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

Prof. Robert J. Baatenburg’s response: I think we have benefit from stimulation […]. Especially in medical schools, people study to become a doctor, they have a goal in their future. But very few people are intrinsically curious to how the human body really works. There are curious people but that’s a minority really. The interaction is sometimes very disappointing. That is one way traffic - I deliver knowledge and theory, but there is not much coming from the audience. Maybe our way of working is not stimulating curiosity because it’s quite rare that students and residents ask why do you do things the way you do it. They accept the way you do it as the standard and they don’t question you very much. Curiosity works two ways: If nobody asks you any questions, you will not improve yourself. And there’s another aspect of curiosity, because it works on safety as well. When nobody questions you then you can make mistakes without anybody saying anything of it and in that way when people are curious, they will keep you sharp and they will prevent you from mistakes.

Curiosity team reflections: What could be concluded from the text above is that the Professor expects his students to be more curious and interactive. The fact is that the formality of the environment is not very helpful as it is so strong that the students may not feel comfortable enough to express different or conflicting opinions and question the methods or techniques used by the doctors. Stimulation of these attitudes could improve the used procedures and lead to an environment that fosters new ideas.

Suggestions: What the hospital might take into account are the following suggestions:

  1. One possible way could be enhancing curiosity by changing the teaching techniques in a more creative way. Another aspect could be establishing a more creative environment, in which students will feel more at ease to express their opinions and exchange their knowledge. (i.e. outside activities, student volunteers to chair the next teaching session, reservation of time by the end of each lecture to devote it to more personal reflections)
  2. Another possible way may be the introduction of more informal conversations with the students in order to create a more open environment, preferably on weekly basis.
  3. Finally, the professor could try to acquaint with each PhD student’s personality and interests in order to stimulate their curiosity. This way, students acquire the feeling that their ideas and opinions no matter how extreme, are not dismissed but appreciated. As suggested in the article "Curious about Curiosity?" by Sharon Walsh, some activities that the lecturer could introduce to the students may include: “questioning, increasing awareness, confronting ambiguities and uncertainties, and making the strange familiar or making the familiar strange.”

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.