Kathryn Truant CDA MEd – a CDA's Role in Education and Oral & Maxillofacial Surgery

830 Exit interview

At the beginning of 830, Dr. Galy assigned 10 questions to consider as the course’s content unfolded (assigned readings, lectures, guest speakers, and the cohort’s presentations). We were then instructed to schedule an individual ‘exit interview’ with Dr. Galy, where he would ask 3 of the 10 questions randomly (he picked numbers out of a hat). The following are the notes I prepared for my interview:

Glenn asked me questions 2, 4, and 7 – He liked my responses to 2 & 4, but he said my question 7 lacked detail 🙂

Section One Questions from Planning Programs for Adult Learners (Caffarella & Daffron, 2013):

1. Chapter One: Planning Programs for Adults. Referring to one of our guest speakers, identify their organization’s approach (p. 10-16). What primary purpose is driving this program? If you were helping this organization implement a program change, what aspects would you target? Why? How would you organize the overall ‘roll out’?

From Ms. Dalya Israel: Executive Director, WAVAW (Woman Against Violence Against Women)
APPROACH: WAVAW follows the pragmatic and radical approaches to program planning:
Pragmatic: (2021, p. 14)
Practical, real-world, change is a process and the process is fluid (aligns with industry expectations and standards)
Radical: (2021, p. 17)
Focus on social activism, democratic principles, and transformation
PRIMARY PURPOSE: A rape crisis centre – They provide support services to survivors of sexualized violence.

– I would change the name of the organization because it is a rape crisis centre for all people (and NOT just women). WAVAW needs to look at the organization’s entire branding – obviously there has been many societal changes since 1982, “We are visionary. We are leaders at the forefront of service provision and social change” (from their ‘about us’ page). In Dalya’s own words, come up with an idea of how to improve services, then research how to resource it.
– I would suggest a merger between WAVAW and EVA: the communities they serve seem similar.

This reminds me of Week 3 video Instructional Design Considerations – Glenn advises that when considering changes to Instructional Design, we must include reliable resources or professional consultants.

2. Chapter Two: Referring to the nine major assumptions. Which two assumptions (p. 33-36) do you consider to be most crucial to the successful implementation of a program? Why? Support your answer with points mentioned by one of our guest speakers.

The Nine Major Assumptions:
– The lifelong improvement of one’s KSA (Knowledge, Skills, and Attitudes) reflects industry innovations and emerging cultural issues.
– ADAPTS adults to be open to accept learning and change (acclimatization). “Some of these changes can be demonstrated almost immediately, such as learning a specific job skill, whereas other changes, such as abolishing discriminatory practices, may take years of continuous effort on the part of educators” (2013, p. 82).
– From Jake Delleman, MADD: MADD is trying to bring about societal change – however, their approach is not effective because I believe that MADD should also focus on community partnerships, specifically addiction treatment/education.  
Program planners are leaders BUT they must be learners first and foremost to gain trust. Walk the walk before you talk the talk (Brookfield? or Bain?). Look at Hattie (2009) research on visible learning: SME (Subject Matter Expert) is at the bottom of the list – Instructional strategies is at the top! Instructors NEED TO BE ADAPTABLE (Ha! Context!!)

From Ninu Kang, Executive Director EVA (Ending Violence Association of BC): Every step of successful program planning is about learning from needs assessment and exploring community partnerships: What are the deliverables (needs assessment and curriculum development)? Who are the learners? Who does this program serve?

From Gord Houston, Director, HR Advisory Services, McLean & Company: What is the ‘practical’ application? What is the method of assessment? Gord spends a lot of time with each prospective student/participant/executive assessing their needs and views before the planning begins.

3. Chapter Three: Exploring Foundation Knowledge of Program Planning. What are three (3) vitally important insights that you have gained about the topic of ‘power’, in relation to program implementation? Support your insights with points mentioned by one of our guest speakers.

“Positive power gives us the opportunity to use our influence to assist others to achieve their goals, to give voice to those who have been silenced, to cross boundaries where deep divides exist, and to build relationships for the good of all involved” (2013, p. 135).

It is difficult for people to trust leaders/people in power positions; this is the reason Dalya Israel from WAVAW believes that consistency, communication, and transparency are the key to successful program planning. Dalya discovered this important insight when she realized her mistake in not including all stakeholders in decision making based on her own assumptions.   Unintended consequences of power: too much power – transformative justice, and learning from errors.

From Gord Houston, Director, HR Advisory Services, McLean & Company: Leaders (those with the most power) decide the timeline when releasing foundational knowledge (emerging transparency) – I DO NOT AGREE WITH THIS STRATEGY: POOR LEADERSHIP, LACK OF TRUST –

I researched double-looped learning: it is a governing principle in sharing information, and feedback:

Invista Performance Solutions (20160. Retrieved from https://www.invistaperforms.org/double-loop-learning-leadership-development/

From Jake Delleman, MADD: The use of clear and powerful language – crash (NOT accident), criminal (NOT impaired driver). Autocratic leadership (from Glenn’s week 3 Part 1). Also, see: POWER TOOLS (from Cooperation Tools) Christenson et al. (2016).

4. Chapter Four: Discerning the Context. How are an organization’s contextual factors important to the successful implementation of a program? Link your answer with points emphasized by one of our guest speakers. Also, include any points that came to your attention during your interview with a program manager.

CONTEXT (defined): the circumstances that form the setting for an event, statement, or idea, and in terms of which it can be fully understood and assessed.

It’s crucial to develop a strategic cultural framework that learners identify with: recognizable (from Kevin, Khairunnisa, Len’s weekend 2 presentation).

From Ms. Dalya Israel: Executive Director, WAVAW (Woman Against Violence Against Women): the 3 aspects of contextual program planning – consistency, communication, and transparency AND meet the community that you serve WHERE THEY ARE AT!

***See also Glenn’s Week 2 Part F: how context is instrumental in TOL plans – 5 points are explained from Context Matters in Program Implementation Health Education Volume 110 (2010):

1. Understanding the organizational & cultural context (critical for implementation and sustainability***)
2. Implementation is likely to be successful with strong leadership – contradicts Hattie’s (2009) study somewhat – not in his Top 5 visible learning contributors!
3. Stability in terms of resources and personnel
4. Open communication and an open communication pattern (e.g. WAVAW vs Gord Houston
5. Having shared collaborative decision-making processes in place: calibration sessions, formal staff meetings, etc.

The one thing that resonated with me from my research project interview with Dr. Beverlie Dietze was her response to my question about sustainability. It one thing to understand cultural context but moving forward how does one sustain this practice.

5. Chapter 9: Devising Transfer of Learning Plans. Why is the transfer of learning so important when implementing a program? What critical tips would you highlight if you were a consultant? Link one of your tips to a point emphasized by a guest speaker.

TOL must be part of the plan or a program is irrelevant. New KSA must be practiced and applied immediately. “Although a certain amount of time must go by before transfer can be measured in the workplace, program planners do know that immediate application of KSA is ideal” (2021, p. 265). IT IS IMPORTANT THAT KSA BE ONGOING AND PRACTICED – TO TRULY BE MEASURED.

Knowing is visual, tactile, practical.
Procedural knowledge: knowing how to do something VS declarative knowledge: knowing about something – The Mind at Work (Rose, 2014, p. 154)

CRITICAL TIP: Provide formative feedback during the program, and continued check-ins or mentorship after the program.

CRITICAL TIPS from Week 2: Part E –
1. Building self-efficacy (a person’s belief in their capacity to execute behaviours necessary to produce specific attainments (HATTIE #1 !!!!!)
2. Fostering connectedness, engagement and active learning
3. Development of self-management skills

CRITICAL TIP: Create a Taxonomy (all 3 domains: Affective, Psychomotor, Cognitive)

**From Gord Houston, Director, HR Advisory Services, McLean & Company: emerging transparency (a TAXONOMY?) and a ‘What not to do List:’
– no connection to business strategy
– not connected to a competency framework
– no true sponsorship of the program
– no motivation for development, and no consequence for non-development (Drive, Pink, 2009)
– no practical application – all “training” events
– no communication or celebration
– no feedback loops
– no follow-up from the executive team
– no method of assessment

*** Week 2: Part D – (Chickering & Gamson, 1987) 7 Best Practices When Implementing an Educational Program:
1. Connectedness & Contact: orientation sessions, internships, peer learning activities, service learning (check out Eric Mazur, Harvard Physics professor as per Glenn) – Also, Habley et al. Increasing Persistence – Perseverance &Persistence … POSITIVE LEARNING ENVIRONMENT – AFFECTIVE DOMAIN
2. Collaborative Learning Activities: group and team-based activities, problem-based learning (e.g. cohorts have a higher completion rate that individual graduate programs)
3. Active Learning Techniques: doing, roleplay, field trips, practicum, action-research projects – followed my metacognition, reflection, self-assessment
4. Feedback: specific, prompt (students will move on), self and peer assessments with clear criteria
5. Time on Task: INTERLEAVING (Robert Bjork) – instead of BLOCKED PRACTICE – Interleaving is a process where students mix, or interleave multiple subjects or topics while they study to improve their learning. Blocked practice, on the other hand, involves studying one topic very thoroughly before moving to another topic.
6. High Expectations: Pygmalion Effect based on Rosenthal’s research – The Pygmalion effect refers to situations where teacher expectancies of student performance become self-fulfilling prophecies; students perform better or worse than other students based on the way their teacher expects them to perform – coupled with support and the necessary resources leads to improved performance.
7. Respecting Diverse Talents & Ways of Learning: An example is indigenous approaches – recognizes interconnected dimensions of learning; emotional, spiritual, cognitive, physical e.g. the Physics instructor that assigns a research project where students must demonstrate their learning in original song, poetry, art, videos.

Example of Resource – Pulling Together: A Guide for Indigenization of Post-Secondary Institutions (Antoine et al., 2018), or some professional consultant or resource.

Modelling: The more collaborative leaders are (higher up) the more collaborative institutional or structural change becomes – this is crucial in devising a TOL plan.

Section Two Questions from Change Management (McCalman et al., 2016):

1. Chapter Two: The Manager and The Objective Outsider. Select ONE of the Golden Rules outlined on p. 34-36. Discuss this Golden Rule in terms of its implication(s) for the successful implementation of a program.  Support your answer with points emphasized by one of our guest speakers.

Golden Rule #4: The change agent is an outsider external of the hierarchal power structure of the organization.

An external change agent/consultant needs to be fair, unbiased, know the culture of the organization (Gord Houston interviews all stakeholders, Phillip Gruner’s ‘who’s who in the zoo’)

3 examples:
Ninu Kang (EVA): internal
Dalya Israel (WAVAW): internal
Gord Houston (McLean & Co): external consultants
Phillip Gruner: internal/external: perceived as being external (Corbin)

***Crucial – shared decision making – get locals on board! An external change agent receives greater resistance that an internal change agent (as per McCalman et al, 2016 – ‘Force Field Analysis’)

Qualities of an effective Change Agent (internal or external):
– solution-based mindset: this is the issue and here is how we are going to address it – the problem owner!
– clear vision as to timeline (90 days, direction, solution), approach (conventional, pragmatic, radical), leadership style

– an external consultant can be brought in by the internal CA!!!


2. Chapter Two: The Manager and The Objective Outsider. There are many types of resistance to change (see p. 31-32). Select one type of ‘resistance to change’. Link your discussion to: a) points mentioned by one of our guest speakers; and b) the interview you conducted with a program manager. 

Phillip Gruner’s presentation regarding Northlands is an excellent example of organizational resistance to change. Northland’s demise was triggered by:

–  Real (not perceived) power conflict. Board members wanted complete control, and their resistance to accepting guidance from the city of Edmonton (even though they owed millions of dollars!!) is well-documented. They believed themselves to be untouchable.
– Organizational Culture. Proposed change disrupted the “values and norms within the organizational culture” (2016, p. 31). It was ‘an old boys club!’ – even though a new ‘puppet’ board was created.

Dr. Beverlie Dietze, the successful program manager I interviewed at Okanagan College, employs a completely opposite leadership style. After a complete upgrade of OC’s PD department, a method similar to the Leavitt’s model was applied – A TEAM APPROACH – where 4 interactive variables change and the TEAM ADAPTS: Task (purpose), Structure, (power & communication), People (competency), and Technology (processes used). One common mistake in implementing change is to isolate TASK (for example) from the rest of the organization.
– Her team’s workshops have become well-attended, and meet emerging and current trends – technology, COVID. There is true collaboration and shared decision making on every level – the team meets every day! Beverlie has the final say though.
– Beverlie’s leadership style reminds me of Phillip’s new position as CEO of Vernon Immigrant Services:

Leadership Style:
TASK-ORIENTED – Conventional (& Pragmatic): SMART goals (specific, measurable, attainable, relevant, time-based), deadlines, pressure to perform (pressure, morale can suffer).

TRANSFORMATIONAL – pragmatic & RADICAL: inspires and intrinsically motivates staff to innovate and create change to advance organization’s future, future focused, strong communication skills, clear vision.

Houston, 2021

3. Chapter Three: Cultural Attributes of Change. What was one big ‘take away’ that you learned from watching the interview regarding the scandal at Staffordshire Hospital (see p. 47)? Have you noted anything similar in recent years? Support your answer with a point highlighted by one of our guest speakers or the interview that you conducted with a program manager.

Intro of situation from the Frances Report (high death rates, patients dying naked and covered in urine and feces). It was the entire NHS (not just the Mid Staffordshire Hospital): https://youtu.be/I7GgVi-SRMA

THE CULTURE: shame and blame, the triggers, the trauma

Look at Julie Bailey: https://youtu.be/wRP-Z39RSEU

Results of studies: staff had no autonomy – they were too busy trying to comply with regulations rather than treating patients. Management style was INSTITUTIONAL – AUTOCRATIC – CONVENTIONAL: hierarchal, one person or group of people call the shots with little industry background, and with little or no input from anyone below their level (this includes employees – professionals – and clients – the patients and their families). These leaders make all the decisions: ‘my way or the highway.’ Examples: Napoleon, Genghis Khan, DT AND Martha Stewart, Elon Musk. Management style is also BUREAUCRATIC – CONVENTIONAL – McDonald’s is an example (uniforms, strict kitchen policies, AND customer service – the most important thing that NHS lacked!). Management style was also TASK-ORIENTED – Conventional (& Pragmatic): SMART goals (specific, measurable, attainable, relevant, time-based), deadlines, pressure to perform, desperation, morale can suffer. Management style was also TRANSACTIONAL – CONVENTIONAL: characterized by control, organization, and planning. Extrinsic motivation (see McGregor’s Theory X screen shot). This style may have worked if NHS was less focused on over-regulation and more focused on staff and patient well-being.

Suggestions for how to manage critical change: Change the leadership style to ORGANIC approach – “Organic leadership is socially constructed by [a group of] people who elect to willingly support the values and assumptions of an individual and behave in a cooperative way to achieve the agenda. This type of leadership is powerful because it transcends official hierarchy” (2016, p. 75).

Organic leadership styles can be identified as:
PARTICIPATORY – PRAGMATIC & radical: collaborative, group decision-making, leaders empower their teams at every level, input sought from staff, buy-in and morale are high – Downside: change can be slow.
SERVANT LEADER – pragmatic & RADICAL: healer, motivator, helps people realize personal goals (I think this change process would be slow as well), focused on the future. Fosters community, improves higher engagement, fosters TRUST. These leaders use persuasion rather than positional authority to make decisions. Example: Southwest Airlines ‘Treat your people right and good things happen’. TEAM-PLAYER – pragmatic & RADICAL: evolves from organization’s stage of development, build the best team: forming – storming – norming – performing until high level effectiveness is reached, motivating and inspiring the team through each stage, supports and recognizes strengths, develops capacity, 9 team roles as per Belbin model:

McMahon, 2018. Retrieved from

TRANSFORMATIONAL – pragmatic & RADICAL: inspires and intrinsically motivates staff to innovate and create change to advance organization’s future, future focused, strong communication skills (see screen shot), clear vision.

– Suggestions from Making the Right Changes (Buchanan & Bourne video): 2 issues: culture (new leadership – patient centred), and performance & targets (new leadership – less autocratic).

– Suggestions from CM: “[Leaders] and the organizations they serve will continue to strive to remain competitive in an increasingly global and complex [world]. They will achieve sustainable growth only by embracing communications technology, developing devolved supply chains and strategic alliances, and maximizing the return they receive from their accumulated knowledge base – their human capital” (2016, p. 18).

Employees must be valued: and this can be achieved by considering their well-being, stress levels, motivation and organizational loyalty” (2016, p. 18). Finally, “For the manager this has led to an increasing emphasis being placed on project and teamwork, communications, customer awareness, auditing and quality procedures. They need to supervise, provide individual direction, motivate and control has diminished” (2016, p. 19).

NOTE: Leadership styles are from Glenn’s Week 3 videos.
As per Glenn: LEADERS NEED TO BE ADAPTABLE! There is no miracle style that works in every situation. Durlak & DuPre (2008) studied 500 organizations and identified 23 CONTEXTUAL factors that affected implementation. BUT there is one that stands out: SHARED DECISION-MAKING – participation and collaboration! Especially in community-based organizations: increased effectiveness, and long-term sustainability. See CANVAS Pages Resources Cited in Leadership Video for more studies.

An autocratic system of management is not effective in healthcare

I had to find out what happened to the NHS Trust and I found this article from the BBC from December of 2019. A film called The Cure had just been released (not a documentary – it is a dramatization of the story). It’s important to note that many families were upset that their pain was used as entertainment. Anyways, this excerpt from the article. From a BBC article in 2019:

While it is important that those lessons are learned and what happened is never forgotten, it is equally important to recognize that Mid Staffordshire NHS Foundation Trust no longer exists. It is now being run by a ‘local provider’ namely two other Trusts.

The County Hospital is a much valued and highly regarded local hospital.

During the last five years there has been significant investment in improving facilities and services, including the refurbishment of all wards, a new chemotherapy centre and installation of new laminar flow theatres at County Hospital.

“I am very proud of our loyal and dedicated staff who work hard to maintain the highest standards.” Says the CE of one of the Trusts.

More Resources:
Making the Right Changes (Buchanan & Bourne) https://www.youtube.com/watch?v=7152JFhYfBU
The Francis Report: Lessons Learned https://youtu.be/CY-P9n_7atU
Robert Francis: lessons from Stanford https://youtu.be/4yBVJ0Bg9LY

4. Chapter Three: Cultural Attributes of Change: Referring to an organization (perhaps that you have worked at), highlight some of its cultural clues? What do these cultural clues potentially signal about program implementation, leadership and the change process?

Until I began teaching at Okanagan College, my entire career (decades) was spend working as a health-care professional in the private sector, where a top down approach to management was the norm. Responses to suggestions or recommendations for change from upper managers/proprietors (the dentists) were routinely:

“We can’t have the tail wagging the dog” and, “Is your name on the door?”

The organization had 3 types of culture (from Schein’s iceberg): Artefacts, Values & Beliefs, and Underlying Assumptions. The Artefacts were impressive, and so was the website, mission statement, etc., BUT the 3 levels did not align.

Did their business suffer? Perhaps not when there was an abundance of skilled professionals available for work – but times change and the critical shortage of CDA’s (for example), gave employees the advantage – if you weren’t happy or if you were not part of shared decision making and did not feel respected and appreciated – if you didn’t understand the CULTURE – you are confused by the CULTURE, you leave and get a better job.

 Christensen et al. (2006) argue that there are 4 types of cooperation tools that managers can use:

Retrieved from

These tools, and knowing when to use them are based on context, and on the paradigm of private vs public sector. For example, now that I am teaching at Okanagan College, I sense a broader and more shared upon consensus in my department which has a collective management style – there is no ‘one’ leader who dictates salary, breaks, etc. – our union provides those services for us and they don’t interfere with our instruction and our prescribed outcomes, program implementation and changes to curriculum. 

CULTURAL CLUES AT OC: Regarding change at OC, we have daily calibration sessions, and formal monthly staff meetings, Change or proposals for change are documented and followed up on. We are always improving and a leadership role is assumed by the individual suggesting the change – we are very fortunate because as time progresses it becomes less obvious who the ‘leader’ when we all have the same goal and can split the work – I believe Christensen et al. call this disaggregation: the separation of organizations into units, that when moving in the same direction, work effectively. One thing that has been missing in my department (for me because I’m a newbie!!) are clear timelines – I will suggest a model like Phillip Gruner’s (2021) ‘Run it Like a Business’:

As our culture grows in effectiveness and paradigms morph, the biggest cultural clues are our values (as instructors, CDA’s) which includes routines and rituals, and control systems. The power structure is malleable/adaptable. Re: Amie Peacock, Founder, Composer and Social Weaver, Beyond the Conversation – At staff meetings, as an outsider, you would not know who the executives are because of shared decision making and collaboration at all levels in the organization.

5. Chapter Five: The Nature of Change. Organizational culture plays a crucial role in the program implementation process. Select either ‘Force Field Analysis’ or ‘Success Guarantors’ or ‘Leavitt’s Model’ and highlight several key points that you may find helpful if implementing a program change. Support your discussion with points mentioned by one of our guest speakers.

Force Field Analysis is a positioning tool used by the change agent/problem owner/’right person for the job’ that determines the momentum, nature, magnitude, and potential buy-in of required or prescribed or suggested change.
– Typically follows some method of assessment/consultation. Example: TROPICS assessment: Timeline, Resources, Objectives, Perceptions, Interest, Control, Source. – Advocates the use of diagramming.

– “Change that has been generated by the ‘system’ most affected is likely to produce driving forces that outweigh any restraining forces, the opposite being true for externally generated change’ (2016, p. 95).

– An extremely communicative tool: relative, understandable, customizable, adaptable, will assist in buy-in and lower resistance to proposed change.

More examples:

Houston, 2021
Hudson, 2021
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