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In entry #7, I argued:

There is no ethical way a faculty member can ignore the Baldrige phenomenon.  Just as medicine, economics, and public health must teach the latest documented evidence, AUPHA members must teach the Baldrige model. … Our graduates need to be able to apply the model, and to analyze operations to identify how they depart from the model, and how to fix them. It will not be ethical to do otherwise.

Bold words, but I’ll stick by them.  If your program does not produce graduates who have those skills, it’s failing. The Baldrige model is the only documented path. If you know of another, you should publish immediately.

Bold words, but can we? Do we know how to teach Baldrige?

The winners teach the model every day.  Every first line supervisor and clinical leader in every Baldrige-winning HCO understands the model. Many learned it as they made the “journey” http://www.nist.gov/baldrige/. Others were taught it, as new hires, or new transfers in acquired organizations. It’s “just-in-time” learning; a lot of it by example, coaching, and repetition. Not easy to replicate in the classroom.  

The classroom –for which students pay dearly—must either provide more—promotable skills, or a more universal understanding. It must teach skills, not “What is the model?”, but “How do you apply the model?” Here is a possible path. Assume a 3 credit course—45 contact hours and 135 total student time. The students should acquire the most recent winners’ application (free) and the Health Care Framework ($10).

We will divide the applications into 45 sub-sections, one 90 minute class per sub-section, meeting the usual 3 credit contact hour standard. I suggest starting with the Organizational Profile, then do Section 7-Results, and proceed through the remaining sections in order.

The subsections will average 2 pages each, less than 2000 words. It takes about 30 minutes to read a page of the application. It’s densely written, with numerous acronyms. The student must read with two questions in mind, “How does this work in practice?”  and “What supporting practices and data are necessary?” We will ask students to read, note at least one question, and identify at least one OFI. Student teams will meet for 30 minutes prior to each class, selecting one question and one OFI each. Class will discuss the selected questions and OFIs. A “meta question” can be used for discussion or written submission and grading.

There’s obviously a numbers problem here. Six teams looks like the practical limit, allowing for about 4 minutes class discussion of each question and OFI. Four minutes is unrealistically short. There’s no time for requests, or the meta question.  Also, with 48 students, each student will get only one and a fraction chances to be spokesperson. One solution would be a 4 credit or even 6 credit course. Another would be a ranking of the team questions and OFI selections, discussing only the top 3.

There’s also the free-rider problem.  “I don’t have to study this section quite as carefully; I’m not the spokesperson.” looks pretty likely.  An anonymous team-member rating at weeks 5 and 15 might be a sufficient disincentive.

Is there another way?  Is this worth trying?  I’m game to be somebody’s remote TA (no charge) if you want to try it.

Details for each sub-section:

For each sub-section:

1. Students’ individual preparation:
   1. With both the application and the Framework open, compare what CAMC has done to what the Framework questions require. 
   2. Write down one question to discuss. Good questions often follow forms like “What does this mean for the people doing the work?” “How do you motivate people to change?” “What if [an identified] stakeholder group objects to this?” “Why is this necessary? Couldn’t they skip it?” “How can they integrate this step with [some preceding step or steps].
   3. Identify one or more OFIs, where the winner might improve, either in clarifying the application or changing the process. (Trained examiners score winners only about 60%, and provide a lengthy and valuable list of OFIs.)
2. Team discussion: Student teams will be assigned teams of __ members. “Spokesperson” will rotate, giving each student equal opportunity. The teams will spend 30 minutes together (live or virtual) before class:
   1. Compare questions. Reach a conclusion about the best answer to each question. Drop any question where all members agree they understand the answer. Rank the remaining questions.
   2. Consider the individual OFIs. Clarify, eliminate duplication, if necessary rewrite them, so that all members agree on what CAMC should do to implement the OFI.
   3. Rank the OFIs in terms of importance.
   4. Submit the team’s ranked questions and OFIs.
3. Class discussion:
   1. Questions: Each spokesperson presents their team’s first question. Class discussion, with an instructor summary or commentary.
   2. OFIs: Each spokesperson presents their team’s first OFI. Class discussion, with an instructor summary or commentary.
   3. Requests: Any student may introduce a question or topic where they would like further clarification.
   4. Meta question:  The instructor may choose a question or topic for discussion and/or written submission.  (I will have a library of meta-questions, with grading commentary.)
4. Grading and commentary:  The instructor provides written comment on the LMS submission from each team. It can be graded. Written meta-questions can also be graded. “Best in class” answers and instructor commentary should make clear how each student can improve their answer.