The Educator as
2011 AAP Annual Conference
September 21 – 23 Scottsdale, Arizona
Thomas E. Ungar, MD, M.Ed, CCFP, FCFP, FRCPC, DABPN
Chief of Psychiatry &
Medical Director, Mental Health Program
North York General Hospital
Associate Professor, University of Toronto
Jennifer Riel MBA
Associate Director, Desautels Centre for Integrative Thinking
Rotman School of Management
University of Toronto
Disclosure Slide
Astra Zeneca, Lundbeck,
Eli Lilly, Pfizer
Mental Health Minute®
How I got interested
“What’s your five year plan?”
Scholarly education studies (contextual learning,
transformative learning, hidden curriculum,
participant observation, knowledge translation and
Airport Bookstores– Reading
Work with family physicians – interdisciplinary
collaborative care, deep knowledge of end user
HBR, Globe and Mail national newspaper, Rotman
School speakers, series, books, Jennifer Riel
Learning Objectives
Gain knowledge about the basic principles of
Design Thinking and relate them to their
educational activities.
Gain awareness and knowledge of their
educational design activities and products, and
how to document these for academic
promotion and professional rewards.
Reflect on their attitudes and values as to
whether educational design constitutes valid
scholarly academic activity, and potentially
transform their career and educational
identities and direction.
Design in Business
Design activity - Project based
Designers care about impact
Design is humanistic, observational, iterative
Design thinking can be described as a discipline that
uses the designer’s sensibility and methods to match
people’s needs with what is technologically feasible and
what a viable business strategy can convert into
customer value and market opportunity.
~Tim Brown
Design thinking is the “balance (of) analytical mastery
and intuitive originality.”
~Roger Martin
The IDEO Approach
The Rotman Model
In terms of the application of observation to the
design of medical education, it is a question of
looking beyond what students tell us to understand
their deeper-order needs and the needs of the
patients they will one day treat. Observation is this
case includes attempting to understand the full
student experience of engaging with the material,
from cracking open to the book, to attending the
lecture, to attempting a procedure for the first time.
Imagination can be the most difficult skill to acquire. So
much of our education, from grade school on, is designed to
drive creativity and originality out of us. We kill new or
unusual ideas swiftly, before we have a chance to learn
anything from them. We dismiss all that we cannot prove in
advance. Designers, on the other, use their abductive
reasoning to explore what might be possible. They ask what is
interesting or exciting about a wild idea, not what is wrong
with it. They build and refine quick prototypes to test out
ideas and learn all they can from them.
Here, educators can learn from the discipline of prototyping
– testing new pedagogies in rough form and iterating to
improve them, rather than attempting to create a perfect final
design before rolling it out. Testing and failing early, then
learning from that failure, is at the root of innovation.
Configuration is the process of fitting the new idea or
innovation into a larger system of activities. It is at this point
that weaker designers struggle. They foist their brilliant new
prototypes on the world without attempting to understand to
what extent the new idea fits with existing activities.
It is important to ask, to what extent does a new design fit
with current culture and existing protocols? How can it be
made to work with them? Can the new design be scaled? Can
it be delivered at a cost that fits within our financial
constraints? If it cannot, how can we adapt it to do so. The
configuration stage is not about compromising the
innovation, it is about integrating it into the existing system
such that it can be sustained.
The Predilection Gap
Cognitive Errors in Academic
Medical Education
“OR” –all or none thinking-analytic or intuitive
 ‘AND”- analytic and intuitive thinking –i.e.
Design thinking
Key Differences
Intuitive Thinking
To prove
through induction
and deduction
To know
without reasoning
To balance
analysis and intuition
Exploit existing
 Focus on the past
 Venerate data,
judgement and
 Refine what is
Explore new
 Focus on the future
 Venerate insight,
dismiss analysis
 Invent what might
An outcome that is
An outcome that
meets the objective
Reliability and
A productive balance
Explore and exploit
Integrate the past
and future
 Combine data and
 Design what should
The Knowledge Funnel
Expanding the Toolset
Reasoning What is true or false?
• Deductive Logic: The logic of what must be
(reasoning from the general to the particular)
• Inductive Logic: The logic of what is operative
(reasoning from the detailed facts to general principles)
Reasoning What could possibly be true?
• Abductive Logic: The logic of what might be
(inference to the best explanation)
Abductive Logic
Novel, surprising
or anomalous data
New theory,
“a leap of the mind”
How does that happen? By:
•seeking the best explanation when faced with new or interesting data
that does not fit with existing models,
•understanding that the “best” explanation may well not be the
simplest, the most obvious or the most accepted, and
•instead of dismissing data that seems to disconfirm one’s model,
embracing it as a cue to think about a new explanation.
The Exercise
The challenge: Think of the worst idea ever
Propose ideas for the worst psychiatric
residency training you can imagine
Rules for Brainstorming
1) Defer judgment
2) Encourage wild ideas
3) Build on the ideas of others
4) Stay focused on the topic
5) One conversation at a time
6) Be visual
7) Go for quantity
Educational Applications
UG PG CE IPE Public Ed Admin Clinical
Where Does Design live in crusty old academia?
University of Toronto Faculty of
Medicine Promotions Manual:
Planks for promotion 2011
 Education
 Creative Professional Activity
Hollenberg Report on Creative
Professional Activity 1983
It is not assumed that CPA and traditional academic
excellence are mutually exclusive or that they can
not manifest themselves in the same individual
 Professional innovation/creative excellence is
expressed in performance, film, and exhibition or
staging of a work of art, original architectural or
engineering design, original clinical or therapeutic
techniques, introduction of an original concept in
approaching a professional problem, etc.
2011 U of T Promotions Manual Professional Innovation and Creative
Development, introduction and dissemination of an
invention, a new technique, a conceptual innovation
or an educational program. Creative excellence, in
such forms such as biomedical art, communications
media, and video presentations, may be targeted at
various audiences from the lay public to health care
Presenting/Showcasing Design
Activity for Academic Promotion
Education-Teaching Dossier
Curriculum Design
Instructional Design
Creative Professional Activity Dossier/PortfolioEducational Design Portfolio
Projects/conceptual innovations/designs/products
Impact Statements
Dissemination Figures/Examples/Testimonials
Tom’s CPA Dossier
Educator’s Statement
“The Creative Professional Activity in this dossier
demonstrates a model of education that recognizes the need
for contextualization of information along the knowledge
cascade between research, specialist clinician, primary care
physician and public. Each new context, practice culture and
practitioner therefore requires an attempt at creative
redesign of the style, placement, methods and language if
effectiveness is to be expected. Ultimately the educational
scholarship requires design activity, which for me is primarily
an innovative and creative process complementing the
foundation of scientific medicine.”
Educator’s Statement
“Each creative professional activity and Innovation in
Primary Care Mental Health Education is approached as a
knowledge translation problem requiring an instructional
design solution that takes in to account the differing contest
of primary care mental health delivery. This leads to creative
and innovative curriculum materials, designs, products, and
practice and learning enablers. To the specialist psychiatrist
these may appear to be unconventional dilutions of specialty
Educator’s Statement
“Contributions in Instructional Design and Innovation
demonstrate the scholarship of synthesis of knowledge as
well as the scholarship of knowledge translation or
implementation science.”
Educational Designs - “Products”
Intellectual Property
How to Create a Design
Friendly Environment
 Personal
Thank You
Primary Care/Family Doctor
Education Example
Reality GP video
Clinical Design Example –
Pandemic Plan
CMAJ Publication on
Pandemic Plan
Public Education Design
Why Design thinking for medical education? relevance?
Link to educator skill sets, natural affinity for teachers, who understand
learners, student or end users and deep understanding of context –
empathic design etc
Examples of medical education instructional design-curriculum design,
educational tools, acronyms, mnemonic device creation, video creation,
case writing, simulation design, games, knowledge translation materials,
interventions, social media public health campaign strategy and products
Educational Design to assist identity formation for medical educators –
faculty development and career validation
Challenges for design thinking in reliability oriented world of medicine
and science, where educators and clinical teaching is second or third
fiddle to research
How to document and present educational design activities-the
educational design portfolio-creative professional activity dossier
Challenges for academic institutions to recognize and evaluate
meaningful impactful non traditional academic educational design
It’s in our interest to embrace design thinking to enhance the field of
medical education and innovation.
AAP Workshop Outline
10 minutes
Disclosure Slide
Learning Objectives
How I got Interested
Design Thinking Primer – PowerPoint
20 minutes
Abductive Reasoning Exercise
20 minutes
Educator Applications
Promotion & Documentation
CPA Dossier/Design Portfolio
Design Products - Example
Educational Identity Formation
30 minutes
How to Create a Design Friendly Environment
10 minutes
Intellectual Property
Intellectual Property
Intellectual Property
Clinical Care Design (Practice

The Educator as Designer - Association for Academic Psychiatry