Collaborating Across the University and Beyond Judith Albino

Collaborating Across the University …and Beyond Judith Albino, Ph. D AAL Senior Consultant President Emerita and Associate Dean Colorado School of Public Health

Goals for the Session: • Analyze cases with collaboration as the goal. • Identify obstacles to collaboration in various areas of academic work. • Use the four frames to develop strategies for addressing obstacles to collaboration. • Consider how you can develop new collaborative efforts or improve current collaborations at your school. • Outline a plan for the collaboration you want to accomplish.

Collaboration doesn’t just happen • Understanding both positive energy and resistance is essential. • Consider structural, human, political, & symbolic frames. • Build a sense of urgency. • Create a vision. • Build a coalition. • Plan, evaluate, revise…. • Institutionalize collaboration.

When You Meet Resistance: Consider: 1. What makes this difficult? 2. Who will have to change? 3. Who loses or gains power? 4. What would be better? 5. Who would benefit? 6. Who will get the credit?

Let’s try it out…. Working in groups, read and discuss your case, then answer the questions on your work sheet, and plan to report out.

Group Reports

Case 1. Team Science: The New Challenge Great State University has just received a Clinical and Translational Science Award (CTSA); as academic dean, you are the point person from the dental school. Your school had very little input to the application, but the dean says it now is time to make this “real” – especially in terms of research. You know that you need to engage more dental faculty in research, and that you need to engage them in collaborative research with faculty in the other schools at Great State – Medicine, Pharmacy, Nursing, and Allied Health. The other schools have associate deans for research, but each is larger than the dental school and all generate more NIH funding. In the case of the medical school, the difference is 100 to 1; the dental school has about $2 million annually in funded research. You met with the associate dean for research at the medical school, but he had little advice for you about stimulating collaboration. “That is best worked out by individual faculty members who discover shared interests, ” he said. You don’t know where to turn next. Most of the bench research is focused on materials, and there is one faculty member in community dentistry who is engaged in a project at one of the hospitals downtown. You know that many clinical faculty believe that they don’t have time for research, even though some scholarly activity is expected. As one outstanding clinical faculty member said, why would I spend my time on research? I’m not good at that; I am good at teaching students in the clinic. He’s got a point, but the CTSA is intended to stimulate clinical research. What to do?

Case 2. Interprofessional Education There is a lot of talk nationally about Interprofessional Education, but the silence is deafening at Northern State University Dental School where you are academic dean. Although the dental accreditation standards now require competence in communicating and collaborating with other health disciplines, it is not clear how that should happen. Moreover, as things began moving on the IPE front at NSU, dentistry seems to be waiting for the next train. You were invited to, and attended, some organizational meetings, but this morning you heard that all medical, nursing, and pharmacy students will engage in a semester-long interprofessional experience. A call to the program director resulted in his response that the program is built around cases that don’t have much to do with dentistry and that “we’ll just have to keep working on this. ” Your dean’s response is that interprofessional experiences occur naturally in hospital rotations, but you think that response misses the mark. Training in interdisciplinary team processes will be offered, and you believe that it should be available to dental students, as well as those in other schools. One or two clinical faculty members expressed some interest in IPE early on, but it’s difficult to know how to engage them when it seems that dentistry isn’t part of the university’s plan. You know that you need some allies, and you also need a plan for bringing the breadth and depth of dental practice to the attention of others at the university.

Case 3. Managing Up When You Are Down As Director of Clinics at Silverton University School of Dentistry, you have wanted to develop a model for clinical education that replicates a group practice model. This requires several faculty members working in teams with smaller groups of students at different levels of their professional program. A new dental building has been fully funded by the gift of a major donor, and plans for clinics in the new building are being finalized. You chaired a committee that worked over the past year to review and evaluate clinical education at the school in preparation for this move. The faculty are with you, and the plan that the committee has come up with is innovative and detailed. In the dean’s words, however, it is too “radical. ” The alumni, he says, would never go for it. The dean is a great fundraiser, an outgoing man, who has been in his role for 20 years and often is viewed as a sort of “godfather” figure, but he has not kept up with innovations in dental education. You respect the work he has done for the School, but this time, you believe that he is wrong. Many alumni, and especially a large number of those who graduated 10 -20 years ago, are working in group practices. You described the new clinical teaching model to some of them, and they found it exciting and want to help. You had an opportunity to briefly describe the plan to the VP for Health Programs who seemed interested – primarily from the perspective of program innovation, but he just urged you to work with the dean to get it implemented. You’re discouraged and wonder how you can make this happen.

Case 4. Community Health Concerns You are the Chair of Community Dentistry in a dental school that is perceived as having pulled back from the community several years ago. That happened because the opportunity for a new school building, with abundant clinic space, meant that using hospital and community clinics was no longer necessary to accommodate the expanding dental school class size. The result was that for many years, patients often drove long distances to use your services, which are designated and supported as a safety net clinic by the state. Times have changed, and there is now genuine interest on the part of the School in getting students back into the community – to experience oral health disparities up close and also to broaden the training experience in terms of the opportunities that may be available to graduates. As you began reaching out to the hospitals and community health centers, however, you did not receive a warm welcome. Even visiting with churches in the community, you found that people had a negative image of the University of City. State – and especially the dental school. Memories are long, it seems – and the School is described as having abandoned the community. “How do we know you won’t do it again? ” You have a large commitment of funds to realize this new model, but you are stumped as to how to make the friends you need. The best option for success is to work with, and build on, the relationships and services of current community institutions. But how can you do that now?

Case 5. Practice Makes Perfect As an associate dean at Mid. South University, one of your responsibilities is developing and sustaining relationships with organized dentistry and the practice community. Recently released reports at both the national and state level have highlighted oral health as a top priority for improving population health. There is an opportunity here that could result in a win-win for dental practice and dental education. A public communications plan is contemplated that would highlight oral health problems, dental practice as a solution, and the need to train more dentists. To date, however, the State Dental Association has seemed to want to go its own way, simply underwriting a “ 1 -800 -dentist” type of campaign. You have suggested instead a focus on the high level training of dentists, the research occurring in dental schools and the pro bono work of both schools and practitioners, along with the role of practicing dentists in creating overall health in the community. This would highlight the major public benefits of dental academic and professional services and activities, as well as help people to understand their individual health issues. The State Association is resistant, however, and even after a presentation at their meeting, they seem more focused on messages that get people into their offices. You feel as though you have hit a wall, but there must be a way to collaborate.

Group Reports

What’s Your Plan for Collaboration? During the last part of this session, you will work to further develop your plan for collaborative activity at your university. Work in pairs to share your plans and seek advice, focusing on what you perceive to be the greatest challenge to implementation of your plan. Decide which of the four frames will be most helpful in addressing the obstacles your face.

Final Notes on Collaboration • Collaborating is a journey. • Collaboration always involves change, and collaborations will change over time. • Collaborations require mutual benefit. • Collaborations are fragile. • Collaborations are more than the sum of their parts.

Enjoy and celebrate your collaborations! Judith