A story on NPR yesterday discussed current research on medical training, and specifically the formalized exploration of errors in medical practice (you can find the audio stream here). The intro to the story, and the report itself, were oddly resonant with issues in the management of arts and culture. Said the intro:
It’s a basic principal of education that we learn from our mistakes. And it’s an important part of learning in the medical profession. But new research indicates that doctors in training get fewer opportunities to discuss medical errors than their counterparts who are learning to be surgeons.
The report, published in the current issue of the Journal of the American Medical Association (read the abstract here, along with the full article if you like medical journals), compared internal medicine and surgery residency programs at four Northern California hospitals, to see what part discussion of errors played in the training process. What did they conclude?
Our findings call into question whether adverse events and errors are routinely discussed in internal medicine training programs. Although adverse events and errors were discussed frequently in surgery cases, teachers in both surgery and internal medicine missed opportunities to model recognition of error and to use explicit language in error discussion by acknowledging their personal experiences with error.
The study brought to mind a similar frustration in nonprofit arts and culture. Given our funding structure, our advocacy efforts, and our culture of feeling constantly under seige, we seem to lack an open place to discuss what we do wrong. Almost every foundation report I read about a funded project carries good news (underserved audiences were reached, goals were achieved, worlds were changed). Much of the research on the public aspects of the arts is done by advocacy organizations or community coalitions with an admitted bias (of course the arts have a positive impact on city economies, education, at-risk youth, and luring the creative class, and we’ve designed research to prove it). Even at professional conferences, we are more likely to share ‘best practices’ and handy tips to sell tickets quickly, rather than exposing and exploring times we dropped the ball or didn’t even see it.
It’s all fine and friendly, but such one-sided and guarded discussions are contrary to learning. In final project reports, I’d like to read about not just what went right, but what elements of the project totally missed the mark, what original assumptions proved to be flawed, and what course adjustments were necessary along the way. In economic impact studies, I want to know where the correlation between nonprofit arts activity and economic benefit were actually quite weak.
Unfortunately, the system we’ve established has a bias toward vaguely positive spin. Anyone receiving a major grant, and hoping to get another one someday, will want to show how wonderfully they managed the project and the cash. Most publicly promoted research on the benefits of the arts is prepared and presented by organizations with a direct financial stake in showing those connections.
It’s not that we’re all lying. It’s that we don’t feel comfortable or rewarded for openly sharing the whole story — good and bad. If we really want to grow our way into a vital and dynamic society of arts and cultural organizations, learning should be at the top of our lists, despite the discomfort of the process.
The problem only becomes more pronounced when someone steps out of the norm and clearly speaks their mind. Penny McPhee’s wonderfully blunt speech to orchestra managers last year was just such an occassion. The fact that her clear statements and tough love were so surprising only proves the fact that we don’t hear such things very often. Said Penny:
We continue to claim as one of the primary successes of Magic of Music that it has changed the conversation within and among orchestras. If that’s true, the proof should be that there is room for dissent and aggressive disagreement. It should mean that different points of view are not heresy. So, let’s find out if we’ve really changed the conversation.
Bring it on.
