We need imaginative approaches to training

Chochinov's framework may help health professionals to provide more compassionate and respectful care for our patients.¹ However, great ideas alone don't always lead to better practice, even when supported by training and re-training.

We are all taught good practices as students but usually conform with the habits of colleagues and bosses once we enter the “real world” of work. Unfortunately bad habits contribute to the culture of our parent organisations and are engrained and very hard to change. Replacing a bad culture with a better one requires will, leadership, and good strategic planning, but, as is often said in business circles, “culture eats strategy for breakfast.”²

So how might we persuade people to adopt new and better habits? An interesting approach is suggested by Fred Lee in his book, If Disney Ran Your Hospital.³ He explains how exercises in imagination are crucially important components of staff training at Disney (world leaders in customer satisfaction). Lee adapted Disney's technique to training healthcare workers. He reports the case of a surly radiology department receptionist with bad interpersonal skills. Lee persuaded her to imagine that a patient was not a stranger but instead was her favourite aunt. The receptionist's behaviour became far more compassionate and caring and—most importantly—the changes persisted. Lee's book abounds with similar examples and he explains why these methods beat many traditional approaches to staff motivation and training.

Chochinov has described a better world, but real work is needed to get us there. New habits will overcome bad cultures only if better ways of learning are accepted.