by working with health care and policy managers. To gain such experience early in the master’s program helps them to see the theory from the lectures in perspective, and to have substantive discussions in their working groups. The other course is Health Service Innovation, a course with students from various master studies. Here they come up with innovations, based on real-life issues and by using theories from their curricula.”
Why is impact-driven education so important for the EUR?
“We’re a university of thinkers and doers, and this is a big part of the ‘doing’! Let me give you an example: a few months ago, I got a call from a former student who now works as a manager in a university hospital. She had a big and complex problem to deal with and asked if I wanted to think along. When I asked her what she had already tried in her attempt to solve it, it turned out that she had chosen an approach of which we already know it doesn’t work; extensively discussed in various publications. When I asked her why she had approached it that way, it turned out she had never really consulted any scientific articles since university. Students do not, as a natural reflex, use all the available scientific knowledge to see what the options are for solving their problem.”
“In my courses I try to think about how I can help people to learn the skills to think about such problems, about the questions behind the questions, about the dynamics that perpetuate the issue. The knowledge we offer in universities has a half-life of, let’s say, five years. After that time, science has moved on - especially in the field of health care, where enormous amounts of articles are published. If knowledge evolves that quickly, this means I must teach my students the skills to find, understand, synthesize and apply knowledge themselves; to do something with that knowledge so that it can be used in practice.”
In what way have students from ESHPM already made an impact?
“Last year we had an interesting question from a hospital: how they could make waiting time - which of course is common in hospitals - worthwhile. What can you do with the time that people are waiting? Nothing is likely to come out if you put students at a table with glue and some cardboard. But different things happen when you say: go sit in a hospital, go talk to the people there, ask them why they have to wait.”
“The easy solution would be to come up with ways to make waiting fun; there should be a TV, there should be toys and nice magazines. So you’re basically pimping a waiting room. But if you’re going to do demand-oriented research, you’ll start understanding the system that perpetuates the waiting in the first place. One of my groups did this very methodically, and saw that people are often not well prepared for their conversation with the doctor. As a result, the consult takes too long and the doctor’s next appointment is delayed. Consequently, people have to wait. The students thought about how they could prevent people from walking into their doctor’s appointment unprepared. What if you start seeing waiting time as ‘doing time’? That’s a completely different mindset!"
"They created a concept in which the consult starts immediately upon entering the hospital. This eliminates all waiting time; patients are filling in their own anamnesis before even seeing a doctor. Impact learning is about learning to recognize the question behind the question, to come up with creative new things and thus contributing to solutions that this hospital can work with. That is how we make an impact in society.”
What are the basic requirements for impact learning at a university?
“I did some research on that for Health Service Innovation. I spoke with healthcare directors and innovation managers about the most important skills you should have in such a position. I took this as a basis for the skills our students have to practice with: working together as a team, merging different perspectives, testing, and not being seduced into thinking that you understand something too easily. Furthermore, students should be able to network and have the guts to ask a question. Things like that.”
And what would you say is the role of the teacher in the cooperation between students and external parties?
“Facilitator; you look at what students need and how you can support them. That role requires me to do the same things I ask them to do: to keep engaging in conversation and to search for the question behind the question. I had a lot to learn in the beginning, and even this year I did something I deemed impossible in earlier years. Normally, I collected the problems of our ‘problem owners’ myself and turned them into a text for my students. I didn’t want my students to speak to the partners directly because I was afraid they would be steered into a certain direction. But now that, due to corona, students are all over the world and it has become more difficult to do practical research, I thought: after three weeks I’m going to give them an opportunity to speak with their problem owners and ask questions. It went really well! The students were well prepared, asked good questions and received useful feedback. So, here too, it could be that limitations are only a product of your own thinking.”
And if we look at a physical or logistic basis for impact learning?
“I would love for students to have access to a fab lab – manufacturing laboratory. Almost all hbo’s (higher vocational education, red.) have such a space. They contain 3D printers, laser cutters and all other kinds of material to actually make what you have come up with. Within EUR we don’t have access to anything like that yet. That’s a loss, because practical challenges that can be useful for the development of our students cannot be fitted into our curricula as a result. Two years ago, I spent some time looking into the possibility of working together with a minor course in Medicine, and with the Delft University of Technology, where they have courses similar to Health Service Innovation. Students from Delft could bring important knowledge of how things can be constructed. Currently, we are mainly working on issues concerning concept development, while I think we should also have more ‘crafty’ challenges to offer.
Where is the boundary of things we shouldn't want?
“We should not think that the contribution we make to society merely concerns knowledge. For me, it is important that we think about the skills our students need to be able to make an impact. Years ago, an accreditation committee ruled that the master’s in Health Care Management had become too much of a vocational institute; not academic enough. ‘Academic’ in that sense would mean that we study the behavior of managers and train people to be scientists. Of course, we always train some students for a career in science, but most of them end up working in the field, becoming health care managers and policy officers at health care institutions. At the time, I couldn’t wrap my head around the judgment of that committee. It led to the disappearance of just about everything skill-related from the curriculum.”
“Making an impact requires people to develop skills to work together, to search for and connect literature, to negotiate and to lead meetings. All these things are super important if you are working at an academic level, but they are being put aside. It would be like educating law students without teaching them how to plea. To train doctors by telling them everything about the human body, but nothing about how to communicate with patients or how to handle a bad news conversation.”
Lastly, what do you hope your role will be in the Impact at the Core advisory board?
“I would like to focus more on a continuous learning path. We always concern ourselves with bachelors and masters but, if you look at it from a distance, there’s also the PhD, university lecturer and the associate professor. What can we offer the latter in terms of impact learning? I could see bachelor’s and master’s students being involved in research carried out by scientific staff; they could take on data collection or do certain research tasks. The strength of my education lies - I think - in the fact that I always have hundreds of examples from the field, stemming from my work as advisor and interim manager. PhD’s have that as well, and it makes the process of learning so much more tangible.”
More about Impact at the Core
EUR aims to make a positive societal impact with its education. With that ambition in mind, we are building courses and programmes where students can work on the wicked problems of our time, alongside professionals from the field and fellow students from other disciplines. In surveys, students have stressed that they expect us to teach them the skills necessary to deal with contemporary societal challenges, in order to prepare them to find a fitting job in a field they are passionate about. Impact at the Core is a programme set up to fund, support and co-develop initiatives for education that revolves around the meaningful, tangible effect that we induce.
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