Common sense in pharmacy is rarer than you think

Pharmacy students often complain that many of the things I teach are "just common sense."

I typically respond by asking, "if managerial decision making is just common sense, why are good managerial choices so uncommon?"

Don't get me wrong -- there are many excellent managers and pharmacists who make solid decisions day-in-and-day out. However, almost all pharmacists have been on the receiving end of monumental blunders made by co-workers and bosses. In hindsight, many blunders could have been avoided by better decision making processes.

So, how do we improve our decision making?

The first step is do understand the various forms of decisions we face in pharmacy practice.

There are five types of decisions pharmacists face -- legal, clinical, economic, managerial, and ethical. Different inputs and processes go into each.

If we incorrectly identify a problem, we will use the wrong process to solve it. This can result in poor solution.

For instance, if we look at all ethical problems using a legalistic framework, we might make decisions that legally justifiable but morally indefensible.

Identifying knowledge which is "common" in common sense requires a detailed understanding of all five processes of decision making -- legal, clinical, economic, managerial, and ethical.

I suggest that most students and many pharmacists need more knowledge and training to successfully apply common sense to pharmacy problems.

Why lectures suck

People learn by:
1. listening
2. doing
3. reading
4. talking to other about what they know
5. watching others do something
6. making mistakes and correcting those mistakes

Lectures only utilize (1) listening which is usually tied with (3) reading. That is the way education used to be and still is in many places.

Project-based learning (also called case-based or problem- based) can employ all six of the above ways of learning for students. The problem is that it requires a teacher who is knowledgeable, flexible, creative, and committed to student learning. It also requires much more time from the professor. These things are not always available in pharmacy educational settings.

Watch this video. It clearly illustrates the value of project based learning. But to really understand, you need to apply the method on sayyyy.....a PROJECT!

How to stop worrying

In the last post, I described a book by Dale Carnegie, "How to Make Friends and Influence People." I have another one of his books to recommend. It is "How to Stop Worrying and Start Living." There are all kinds of great ideas in this book, but I want to focus on a single one. It deals with HOW TO STOP STRESSING OUT OVER YOUR PROBLEMS.

If you think about it, a lot of things can go bad in this world. If we let them get to us, we can forget to enjoy all of the good things in life. So, if you find yourself worrying about some problem like, "What if I lose my job? What if I do really bad on this exam? What if my political candidate does not get elected?", ask yourself the following questions,

1. "What is the worst that can possibly happen if what I fear happens?"

I often ask this of my students when they worry what they are going to do with their life. I am kind of sadistic in even asking that question because their faces scrunch up and they exude stress as they think about the question. After listening to their fears, I ask them, "What is the worst that can reasonably happen to you after graduation?"

They usually answer, "I won't get a job."

2. The next thing to ask is "What is the likelihood that the worst case situation will occur?"

When I ask the students, what is the likelihood that they will not get a job, they typically say, "Not very likely, but still possible." I tell them that they are correct, that they might not get a job and they need to prepare themselves mentally to accept the worst--if they think it can happen.

3. The final 2 questions to ask yourself are, "What steps can I take to reduce the possibility of the worst case occurring, and how can I increase the chances that some other better outcome occurs?"

Immediately after asking this question, students typically start thinking of actions they can use to reduce the threat. They take control and their worry starts to disappear. It also steels them to do what it takes to be successful.

One of the benefits of this process is that answering these simple questions can help identify and assess the cause of the worry. In many cases, the worry is overblown and can be put into better perspective.

The other benefit is that even if the worry is real, imminent, and scary -- taking action helps give the worrier a sense of control over the problem. And worry is reduced when we feel in control.

Which is more important -- a good process or a good outcome?

In the long run, a good process will be more likely to result in better outcomes over time.
Let's say you want to hire a new employee.  You can get lucky once or twice with a poor selection and hiring process, but over time your luck will start to fail you.

The problem with good luck and bad processes is that it can be hard to tell them apart.  Thus, an incompetent person who does not know what he is doing can be labeled a genius because of some short term good luck.  And once labeled a genius, it can be hard to recognize or admit a person's incompetence until major damage has occurred.

Therefore, it is essential to employ good processes in order to achieve good outcomes.

Common Sense

Students often complain to me that managerial problem solving is just "common sense."

In truth, common sense is not really all that common in actual work situations, because common sense is typically based upon mental models that are not tested or examined. Common sense also tends to disappear in times of stress and emotion. Common sense also does not work well for complex problems.

In real life, we don't have time to use our common sense, so we just wing it and suffer the consequences.