The COVID-19 pandemic has brought with it unprecedented challenges. We, at the TRP, have adapted swiftly to ensure that the program continues to be delivered smoothly. This is a personal memoir by our Program Director Joseph Ferenbok, talking about how the TRP went virtual.
Joseph Ferenbok, TRP Program Director, May 2020
For years I have been involved in eLearning discussions, taskforces, tool development, and curriculum design. Throughout the years I have had some interesting successes and been involved in some monumental failures. I have tried many strategies of integrating technology-assisted learning into my thinking about teaching and learning.
In one of my first experiences as a teaching assistant, I ran a forum for my tutorial sessions that ended up having more than triple the number of posts than the other seven TA’s combined—and at the time, I was absolutely convinced of the power and potential of the internet as a learning tool. But then I tried to build an entire learning community online. The system that was designed had more bells and whistles than virtually any of its contemporaries—it represented a monumental achievement of coding and development for its time. The problem is that no one signed up. No one wanted to use it. It was pretty but too complex and unfocused.
Learning from that experience I tried the opposite approach—to work with people to develop technologies that supported learning objectives. But the push back, the reluctance to change even when it would mean less work and improved learning experiences forced me many times to abandon even this participatory strategy.
If there is one thing that may be seen as a positive of the COVID pandemic in the context of education and curriculum design, it might be this: it has forced people, students and instructors alike to disrupt their entrenched ways of doing things. It has forced us to try and adopt models of delivery and engagement that were inching forward because of sunk costs and established momentum. Virtually overnight everyone went to online content and delivery, and the resistance, the culture, and pressure that defends the status quo were systemically removed leading to accelerated adoption.
The COVID situation has provided conditions to experience technology-assisted learning and has forced us to rethink the pedagogy driving learning, and it is likely that this shift will leave a lasting impression on educational practices, efforts at sustainability, and the deployment of hybrid approaches to learning. At the end of the day, it was not the readiness of the technologies, nor the underlining politics or economics that created the circumstances for innovation, but the removal of cultural practices and barriers that made rapid change possible. Buy-in from people has again proved to be the most influential preexisting condition for the adoption of innovation.
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“Translation is a social good, and through Translational Thinking, we are on a mission to expedite the transformation of knowledge into health benefits for society.”
Driven to improve patient care, Joseph catapults projects forward with passion, wisdom, and a contagious chuckle. He is Co-Director of the Health Innovation Hub, a Faculty of Medicine initiative intended to connect, align, serve, and facilitate the translation, innovation, and commercialization of ‘Health Matters’.
Here at the TRP, Joseph is our inspirational Founder and Program Director. He is also a Course Director for Foundations in TR and for Methods in Practices and Contexts, and the Instructor for the Translational Thinking module.
There has been a trend over the last few years to focus on patients in healthcare. Setting aside the evident irony of the obvious necessity of including the patient in healthcare, there are some subtleties for innovation worth considering.
The first is why? Why focus on the patient? There are other ways to approach innovation. You can focus on the system or services, or products. Etc., Now many of these are by no means mutually exclusive or entirely distinct, but the approach—how you frame your problem and the space in which you are trying to problem-solve—will invariably have an influence on the processes and on your endpoints and outcomes. The mindset with which you approach a problem will guide your thinking and help determine where you end up. So if you start thinking about a healthcare problem from a systems perspective, you will be looking for systemic issues to solve and your interventions will likely involve changes to the system that will try to address the space you define. This may or may not actually impact patient care. For example, a systemic change may result in significant economic savings to the system, but these benefits may not actually be seen by patients—savings may actually be converted as profit-taking or, in the case of public systems, put into other priorities of the system.
Another important nuance is the understanding that even when the “patient” is prioritized in the process—that is, placed as the subject or beneficiary of the innovation—it does not mean that the patient is the agent of the resulting intervention. Improving patient care or the patient experience may involve other stakeholders as objects or agents of a particular innovation. Sometimes changing what a caregiver or a clinician does is by far the best way to improve the patient experience. The point here is that placing the patient at the center of translational thinking does not mean that patients are the only means to the desired state. In a patient-centered approach, however, it should mean, that patients are the end beneficiaries of the innovation, that patient care or the quality of the patient experience is included as a central measure of success for the intervention.
Since the intension of Translational Thinking is, in principle, to have tangible impact on human health, prioritizing benefits for patients as an outcome measure of the innovation process is a significant frame-of-mind for approaching the process of mobilizing knowledge for social and economic benefit.
Most of the world is aware and has begun to grow tired of the extreme measures being taken to fight the COVID-19 global pandemic. Protests to loosen restrictions and demands for a return to normalcy dominate public and private debates. But significantly fewer extreme measures and attention are being paid to yet another pandemic we’ve been facing.
This other pandemic has been going on for so long that it has really become part of the background context of our daily lives. It has permeated every aspect of national and global societies, but it is usually consigned (for the most part) to buried stories, outros, or footnotes of the mainstream media. Yet its spread, the resulting devastation of our communities, and its death toll continue to rise—insidiously ignored or maliciously rationalized.
Statements that there are “good people” on both sides when one side is trying to defend individual rights while the other uses violence and spreads intolerance are so commonplace on the world stage these days, that they too represent a pandemic. A pandemic of intolerance, racism, and ignorance. A pandemic of harmful, selfish and uninformed ideologies fueled by self-serving agents of misinformation and duplicity.
Racism and intolerance are a pandemic that we have faced for decades, no, centuries and it only seems to be flaring up again in the current climate. But the trouble is that we have reached a level of saturation and indifference where, as a global community, we seem ready to ignore this pandemic and ignore its cost in human lives, in favour of returning to normal, to the status quo of caring about our own individual lives.
Unlike with COVID-19, rarely do we talk about the impact of intolerance on humanity, on society, on progress, and even the economy—these seem too abstract and too distant when compared with social distancing and isolation.
Innovation, the creation of new and better processes, products, and services depends on cultivating and nurturing new ideas. Diversity brings together multiple perspectives and ideas and strengthens the quality and impact of education, research, and overall human progress. Racism and ignorance stifle different perspectives and new ideas—they stifle humanity and progress!
At the TRP, we aim to provide a safe and positive space for creativity and innovation. We aim to encourage diversity, multiple perspectives and are devoted to fighting intolerance in all its forms. We aim to attract and retain diverse and excellent students, faculty members, and trainees, and to foster flexible working conditions that accommodate personal circumstances and create an inclusive environment. We support those peacefully fighting anti-Black racism and racism as a whole. It is our collective responsibility to build an equitable, diverse, and inclusive environments where students and faculty continue to seek opportunities and partnerships that remain true to these goals while working diligently to stand in the way of those who oppose these ideals, spread hate and division, and stand in the way of creating a healthy human community.
TRP Program Director,
June, 1st 2020
The TRP is designated to be a “Professional” program but there is no formally recognized profession of Translational Research within the scope of health science or healthcare. What then does it mean to understand the TRP as a professional program, Translational Research as a profession, and perhaps more significantly, professionalism broadly as applied to healthcare and the health sciences?
As it turns out the academic designation is perhaps the easiest to deal with. A graduate program, masters or PhD is understood to be a course of advanced study. A master’s degree historically has been understood as a step towards a PhD that moves a student beyond a bachelor’s information dump towards a better understanding and more critical thinking required in PhD programs. However, some master’s programs are intended to provide students with advanced understanding towards a specific field of work—think law, engineering or business. These types of programs generally have been course-based (rather than thesis-based) and have prioritized domain-specific knowledge or applied research to support a career trajectory rather than groom students specifically for PhD programs.
Recently, a range of professional master’s programs have been developed that seem to aim to provide students with advanced standing but are generally only loosely affiliated to a specific profession or field of work. These programs seem to focus on the credentialing to be able to give students a professional advantage or designation and provide degrees as a measure of accomplishing a minimum standing in a series of courses.
Perhaps at the other end of the professional program spectrum has seen the rise of professional programs that continue the tradition of advance study but also incorporate professional-oriented skills or competencies. This type of program, in the context of graduate degrees, is more difficult to categorize according to established taxonomies, because it may not be specifically affiliated with a specific professional domain, may not have a basic or discovery research focus, but may still allow for advanced study as well as a focus on skills and competencies that may be understood to be transferable and professional.
The TRP falls into this latter—ill-defined class of “professional” master’s programs. It is intended to allow students to pursue self-directed advanced study—the self-directed nature and a current lack of a formally designated profession of translation means it is not affiliated with a specific profession (our students are interprofessional). The TRP is not thesis-based so it does not require a written tomb for graduation—though students produce reports, white papers, artifacts, and other forms of deliverables. The lack of a thesis, however, does not mean that students are not engaged in research and the generation of new knowledge. In practice, most Capstone Projects to date have involved a high level of research and methodological rigour, including research ethics approvals and highly structured protocols. However, these have generally been focused on innovation and impact rather than publication.
Admittedly, articulating the skills and research accomplishments of our graduates is an important area for improvement. Demonstrating the depth of understanding and the achievements of students in familiar research domains (despite the ‘professional’ designation of the degree) means that our students have significant value to the research community both before and after the program, and are not barred from pursuing PhDs or other advanced study opportunities when they choose to.
The opportunity for students to pursue advanced study while simultaneously developing transferable workplace skills, means that the program provides an unconventional type of educational experience that blends the rigour of a traditional masters degree with knowledge that allows students to excel in areas that involve multidisciplinary collaboration, creative problem-solving, teamwork, navigating ambiguity and leadership—not usually competencies historically prioritized by traditional research masters programs.
This is perhaps half of the “what” of the TRP related to its professional designation. The “How” and the “Why” of professionalism will remain for Part 2: Defining Professionalism and Part 3: Significance of Professionalism in Translational Training.
Every graduate degree should, at least in my opinion, offer the opportunity for students to achieve a credential, learn something of significance and find avenues for personal (and professional) growth. These outcomes, however, are by any means guaranteed or consistent either between programs or between students within a program. This makes it hard to, with any certainty, tell a student what they will get, but this is what all students want to be answered: “What will I get from the TRP? Why should I invest my time and energy?”
What you will gain from any experience, any graduate program will–at least in my experience–be greatly determined by what you are prepared for and open to. Why does one person have an epiphany when another sitting next to them doing the same thing, experiencing the same lesson, does not? An unwavering truth of any experience is that, generally, what you get out of it will depend on: who you are—that is your character and characteristics; your purpose and motivation; and the nature of the program—it’s content, structure, and philosophy.
The TRP is designed to be focused on facilitating the process of learning. This means that you are given back control over your learning. This is antithetic to most conventional wisdom still pervasive in traditional paradigms of pedagogy because takes away control from the institution and its agents, and places the measure of “success” and achievement on individually defined accomplishments.
For educators, giving up control is not easy—it’s a lot more work to try to inspire learning than to assign marks for standardized responses. But for learners, taking on the responsibility of control is, perhaps, even harder. First and foremost, you are not conditioned to focus on your individual learning–you are conditioned to base your educational self-worth on grades. And even though intellectually you may understand that getting an A on a test is not the same as remembering, understanding or being able to apply the material on that test, fighting decades of conditioning is hard. It requires a cognitive restructuring and cultural shift on the part of a learner to allow themselves the space to think differently, to push themselves out of their comfort zones, to dedicate themselves to personal challenge, to the less travelled path in an undiscovered country of uncertainty and ambiguity.
Also, self-directed learning is hard. It takes initiative, dedication and humility—you have to be able to admit ignorance and be open to being wrong. It involves a high degree of self-awareness, honesty and self-permission to fail. This is not, at times, easy or pleasant. You will face challenges, potholes and sometimes long frustrating periods of featureless nothingness—sometimes it can feel like rolling a boulder uphill. But then there are the chances to explore and observe, appreciate and reflect; moments of joy, epiphany, friendship, and moments of EUREKA!
This is what the TRP provides, an opportunity for personal and professional growth and the prospect for collaborative self-directed learning. A sandbox for you to play where your peers become more than passive disinterested spectators—they become the experts, touchstones, instruments of feedback who enrich, support and ground your experience. All this is hard to internalize in the abstract—without experiencing it—so it also requires trust–a leap of faith, if you will. But the TRP Team have done this before and together with you we can do it again. The way is simple, but not easy.
For those of us, we happy few who make the effort, who learn to learn, who contribute to our own growth and the learning of others, the effort is extremely rewarding–not just for a year or two, but for a lifetime. It is a calling–not just a degree.
This is our mission: to challenge you to think differently so that you can apply knowledge to improve people’s lives. It is a purpose to improve and grow together. It is a commitment to that if, and when, you decide to take up arms against the sea of healthcare challenges, we will support you. And it will not end when you graduate. You will pay it backward and forward, and as you do your thirst for impact, your drive for creative collaborative problem-solving, for like-minded-translators, will continue to grow.
So, what will you get from the TRP? Why should you invest your time and energy?
You get a mission and a community united by the noble calling to improve lives, through medicine, health and care—you get to: learn with purpose.
There is currently no official or globally recognized profession of Translational Researchers. Nor, is there any one profession involved in the landscape of translating observations into research or impact. Our program attracts a variety of people from a variety of different backgrounds, who have a variety of objectives and personal goals. Asking what “job” or “career” the TRP may help you attain, misses the point of what the program is trying to help you achieve.
The point is that TRP is a guided mechanism, a platform for you to learn and explore your passion and ideas. Our goal is to challenge students to stretch their perspectives, open themselves up to new points of view, and learn to be better more creative and innovative problem-solvers. We provide you with a framework for tackling translation, a community for you to practice and engage with; access to institutional resources and personnel, and we provide you with guidance and help facilitate your learning. BUT it is you who must provide the direction, the drive and the curiosity to use the opportunities to establish your trajectory, your career, your own individual development plan.
The TRP is about self-directed learners who want to learn to deal with complexity and navigate ambiguities in complex problem spaces as they unfold. The TRP is about adapting, collaborating and asking for help. It is about learning to be your own guide and your own champion. It is about gaining confidence and resilience to take risks and learn from faulty strategies. It is about you learning to become the better you that you want to become. It is about the process of growing and learning.
So, the answer to what career path or job the TRP can help you attain is meaningless–TRP can help in just about any career path. Some of our students have gone on to find jobs in hospitals, industry, and government organization. Others have changed the way they practice medicine or the way they approach patient care; others will do things I cannot even yet imagine or articulate. The real question is “How will you use the TRP to shape your potential?”
What are your passions? What are your goals? What career or job will you attain or improve or develop if you learn to apply the competencies and skills you gain through the TRP? Those are much more important questions that will actually help YOU answer what career path you should plan for, what job you should decide to attain, or what pivot you may want to make in your life’s journey.
That is at the heart of our program and our philosophy.
Joseph Ferenbok, PhD
Translational Research Program in Health Science