If you've watched Gray's Anatomy, then you've gotten an insight into the complex hierarchies (等级) that rule a hospital. Over 17 seasons, the show's heroine, Meredith Grey, got promoted from a lowly intern (实习生) to chief of general surgery, learning from the presiding residents and older surgeons along the way. There's rarely doubt about who is in charge, who has more expertise, or who should be supervising and training other staff. Grey's fictional journey illustrates the complicated dynamics of a health care setting, whether it's a local clinic or a busy city hospital. Those hierarchies can help teams provide care efficiently, but what happens when those traditional roles are disrupted?
"These status barriers are tricky. "says Sara Singer, a professor of organizational behavior and a professor of medicine. "They can get in the way of medical professionals learning new skills, particularly when junior employees are asked to show more senior coworkers how to use a new technology. "But, as Singer and her coauthors reveal in a recent paper, upending these complex hierarchies can be a useful training strategy.
Singer and her coauthors studied observations from five different primary care settings over the course of nearly two years. At each, medical assistants and patient-service representatives had to learn several new digital technologies. Even though these positions are fairly low in the medical and administrative order. Singer says that within these jobs, tenure and status are still important. So when younger employees were selected to be trainers, that threw the typical power balance off the good state. At some sites, employees struggled to pick up the skills they needed. "There were some groups where the training seemed to be taking and people seemed to be following on with the work that was intended, "Singer says. "But at other places it just wasn't working out. "
By creating a system that gave everyone a chance at those opportunities, clinics could remove the jealousy that might come from selecting one younger employee over another time and time again.