From the Design Quarterly: Breaking down silos in healthcare education
November 29, 2018
November 29, 2018
How design can support the creation of a cross-disciplinary culture of learning
Silos (like the office cubicle) grew strong during the 20th century, when they mirrored the specialized roles that typify a highly industrialized society. But today’s companies, healthcare institutions, and employers see the value in thinking and working across departments. They want to hire those who are trained to work collaboratively, to learn from other disciplines and departments with innovation in mind, working toward common goals.
Healthcare professional education is reorienting, too. There’s a push for professionals who can see the big picture and collaborate across the care continuum. In recent years, the education of health professionals has refocused to teach providers to be better versed on the most appropriate path to health through a broader, more integrated curriculum. This gave us interdisciplinary education, which was all about getting multiple disciplines together talking to produce a broad-based culture of learning.
Today, health education is embracing interprofessional education (IPE) in which students learn about and from each other—across disciplines and departments, resulting in an individual that’s better versed in healthcare overall and prepared for the real world. IPE started in health and now it has blossomed to other aspects of education.
Trace the careers of six healthcare professionals from the same program and it’s unlikely any two are following the same path. There isn’t a “typical doctor” anymore, nor nurse practitioner, and so on. One medical professional may be developing apps. Another might be specializing in neuroscience. Another might be performing fundamental research. Educating for career paths that we can’t envision is huge driver for creating collaborative environments. In today’s post-secondary educational environments, we want to get different kinds of students and educators talking about things and discovering things from each other. How you do that? How do you design space that enables and even encourages it?
In our recent post-secondary and career/technical education (CTE) work, we’ve seen how different design methodologies are required to meet the opportunities presented by an increasingly collaborative, cross-disciplinary culture of learning. We’ve employed a few approaches that lend themselves to promoting this pedagogy in post-secondary environments.
This visceral connection to nature fosters a sense of calmness and wellness for occupants.
To create meaningful 21st century learning environments that promote collaboration, we need to flip the design process. In the past, informal spaces were placed in left over space. At Camosun College in Victoria, British Columbia, we turned the planning approach around. A focus on collaboration space drove the design and created the framework around which academic programs are arranged.
In our interaction with the user groups and the college steering committee, an emphasis on collaboration and informal learning spaces emerged. We designed two bisecting “axes of collaboration” as a sacred area on each level of the school where informal collaboration and learning will take place. This concept acts as the frame for program accommodation, allowing us to stitch traditional classrooms in, but not take away from the critical collaboration space.
Breaking down the silos in our own process was fundamental to finding the design solution for Camosun College. Initially, we met with individual departments separately. It wasn’t until we all met as a collective group that we realized the design solution to embody the school’s attitude toward a shared interprofessional approach. Stacking laboratories on one side of the building might have been a solution in the past. But people, in general, integrate better horizontally. That was an “aha moment” for the team. Rather than stacking the labs on all four levels, we clustered them all on one floor encouraging programs and people to work in close proximity.
Health is something everyone has access to. Everyone knows something about healthcare. What’s happening in health science buildings should be affecting the public and other students. Why not build paths through these buildings for people that aren’t part of the program who might want to see what’s going on, without interrupting? That might create interesting intersections between the public and education institutions themselves.
At Conestoga College in Ontario, we took a building located between another building, a transit stop, and a parking lot and created an interior shortcut for everyone to use with transparency to the educational program. Visitors get to see into the simulated learning facilities and a huge practice lab off the main atrium.
At Camosun College, uniting the labs on one floor was the breakthrough in making the architecture match the pedagogy. With all the labs on the top floor, there’s greater awareness and information sharing between departments. They use the same huddle spaces and collaboration spaces. There’s a lot of glass and transparency—education and collaboration are on display. We grouped all the staff offices in one area to further encourage collaboration and mitigate territoriality. Once we got over the hurdle of anyone owning any single level of the building, the design conversation focused on space typologies to provide equality and simplicity.
This interconnected environment like that of The Edmonton Clinic Health Academy may be new to students, faculty, and administrators, who, thinking departmentally might ask: “Why can’t we have our own floor?” early on in the project. This type of design requires dramatic cultural change, dialogue, and creating understanding around the new connected spaces and why they are necessary.
At Camosun College, we simply cut three large holes through the floor plates to create full-height atrium spaces. It was all about connection. Now, there’s a lot of visibility and transparency within the building, so that there isn’t any one group or floor that feels disconnected. Not only do the large cut-outs connect the building community visually, they encourage the use of the stairs—reinforcing that healthy lifestyle culture that underpins the whole program.
Similarly, in the upcoming British Columbia Institute of Technology Health and Science Center, we took the idea of a typical atrium and deconstructed it. One floor features traditional labs while another features simulated learning spaces. There are sections of the deconstructed atrium in each, conceived as open flexible areas which related to the adjacent program. The simulation floor has a debriefing area outside the simulation spaces, while the lab floor features several interconnected collaborative spaces for group work. The deconstructed atria help students connect and learn within the building as they move through their daily class schedule.
Today’s medical breakthroughs are often technological, and we need to educate for healthcare innovation. So, we need maker spaces—places where things can be built and experimented on—from a new stent design to computer-aided design for dentures. We must keep in mind that we’re training technologists, not just healthcare providers. And these spaces are likely to be outfitted with the latest technology (such as real MRIs) that professionals will use in the field. It’s practical, hands-on discovery and learning—fast-paced and focused on innovation.
Camosun College enjoys a temperate climate which presents a unique opportunity to fully connect program to nature, reinforcing the broader mandate for promoting community wellness. On the ground level of the building, strong connections with the rest of the campus are forged with generous public spaces open to students and the larger community. A cultural center on the first floor, for example, is a special area near the entry that is open to the community. It recognizes the First Nations community in the region with a circular space designed for activities such as smudging ceremonies, graduations, or community drumming circles.
The building integrates with natural environment in which it sits. Two interior atria feature live trees, bring filtered light and nature into the building, and connect students to nature. This visceral connection to nature fosters a sense of calmness and wellness for occupants. The architecture seamlessly flows into the landscape where the interior social stairs extend from inside to outside the building, further connecting students, staff, and nature.
We locate collaboration zones in the public areas where the traffic is heaviest. Finishes and lighting elements are designed to highlight these spaces, inviting occupants to stay. At Coast Mountain College, another CTE post-secondary institution in northern British Columbia we used mass timber to highlight the collaboration zones in a revamped building. Beautiful Douglas Fir cross laminated timber shear walls demarcate the collaboration/huddle zones. By strategically locating the required shear walls for seismic upgrading with the location of huddle spaces at the entrance to each of the trade shop bays in the building, a structural and code requirement transforms into a design asset.
While these institutions are embracing IPE in different ways, all are broadening the idea of healthcare and healthcare education. They’re educating each professional for a fruitful career that’s going to be highly collaborative, highly technological, and communication dependent. Our designs share those goals, by opening departments and people up to one another, placing people strategically into areas where they must move about and connect and, as a result, these spaces better educate the whole healer.