Curiosity at Erasmus MC

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Based on Professor Robert J. Baatenburg’s statements, we assume the organization may run a risk of facing a problem with the stimulation of curiosity among the students. Thus, as far as curiosity issues are concerned, there is an implication that this situation might be recognized as a “crisis”. In this aspect, the organization can be placed in the crisis quadrant of the adaptive Cycle.

Figure 3: Erasmus MC Curiosity positioning in the adaptive Cycle

Non-human challenges to curiosity

Guidelines as necessity (balance between practice and creativity)

Protocols vs. flexibility (protocols save time and make your life easier)

Bureaucratic barrier to curiosity (experiments / operations are protocoled)

Organisational and human challenges to curiosity

Cultural inhibitor to curiosity (first name basis / formalities)

Philip Backx’s response: We have discussed it with the residents why doesn’t anyone have a question. Why don’t they ask me why I am doing this and if they think it is good or not. And it turns out that it is the hierarchy. The students feel that the hierarchy is so strong, especially within medicine. It is like a culture. And we decided that everyone should call each other on the first name bases, not in front of the patients, but when we are not in front of them, they can call us on our first name bases. Even when you tell them: "call me in my first name”, they say "OK, professor". It is tough for them because that is a cultural barrier to curiosity in a way.

Curiosity team reflections: Due to the fact that the hierarchy is so deeply rooted in the organizational culture, it could not be easily overcome. In order to help this process of handling this situation, the doctors try to create an element of informality by being on first name basis but they still haven’t found an effective way to surpass the cultural barrier to curiosity.

Suggestions: Even though already implemented techniques seem not to be effective yet, it needs to be pointed out that cultural change does not occur instantly. It is our belief that the department is heading in the right direction regarding this specific approach and efforts should be continued in order to sustain it and foster it even more in the future. In this respect, contribution to such informal environment should be mutual both from the student as well as the managing team’s side.

Challenging case - Patient (as partner)

Prof. Robert J. Baatenburg’s response: The demands and the way patients want to be treated have been changing over the last ten years intensively. Patients are much more informed and demanding and […] it is conflicting on our old way of doctoring. I think that the patient as a partner it is an interesting concept, when you have a patient that comes to you with specific needs and demand. We have to respond to that.

Curiosity team reflections: Recently, a new tendency has occurred since the patients are becoming more and more informed and the doctors need to follow up on these expectations in order to sustain their competitive advantage over the other hospitals. In that respect, they are looking for new approaches towards the patients. It is the curiosity that drives the hospital’s staff to explore and to be constantly a few steps ahead of patients’ knowledge.

Students don’t question decisions / teaching techniques

For further information regarding the Company, the Interviewees, the Interview Structure or Reflections obtained during the process, see Case study Group 2.

For further information regarding the role of Curiosity in the Adaptive Cycle go back to Group 2 Student Lecture.