From Innovation to Intrapreneurship: Fostering academic success via the GridlockED project and innovation fund

Abstract

Background

Funding for educational innovations is increasingly scarce in academic medicine. While there is some funding for medical education research, this is often for discovery or application work, and there are few avenues for those with a heavy innovation focus to fund early work.

Objective of the Innovation

The objective was to develop an intrapreneurial unit focused on medical education projects and scholarship.

Development Process and Implementation

The GridlockED and TriagED games are educational or serious games that seek to teach health care learners about emergency medicine processes. Both games were cocreated with learners and brought to market in the past 3 years. All of the proceeds from the sales of these games have been accrued over time to create a new innovation fund. This fund seeks to support trainees and early career educators in their medical education projects.

Outcomes

Sales for GridlockED began in March 2018 and the TriagED began in November 2019. In the first year, sales for GridlockED yielded a total of $9,534. After 18 months of sales, the fund has accrued a total of $14,530. The fund has helped finance the development of new games. Additionally, the fund awarded two internal $500 Kickstarter grants to assist with evaluating and improving two local education projects. The GridlockED and TriagED games have also spurred multiple academic opportunities for junior educators interested in this domain: five workshops, eight conference abstracts, two peer‐reviewed papers, and two research protocols are being developed.

Conclusions

The GridlockED and TriagED games represent a new academically oriented, intrapreneurial approach to medical education work.

NEED FOR THE INNOVATION

Despite increasingly sparse and competitive funding for medical education research work, ¹ , ² there is increasing pressure for those in health professions education to engage in high‐quality scholarly work. Academic medical centers pride themselves on engaging in new and innovative practices of teaching and learning and advancing that through traditional scholarship. However, available funding is primarily focused on empirical research, with few dollars accessible for new innovations in health professions education. ³ If funding is sparse and new innovation is desired, it follows that we must find new models for generating funding for health professions education innovation and scholarship.

Early success is key to garnering later success. ⁴ This phenomenon has been referred to by some as the Matthew effect. ⁴ Given that scientists who have been previously successful will more likely be successful in the future, it is crucial for those early in their careers to be given an opportunity to gain early success in terms of their access to grants, even if those grants are only at the local level. Those scientists who have early success build an infrastructure for further projects, gaining momentum that allows them to further magnify their outputs as they accrue more funding. To foster success in health professions educators, therefore, it may be of crucial importance for local grants to be accessible and available to provide individuals a way to garner early wins, to pave the way for their later success. Furthermore, seed grants that allow individuals to nurture their idea from concept into pilot testing can be sparse for medical education research—however, within early piloting, it is very difficult to establish a track record of success that is expected in nationally competitive granting competitions.

BACKGROUND

Intrapreneurship is a seldom used concept for academic medicine. Locally, we believed that intrapreneurship may be the solution to the problem of scarce resources for innovation work and education scientists who are early in their career. Intrapreneurship is defined simply as adopting entrepreneurial behaviors and philosophies within an existing organization. ⁵ Intrapreneurship can take many forms, but there are some key dimensions that are described in the literature. ⁵ Intrapreneurial methods can be used to explore a number of new dimensions within an organization: new ventures, new businesses, product/service innovativeness, process innovativeness, self‐renewal, risk taking, proactiveness, and being better able to compete more “aggressively” in their segment of the market. ⁵ Essentially, intrapreneurial offshoots within organizations allow larger corporations and organizations to provide affordances to certain groups within those institutions to act more independently, as if they were smaller ventures. By doing so, a smaller unit can be given license to innovate, experiment, and take bigger risks—something that may be normally frowned upon within a larger organization. Examples of successful intrapreneurship can be seen within other fields such as the technology industry and the military. ⁶

Within academic medicine, exploring angles for engaging in intrapreneurial processes and projects may hold the key for new innovations. It allows smaller contained units within a larger institution to experiment and be agile, while the larger organization remains steadfast in its approach to fulfilling its core mission and values. Intrapreneurial units allow higher risk activities (e.g., adopting new approaches, new products) to occur, and when new models are successful, they can then be more quickly scaled across the larger organization.

DEVELOPMENT PROCESS

The GridlockED game, ⁷ , ⁸ , ⁹ , ¹⁰ a serious game that focuses on teaching health professions trainees about the inner workings of the emergency department, was originally developed as a knowledge translation project for a program of research by our local researchers. ¹¹ , ¹² GridlockED was created via an intrapreneurial team within the division of emergency medicine in 2017–2018, which was composed of a combination of faculty members and medical students. The game was designed as a knowledge translation platform for the previous research work by some of the team members (TC, MM, PS, SH and others) ⁷ and tested extensively in various target markets. ⁷ , ⁸ , ⁹ The initial game development was self‐funded by two of our team members (TC, AP). Notably, none of the participants had any dedicated funding or protected time for this project.

After initial game design and testing, our group engaged the McMaster Innovation Liaison Office (MILO) and an industry partner (The Game Crafter, LLC) to produce the game. The GridlockED game itself was originally funded philanthropically by three of its cocreators (TC, AP, MM) along with in‐kind support from other volunteers (including PS, SH).

The team created a website (www.gridlockedgame.com) as well as social media profiles on Twitter, Facebook, and Instagram. Marketing was mainly conducted via web‐based formats. The team did present at various academic conferences (Canadian Conference on Medical Education, Canadian Association of Emergency Physicians, International Conference on Residency Education, and Games and Learning Alliance conference), which might be seen as a form of academic marketing and promotion. The team also engaged in postmarket surveillance of GridlockED game to enhance the project and marketing over time. ¹⁰

IMPLEMENTATION PHASE

To create the innovation fund, the six originators of GridlockED signed over the proceeds from commercial sales of the game to the University. The innovation fund was set up within a departmental account to hold the proceeds of the sales revenue from the Gamecrafter, which were paid out via an institutional Paypal account. The faculty leads have joint oversight over the fund and how it allocates funding (either through an open grant competition or through game development–related innovations). This created a fund that had two intentions:

1. To directly fund and subsidize the creation of new educational serious game innovations (e.g., prototypes of other serious games, expansion packs) and related academic scholarly activities (e.g., pilot research, conference fees, poster printing); and

2. To eventually become a local, intradivisional grant to foster medical education innovations and development.

The GridlockED game project yielded a new type of academically oriented intrapreneurial unit housed within the greater Division of Emergency Medicine within the McMaster University Department of Medicine. Our approach now allows for more risk taking within this domain of creating serious games and provides opportunity for pilot work of early career education scientists, ultimately laying an infrastructure for their future success. The fund has allowed new developers to be supported and subsidized during their design and prototyping process. Most recently, the GridlockED‐related monies were able to fund the entirety of the costs for prototyping the next game by this group (TriagED, a game that aims to teach about prehospital mass casualty incident triage and disaster management), which allowed for earlier play testing and faster game development, which ultimately allowed for the game to be taken to market more quickly. The TriagED game is now also available for sale, and as part of our agreement with the developers of this game, its sales also now contribute to the innovation fund established initially by the GridlockED game sales. There are some costs for continuing to list the GridlockED and TriagED games on the TheGamecrafter.com website; however, these are essentially included within the costs of sales (i.e., we simply receive less royalties if the games are not selling in higher volume) and require no additional funding from our part to maintain the sales component. There are some small costs for maintaining the GridlockED domain name, and the opportunity costs of having a faculty member (TC) engage in continuing to market the game.

OUTCOMES

There are three sets of outcomes we can assess for our intrapreneurial venture. One set of outcomes is focused on innovation fund generation for the University. Another set of outcomes pertains to the academic productivity fostered by the game, including new educational innovation supported by the innovation fund. Third, we report the unexpected outcomes of increased scholarly output in the area of serious games in medical education.

Innovation fund generation

Previously, we have reported sales and postmarket surveillance ¹⁰ of the GridlockED game, which showed that the game had a fairly robust initial uptake and sales. In the first year of game sales (based only on GridlockED game sales) a total profit of $9534 Canadian dollars (CAD) was generated. The only expenditures during this period were for the purchase of prototypes and subsequently demonstration versions of the game. To date, more than 500 copies of GridlockED have been sold and delivered. Locations include Canada and the United States but also UK/Europe, Australia, Asia, and South America.

After this initial period, a second game (TriagED game) was developed, designed, and prototyped, completely supported by the GridlockED game innovation fund. The collaborators who helped to create this game entered into a similar donation process to the University, thus increasing the number of games donating to our innovation fund. After 18 months of sales, the fund accrued a total of $14,530 CAD—but this includes both sales of TriagED and GridlockED combined.

Outcomes related to supporting academic success

The GridlockED fund was established as part of the workflow for the sales of the game. However, the grant competition was established roughly 2 years after. At the 24‐month mark, we initiated our first internal grant competition within our Division of Emergency Medicine, funded by the GridlockED and TriagED proceeds. Each grant was reviewed by the lead faculty members (TC, MM, AP) who administer the grant using the scoring rubric (Appendix S1). In 2020, we awarded grants of $500 each to two project teams, directly benefiting three junior faculty and one medical student. We intended to launch this competition annually.

Based on projected sales, we anticipate being able to continue awarding grants on an annual basis. We hope that some of these projects yield further monetizable products that can replenish and further grow the fund, allowing us to award bigger awards in future years. Thus far, the first two grants have supported the program evaluation of an institutional podcast (MacEmerg Podcast ¹³ ) and the evaluation of the Do‐It‐Yourself Mentorship Playbook. Each of these project teams has launched their data collection phase and is currently working on their projects. One team has presented their data locally at the 2021 McMaster Program for Faculty Development Day (which is our local conference with faculty development workshops) and completed their first study. ¹³ These outcomes reflect high‐order outcomes for our program, since there has been a distal change by the grant recipients in that they have taken up education scholarship that has not been previously attempted before due to the grant competition. There are also signs that the grant may be precipitating further outcomes since it sparked an interest in trainees working with faculty members in further medical education research and scholarship work beyond the initial grant.

Collateral benefits: New scholarly pursuits

While this was not the intent of the project, this fund has resulted in a “collateral” and unexpected benefits, namely, increased academic scholarship. A value add of the GridlockED and TriagED games is their role in fostering new engagement with education scholarship. By forming our innovation teams and intrapreneurial unit, we have been able to engage a number of junior faculty and trainees to work on various related projects. To date, our intrapreneurial team has engaged in the development of four research protocols (for GridlockED, TriagED, and another game in development entitled DischargED which focuses on discharge planning for internal medicine trainees). The team has also worked together to author peer‐reviewed publications (n = 4 published to date) and present multiple abstracts (n = 7) and workshops (n = 5), many of which were led by early career education scholars.

REFLECTIVE DISCUSSION

In this paper we have reported the structure and outcomes of an innovation‐driven fund that furthers the academic mission of our institution (i.e., scholarship, supervision of learners for projects) by creating a new revenue stream that allows new scholarship and innovation to supported. The sustainability of this revenue stream and innovation fund are highly dependent on the success of these particular games, but as more funded innovations are added to the successes of the intrapreneurial program, we are confident that the fund will continue to grow. To date, there have been more than 500 copies of GridlockED sold around the world, and this game continues to get at least one purchase each month, with some educators purchasing several copies at once.

Considering how sparse funding for education‐related research and innovation has become, it may be useful for considering how we can think outside of the box (or in this case inside the game box!) to create new ways to support initiatives in nontraditional ways. Innovations such as GridlockED and TriagED can contribute to inspiring new ways of creating value from the academy while having excellent spinoffs for both creating sustainable funding and fostering a culture of scholarship and faculty engagement. The success of this initiative highlights that such programs help serve as a potential infrastructure that leads to a self‐sustaining fund that can support developing other medical education innovations and support further intrapreneurship within a department.

We hope to inspire other groups to engage in similar academically minded innovation that take an intrapreneurial bent. While we know that a possible barrier for other groups may be finding that first great idea that will kickstart the innovation fund, we are confident that successes like GridlockED do not have to be unique. Other intrapreneurial enterprises have been reported in the literature (e.g., a prepackaged continuing medical education course, a card‐based game on faculty development, ¹⁴ or game on antibiotic stewardship ¹⁵ ), and this paper may serve as inspiration for how their social/academic efforts might help others do the same. Figure 1 details the workflow of how our intrapreneurial venture established the eventual innovation fund. We imagine this figure may be used as a scaffold for a new framework for fostering education scholarship via intrepreneurial approaches.

FIGURE 1.

Graphical depiction of the workflow for how our intrapreneurial venture was able to become a local medical education innovation fund

For those seeking the replicate this innovation, we have several tips for success in generating an intrapreneurial project that may have revenue generating potential. First off, consider the current research and local innovations that might be scalable—these might be ventures where others have found it interesting or novel. Second, conduct market research to engage in determining whether others might be interested in having access to your local innovation—such as focus groups, surveys, or sample sessions. Third, work with your local technology transfer office and/or patent office to ensure that the innovations have the right protections in place and that the proper paperwork has been filed. Next, consider how you might market your product. You can certainly generate press, buzz, and interest by social media alone; however, partnering with your public relations office may allow you to generate interest from mainstream press and media outlets.

LIMITATIONS

Some limitations to the generalizability of our current model are that not all institutions will have the expertise or passionate individuals to engage in the design of games or other products. While this may be true, we feel that by highlighting this project we can shine a light on new revenue‐generating scholarly activities that departments and schools may be interested in kickstarting with the hope of engaging in novel funding opportunities. Another limitation that we see is that due to its entrepreneurial nature, the work with the board games requires specialized knowledge but separate competencies are required for the innovation fund management. It may take time to find new members of the team able to take on the leadership and development of the innovation fund as it evolves. Finally, for other groups seeking start a similar intrapreneurial venture, it may take time for products to garner enough revenue to support other projects. In our case, we have limited the annual granting to the proceeds that are garnered each year to mitigate this risk, but in other cases with fewer revenue‐generating products or if revenue streams are less successful initially, it may be prudent to wait longer than 2 years to initiate the first round of giving or to consider other ways to engage donors to augment the fund (e.g., Kickstarter campaign, matching funds from advancement office or hospital foundation).

FUTURE DIRECTIONS

Future scholarly goals for this innovation will be to track the progress of educational innovations that are fostered by the McMaster Division of Emergency Medicine Medical Education Innovation Fund. A more fulsome program evaluation would be in order once the program has been established for a few years. Such an evaluation could include an examination of if and how such a fund is fostering career growth for recipients. At that time, we hope that the initiatives spurred from this fund will present an opportunity to further study the nature of medical education innovation and branch into more in depth research about processes associated with generating an intrapreneurial spirit within the academy.

CONCLUSIONS

Intrapreneurial projects such as the GridlockED and TriagED games may create new avenues for raising funds to sponsor new project and developments in education development.

CONFLICT OF INTEREST

Drs. Teresa Chan, Alim Pardhan, and Mathew Mercuri all administer the McMaster Division of Emergency Medicine Medical Education Innovation Fund described in this paper. They, along with Drs. Sneath and Huang, have generously donated their profit share to create the fund. None of these individuals have personally profited from the proceeds of this fund. The authors declare no potential conflict of interest.

Supporting information

Appendix S1

Chan TM, Wallner C, Sneath P, et al. From Innovation to Intrapreneurship: Fostering academic success via the GridlockED project and innovation fund. AEM Educ Train. 2022;6:e10816. doi: 10.1002/aet2.10816