Communities of Practice… Emergency Preparedness

It wouldn’t surprise anyone to say the Boston Marathon bombings and all the events subsequent have overwhelmed the entire metropolitan Boston area.  We were engulfed in the events, glued to the radio or TV or web.


Not only was the event a distraction, but I can make a smooth transition between Communities of Practice in the healthcare world – specifically emergency preparedness because that happened to be my topic of the “intervention paper.”

Emergency Preparedness culls together the planning, identification of disaster (natural or man-made), severity (catastrophic or routine), risk assessment (low to high risk) and command center responsiveness.  The impact on the hospital, staff – and community in general – looms large.  Being prepared in the event of a disaster forces the hospital to be prepared and respond to disasters and to help existing and potential patients should a disaster occur.

“To differentiate between traditional adult learning which bases itself on the assumption that learning is something adult individuals do, Lave and Wenger’s theory heralds learning which takes place in a social group setting.  As well, learning, in the traditional sense, has a finite duration.  Classes or courses start at the beginning, include activities and assessments, and in the end, the learner will be taught the new skill.  However, both Jean Lave and Etienne Wenger overturned the focus to learning as a social experience which germinates from daily living.  (Wengner, E. (1998). Communities of Practice. Retrieved from Communities of Practice:

Even with the utmost careful planning, integration among various government agencies and hospital staff, no one can predict the devastation a bomb hurled during the Boston Marathon.

photo:  Boston Globe (4/19/2013)


Alphabet soup: CEUs are SDL

Doctor typing on PC

My example of self-directed learning is about my husband.  He is the Director of Medical Records at a Family Clinic.  His profession requires a strict set of Continuing Education Credits in order to maintain his credentials.  He’s been in the profession for over twenty years.  The credential RHIA (Registered Health Information Administration) follows his name. Headquartered in Chicago, the governing body AHIMA (American Health Information Management Association) mandates 30 credits within 2 years.

All that said, CEUs are self-propelled and it’s incumbent on the person to maintain the current knowledge to stay abreast of the latest software, coding, trends and governmental policies. 

Keeping on top of the Continuing Education Credits is a form of Self-Directed Learning because there are no specific rules.  The person must be responsible for his/her own CEUs. They can take the appropriate courses via online, conferences, written material, courses or workshops.  I can see the benefits of keeping on top of the current trends.  Many professions require CEUs….but not Instructional Design?

Prepare for the unexpected…

I wish I had a jovial example of a transformative event, but my example is a sad one, but one that has enlighted me and my family.  The sudden death of my mother, at age 74, brought my immediate family into turmoil.  My father, a traditional man, did not cook nor clean, nor shop, so he was fraught with the task of providing for himself.  His health was frail, so it was incumbant upon my sisters and me to find appropriate care.

All this leads to learning about the labyrinth of elder care services: assisted living facilities, home care, nursing care, government entitlements etc.  It is a maze of paperwork.  While it was quite a saga for over five years, my sisters and I gained insight on how to deal with this.  (We are fortunate to all live within 40 minutes of each other).  Having siblings will share in the tasks equally is always benefical.

Step 1:  Have a meeting with the parent about the next steps. Do they want to live alone?  Can they live alone?  Can they still drive?  What ailments do they have.  Start the hunt for alternative housing or in-house aids.

Step 2:   Divide the tasks:

  1. Financial – gain access to accounts; be a co-signatory for various accounts
  2. Health care – learn about the doctors who specialize in the care of the elderly
  3. Legal Documents – get the legal documents in order (Living Will, Power of Attorney, Health Care Proxy, etc.
  4. Housing – assess whether to sell the house.  Find alternative housing if need be.

Step 3:  Hire a geriatric care manager: (optional)  (I wish we did this.  These are experts in elder care issues.

Before I write a thesis on this, suffice it to say, the event was transformative, but the outcome was a learning experience.  We sadly lost our Dad after five years in an Assisted Living facility, but by-and-large, he was well cared for and happy to see us.

Bottom line:  Prepare.  Transformative events are usually unexpected.

Aging, Learning and Singing!

quartetHave you heard about the recent movie, Quartet?  In a nutshell, it stars Maggie Smith.  The plot centers on an old age home full of retired classical musicians and opera singers.  It was originally a play by Ronald Harwood which we saw a few years ago at the Merrimack Repertory Theater.  The characters come together in an effort to sing for a gala of Verdi’s Rigoletto.

This example makes me think of the Adult Learning theory on “theories of the life course.”  As we all go through stages in life from childhood to adulthood, we approach life experiences and learning in different ways.  This is cited in Tennant and Pogson’s “Learning and Change in the Adult Years” (Ch 4). They refer to Eric Erickson (1959) who highlights the stages of life as a developmental theorist “who recognizes that a strong sense of identity leads naturally to a capacity for interdependence.” This charts the life course in terms of phases or stages: periods of stability, equilibrium, balance along with periods of instability and transition. (pg 88-89).  An alternate theory to life stages is highlighted by Neugarten (1976).  She states that circumstances within age brackets are not set in stone, but are flexible with social time, historical time and chronological time.  But it is Merriman (2007) “Learning in Adulthood,” that nicely sums up life stages: “it is how we learn from experiences, rather than how life experiences constrain or limit our learning.”

This parallels the plot of the movie: The main character, Jean, arrives at the old age home. She is the ex-wife of Reggie.  I would surmise, at that stage of life, they fought and argued. They were not in balance and very unstable.  Predictably, in the movie, the characters come together at the climax. They all get along for the annual gala.

While the movie highlights the foibles and frailties of aging, it’s also about the triumphant efforts to keep singing!

Thoughts on Aging and Life-Long Learning

I had an interesting thought this week while reading “Learning and Change” by Mark Tennant (Tennant, “Learning and Change: A Developmental Perspective, Jossey-Bass, 1995). I found I am fascinated with aging and the whole cognitive process. The study of WAIS – Wechsler Adult Intelligence Scale was particularly interesting.

crosswordThis comes to light over the last few months when by sisters and I learned our 85 year-old Aunt has onset Alzheimer’s. We were flummoxed to discover that this brilliant self-taught NY intellectual, who could complete the NY Times crossword puzzle, who is knowledgeable in art history and classical music, who is well read and a political activist and who was once the deputy commissioner of NY housing commission, not only forgets her keys, but also gets lost in her own neighborhood.

That said, it has interested me that life-long learning is a process. Research shows that there is a natural decline in intelligence with age, but with training and learning, the process can be somewhat reversed. Tenant sites some well documented studies that there are shortcomings to standard tests including social and cultural bias. (Tennant pg 17).

Our town library has a wonderful life-long learning program in conjunction with Framingham State University where professors come to the library and lecture on a myriad of topics. My husband and I have seen topics on the Civil War, migration of New England birds, architectural details of Rome and Dennis Lehane’s mystery books. With all that, I am amazed at the wide scope of expertise the lectures provide, but the interaction among the participants (mostly older folk) is amazing.  Although I am many years from retirement, it is a true testament that there are life-long learning programs offered at libraries, assisted living facilities, universities and museums.

We may lose our computational skills (I never had mathematical prowess), but it’s the accumulated life experiences that matter (Tennant, pg 34).

Back to my Aunt. She’s wonderfully active, lucid and agile; it’s just that things get muddled. Taking advantage of life-long learning activities (either as a participant or as a leader) would be good to instill cognitive skills – and even pleasure.