The power of deep work

If you’re like me, it is tremendously challenging to carve out time for so-called “deep work” while at work. Deep work almost seems mythical and elusive to me, at times. In one particularly intense role, I would “save” my challenging work and work that required deep thinking or problem solving for the weekends when I could have some quiet time. Not ideal at all. At other times, I do my very best to set myself up for deep work by closing my email and turning off notifications (all those chat notifications!!) on my computer and phone. In particularly busy periods where I’ve had several contracts I was working on simultaneously, I used online tools to block certain websites, mostly websites where I can waste a lot of time, in order to limit my temptation for distraction.  When I can get into that mode, it seems nearly magical. The ability to think. Just think. Seems like a rarely offered gift

In my work as a curriculum designer, I like to think through an exercise and imagine how it would play out in a training setting. I think about how people will move around a room or virtual space. I think about what materials I might want and if the use of those materials would be feasible and not too cumbersome for the facilitator. I do all of that thinking before I even put my fingers on a keyboard to write out instructions that match my vision. 

The evidence is abundantly clear that we are more effective, more productive, and less stressed out if we have the ability to single-task (as opposed to multitask).  How can we make it happen?

Mark Twain once wrote that “If it’s your job to eat a frog, it’s best to do it first thing in the morning. And If it’s your job to eat two frogs, it’s best to eat the biggest one first.” For me, if I am going to tackle something that requires deep thinking, my motivation, energy, and ability to pay attention are all at their height at the start of my work day.  If at all possible, I try to schedule my intense work for the morning hours. Luckily, I have a fair amount of control over my schedule and when I take meetings and how I structure my day. When I have found myself at the will of others or in particularly meeting-heavy roles, I have found that communicating about what I need to accomplish  and how I will best accomplish it (ie: quiet time in the morning) is usually well accepted and understood. My coworkers are usually amenable to rescheduling or shuffling the day around. I know I can forget that I also can say “no” to meetings. It seems nearly radical and even more radical in a remote environment when we may instinctually want to “prove” that we are at work and doing what we should be doing.  Yet, we have to be careful to not mistake busyness, in the form of being in pointless meetings and responding instantly to group chats, to being productive.

As a manager, I have also tried to give the gift of deep work to my team. In my last role, I blocked off Friday afternoons as quiet time. It was meant to be meeting-free time where we did not expect immediate responses to queries or requests. Plus, we were all working way more than we should have been, so this also gave permission for my team to leave before the official end of the work day if they were able to. 

What are your tips for deep work? How do you make it happen in your busy life? Do you work virtually? How do you manage to keep focused when household distractions abound (no judgement, I frequently do dishes and fold laundry while in meetings!)? Would love to hear from you!

Time Blocking for Productivity

If you are like me, you likely have a lot to accomplish every day and it can often feel like there is not enough time in the day to do it all. 

I often use time-blocking as a time-economizing, concentration-boosting trick. It is a simple technique that helps me stay focused on the task at hand and, as such, check more off of my to-do list. 

First things first, the to-do list is a critical element to the success of this technique. I am a big fan of and heavy user of the app-based to-do list called ToDoist.  It allows for items to turn up on your list every day, every month on the 13th or every month on the third Thursday of the month, every-other-day and probably a ton of other customizable options. For me, this was a game changer. I have reminders programmed for weekly tasks like writing this blog, annual tasks like renewing business licenses, and daily activities like exercising. 

The key to time blocking is to have a robust to-do list where you can see like tasks. For example, you would have a block where you’d respond to emails. Another block could be used for any phone calls you need to make or appointments you need to schedule. For me, a big block of time each day always goes to writing. 

Next, consider the best time to do each of the types of work. For me, starting the day out with exercise energizes me and sets the stage for a productive day. I also find that my creative energies are flowing best in the morning and afternoons are a good time for tasks that require less brainpower. 

By combining like tasks, you use less mental energy shifting how you think and what you are seeking to execute. For me, it it also helps to make sure I am working according to my priorities and the priorities of my clients. 

How do you make the most of your day? 

Why Good Leaders Make You Feel Safe

I was recently reminded of this great TED Talk by Simon Sinek called Why good leaders make you feel safe.  

In his talk, he suggests that when the right environment is created, we are all capable of doing remarkable things and acting in great service to others. He attributes trust and cooperation to building that great environment.

I have found that, perhaps oddly, when I’ve worked in really fast paced environments (ie: disasters, pandemics, epidemics), the tolerance for mistakes is higher. We know that we are making decisions quickly and not everything will go right. But, in some ways, that increases the trust and feeling of safety. It allows for honest conversation. It encourages people to ask for help.

But, how do you do you build a sense of safety? Simon proposes some suggestions, have a listen!

What are your thoughts?

How do you make your team feel safe?

Or, in your own heart, what could you be doing to increase that level of safety and security?  

What it Takes to be a Good Leader

I’d like to share some  ideas about what it takes to be a good leader.

Take a listen to this talk by Roselinde Torres.

She distills the best qualities of leaders into three elements:
1. The ability to see changes that may be on the horizon and prepare for them
2. Networking skills that bring various perspectives to the work
3. The willingness to take some risks and abandon practices that may have been successful in the past but no longer serve the team

The reflection questions below may give you insight into your own practices and habits (and maybe encourage a change or two!):

  • What are your skill levels as they pertain to those three qualities?
  • Take a moment to think about, as she suggests, how you spend your time–do you allow yourself the opportunities to develop in these three ways?
  • Are you cultivating your team to be leaders?

What do you think about her distillation of leadership qualities? I would add skills around trusting and transparent communication to her very valuable list. To me, trusting and transparent communication is critical to giving and receiving feedback and to ensuring that your team is helping you to see what is on the horizon.

Have you considered watching TED talks like this one with your own teams? I have always appreciated leaders and managers who ensure that I keep learning and developing. Plus, they are short enough to fit into team meetings or over a lunch break. How do you help to foster growth and development in your team and in yourself?

Laughter makes us better workers!

Did you catch this great news? Laughter is not only the best medicine, but it makes us better workers, too!  Great news for those of you who (normally) enjoy the water cooler banter with colleagues and organizing the office parties–all of your efforts are justified!

I love tips about increasing productivity, but this one is extra special. Now, how does this news relate, say, to training efforts?

Well, I’ve facilitated lots of training of trainers (TOTs) and I’ve written lots of curricula that other people deliver. One of my great challenges is in convincing novice facilitators that the fun activities are written into the training to, yes, be fun breaks and to allow opportunities for team building, practical application of learning, and create lasting impressions of the materials. Those memories, especially when laughter is involved, can be the most lasting impression of a training and, thus, can help learners to recall other elements of the training.  If you are a novice trainer, challenge yourself to pace your trainings to allow for the active components of the training. If time is running out, consider restructuring your training to limit the PowerPoint or the lectures before you ax the activities. 

So, the moral of this story is…don’t skip the ice breakers, the energizers, and the activities.  Your team will be more productive because of it.

Are you a jerk?

I’ve been thinking a lot about this article, No More Working For Jerks, since I read it back in January. 

My basic take-away is that there has been a shift between folks feeling an undying loyalty to an employer, even the jerks, to a realization that working for a jerk is just not worth it. 

Luckily for me, I have had a very few experiences working for jerks. Perhaps the few experiences I have had, incredulously, shaped me as a manager in positive ways. First, I could not ever imagine treating someone, anyone, like my old boss treated me. Perhaps I don’t have it in me to be a jerk. 

The sudden shift to working almost exclusively remotely has prompted me to do what I’ve come to think of as an “empathy check”. When I am working fast or a million things are on my plate, I have a tendency to shoot off quick responses to messages. I came to realize that a punctuation-less response of “sure”, even if it really was a “Sure!”, could be read as if I was not enthusiastic, only giving it a passing thought, or, worse, didn’t care. Now, I don’t know about you, but in these last few years, I have worked more and more with people I have never met face-to-face. If you’ve met me face-to-face, you know that I almost always mean “SURE!!!!” So, my empathy check can go a long way. 

Similarly, I almost never pop a context-less meeting on someone’s calendar. The exception has often been that I am trying to pull off a surprise virtual birthday party, but that is an aside. I would never want my team to think that I am stewing on something. I would never want someone to be blindsided coming into a meeting with me when something is wrong. And, finally, I would never want a team member to start stewing while wondering what the meeting is about. 

How have your management practices changed over the last few years? If you’d like to meet for some coaching sessions or could use some advice around a particular challenge, please reach out! Similarly, if you’d like to bring leadership and management training to your team, let’s talk! 

Why Your Doctor Should Care About Social Justice

It seems we’ve all been thinking deeply about race and racism in the United States. My interest in public health stems from a desire to work towards equity and justice.

One of my favorite TEDTalks is by Mary Bassett: Why Your Doctor Should Care About Social Justice.  Dr Bassett is the Health Commissioner for NYC and a long time health activist.

As you may know, I worked for several years at Partners In Health (and am working there on the COVID response now) and so appreciated her nod to the work of Paul Farmer when she says:

“But I knew that epidemics emerge along the fissures of our society, reflecting not only biology, but more importantly patterns of marginalization, exclusion, discrimination related to race, gender, sexuality, class and more. It was true of AIDS. It was true just recently of Ebola. Medical anthropologists such as Paul Farmer, who worked on AIDS in Haiti, call this structural violence: structural because inequities are embedded in the political and economic organization of our social world, often in ways that are invisible to those with privilege and power; and violence because its impact — premature deaths, suffering, illness — is violent. We do little for our patients if we fail to recognize these social injustices. Sounding the alarm is the first step towards doing public health right, and it’s how we may rally support to break through and create real change together.”

She ends her talk with this statement:
“Our role as health professionals is not just to treat our patients but to sound the alarm and advocate for change. Rightfully or not, our societal position gives our voices great credibility, and we shouldn’t waste that.”

Videos like this can be great ways to spark ideas among your team members. What if you showed this video to your team and had a conversation about it?

Here are a few questions that may help to spark conversation:
  • What do you think your individual role is in addressing the social issues that accompany illness?
  • What do you think our collective role is in addressing the social issues that patients experience?
  • Have we pushed the envelope far enough as an organization to ensure that we are using our positions of power to advocate for patients and families?

The Happy Secret to Better Work

Here is one of my favorite TEDTalks—The Happy Secret to Better Work.
 
 
 

In his very humorous talk, Shawn Archor talks about how we view the world and how that affects our happiness. Seems obvious.

He also says, though, “75 percent of job successes are predicted by your optimism levels, your social support and your ability to see stress as a challenge instead of as a threat.”  

So what do you, as a manager, do to build that optimism and resiliency among your team? I’ve written about the need for feedback, both constructive and positive, in the past. How can we link that to building that ability to see stress as a challenge and not a threat?

I’ve incorporated several of the lessons that Shawn talks about here (and elsewhere) in my life, including keeping a running list of what I am grateful for. Even on the most craptastic days, there is always something out there that can add beauty to our lives. And if I am really struggling to find something, I create something by reconnecting with a friend, setting a (virtual!) coffee date, or even planning a trip (one of my favorite activities! We can hope, right?). I usually write my list before I even get out of bed in the morning as a way of framing the day in the most positive sense possible.  

Of course, we are in trying times, indeed. When Shawn delivered this talk, we were not months into a global pandemic. I, like many, am managing an entirely remote team. One of the things that seems to be going well on my team is that we’ve built and constantly reinforce the expectation that we will change, evolve, and pivot as needed to address COVID. In some ways, knowing that more change will come, even if we don’t know what it will be, disallows the team to settle into complacency or routine. The routine IS change. That clear-as-can-be communication has been crutial.  What tricks do you have up your sleeve for keeping the optimism on your team?

How have you built up your own optimism and resiliency? How have those skills served you now, given that we are living through this pandemic? What new skills have you been able to tap into?

Nine Events of Instruction

Have you ever been in a training where you feel a little bit like Charlie Brown when he is in his classroom? Where your attention everywhere BUT on the topic at hand? 

Maybe what the presenter said was disconnected with your own reality (a la The Office)?

Or, maybe, just maybe, you jumped into a lecture that was above your head, your pay grade, or understanding? (this video has always been a favorite–glad I have the chance to throw it in here!)

You have been in those situations. We all have been. As a trainer, I like to cue up a lesson to make sure that the stage is set, learners are ready, and that they know what the point of the instruction is. In order to cue up a lesson, I remind myself of the first three, of nine, events of instruction. 

Robert Gagne famously (ok, “famously” in certain circles) outlined nine events that codify learning and instruction. The events simplified and explained what was thought to be “good instruction”.  

Let’s look at the first three:

  1. Gain attention to ground the lesson and to motivate learners
  2. Describe the learning goal and what will be accomplished by the lesson and how it relates to work/tasks/desired outcomes
  3. Stimulate recall of prior knowledge

It should only take a few minutes to move through all three of the primers. For example, by asking about a problem and how the participants view that problem, you can easily accomplish number one and three. By drawing on the past experiences of participants you can touch on point number three.

I recently wrote training materials for health care workers who were being asked to switch up the treatments that their patients were taking. The activity below was meant to build empathy for the patients, describe a bit of what we’d be learning, and help the participants to consider how medications were currently being prescribed and the challenges patients face…


Activity

·      This activity is intended to inspire an empathetic response among participants to the challenges that their patients may face with adherence to their medications.

Say:

·      As we mentioned in the beginning, we are going to give you opportunities to try to put yourselves in the shoes of your patients.

·      Let us do a short demonstration now to start our discussion on adherence. This demonstration will help us to start thinking about some of the reasons for poor adherence.

Do:

·      Ask for three participants to volunteer for this demonstration.

·      Each of the three demonstrations will be slightly different. Please read the instructions before facilitating the activity.

·      Demonstration One:

·      Hand the first participant volunteer two bowls. One bowl should be empty. The second bowl should have 50 or so small candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies, one-by-one, from the full bowl to the empty bowl. The participant should aim to put the 30th candy in the bowl at the 30-second mark.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, stop the participant and ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How might this demonstration be like taking ARVs?

Answer:

·      ARVs are taken at specific intervals

·      A specific number

·      Regulated, etc.

·      How did it feel to not understand why you were doing this task? Did you think that this activity might be pointless?

·      How might patients feel about taking ARVs when they feel perfectly healthy?

·      Demonstration Two:

·      Hand the second participant volunteer the same two bowls. One bowl should be empty. This time, the second bowl should only have 20 or so candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies, one-by-one, from the full bowl to the empty bowl.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How did it feel to be unsuccessful with such a simple task?

·      How did it feel when you knew you did not have the 30 candies that I asked you to move?

·      How might this demonstration relate to patient challenges with ARVs?

·      Demonstration Three:

·      Hand the third participant volunteer one empty bowl. This time, you, the facilitator, should hold the second bowl with 50 or so candies in it.

·      Tell the participant that he or she has exactly 30 seconds to transfer exactly 30 candies from the full bowl to the empty bowl.

·      This time, though, the participant must ask you for three candies at a time. You must hand the participant three candies and he or she will deposit them one-by-one into the empty bowl. Feel free to delay the hand off, give two instead of three, and otherwise make the activity more challenging.

·      Do not count down the time or indicate in any way that time is passing.

·      At the end of the 30 seconds, ask the participant to count how many candies were transferred to the empty bowl.

·      Ask the participant:

·      How might this demonstration be like taking ARVs?

·      How did it feel to know that you had to ask for candies often enough that it kept you from reaching your objective?

·      How might this demonstration relate to how clinics and patients interact?

Answer:

·      Clinics do not always work according to the schedule or needs of the patient.

Ask:

·      Why do you think we did this activity?

·      Do you think that we, as providers, are aware of all of the challenges that patients have with adherence?

·      What are some of the challenges we highlighted in this activity?

Answer:

·      Keeping to a schedule

·      Stock-outs

·      Conflicts between clinic and patient need, etc.

Say:

·      In many cases, patients may not understand why they are taking their medications, just as in the first demonstration. Plus, the idea of taking drugs while still well is a new idea that many people do not understand.

·      We also know that health systems are not always in sync with what a patient may need in terms of clinic hours or amounts of medication that they can be prescribed at a time, and so on.


As you can see, this brief activity, designed to take no more than five minutes or so, accomplishes the first three principles of good instruction. The participants are grounded, ready to learn, captivated by the exercise and they are linking what they are seeing to past experiences with patient adherence and, finally, they get a sense of what the lesson will be about. 

I often write curricula that other people will deliver. I often get push back around activities and cue-up questions as trainers sometimes want to rush to “get to the point”. These segues and lead-ins cannot be viewed as simply nice-to-have or superfluous. When learners can’t connect to new or unfamiliar content, the new concepts will become “slippery” and not stick. The next thing you know, you are Charlie Browns teacher. 

What are some of your favorite cue-up activities or questions?

PS: You can find the entire OPTIMIZE curriculum on the ICAP website. 

Love as a Force for Social Justice

Poverty. Death. Illness. Repression. Injustice.  These are the issues of global health. It is what we confront, among a laundry list of others, as a part of our daily work and as a part of our mission.

Behind all of that is such beauty and joy and resilience…it is breathtaking at times!  I remember being at a hospital in Sierra Leone during the Ebola epidemic. A child who was orphaned due to Ebola had been admitted. She had been found after being alone for god knows how long.  She had illness on top of illness; she was skin and bones.

Everything about what happened next, though, was a story of community and care. I saw a nurse at the hospital draw his own blood to donate to her. Two women unofficially adopted her and ensured that she was fed, diapered, clothed.  She steadily made progress that some would call miraculous.  And right before I left, the sign of her true recovery was that she led the ward, providers, visitors, and patients alike, in a jubilant dance party!

The love behind each and every action in this story is motivating. From the community health worker who found her and overcame his fear to bring her to the hospital. To the hospital workers who stayed in their roles when so many others fled out of fear.  To the nurse who donated his blood. To the women who gave of their time and resources.

The great Ann Firth Murray at Stamford University is renowned for her work in global health, in particular, she was the founder of the Global Fund for Women.  In her long career, she has born witness to tremendous suffering and injustice.  She developed a course called Love as a Force for Social Justice as a means of investigating how love can be a tool that can be used towards the elimination of violence (elimination of violence against women is a critical element of her body of work).  I highly recommend it as a morale boost and an anti-burn-out tool.  You can read an interview with her about the course here.

In the course, she explores several nonviolent movements, from Gandhi’s Salt March to the Dakota Access Pipeline protests, in order to demonstrate how love and commitment can be transformational. She also brings in neuroscience, biology, and psychology to make her points (the science-minded side of me was pleased to see that!).

In our work, we often talk about human rights, empathy, accompaniment, commitment, humility….but we rarely talk about love as a force for change.  It’s seen as weak, at worst, and perhaps out of place at best.

Martin Luther King, Jr, once not-so-famously said that “justice is love in calculation. Justice is love working against anything that stands against love. Standing beside love is always justice.”  Cornel West said, more famously, “justice is what love looks like in public”.So, with love being so foundational to so many social movements and so intrinsically tied with justice, maybe it is time for a small change that would allow a tsunami of changes to come.