Learning Group Call May 4, 2006

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Learning Group CallMay 4, 2006
Dialogue Prompts
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Questioning 1What do we mean by learning?
Early in life, we are urged to study hard, so
that well get good grades. We are told to get
good grade so that well graduate from high
school and get into college...so that well get a
good jobso that we can buy a house and a car.
We spend our lives stretched on an iron rack of
contingencies. The achievement of goals is
important. But the real juice of lifeis to be
found not nearly so much in the products of our
efforts as in the process of living itself, in
how it feels to be alive. - George Leonard,
Mastery The Keys to Success and Long-term
Fulfillment
Human beings are the learning organism par
excellence. The drive to learn is as strong as
the sexual drive it begins earlier and lasts
longer. - Anthropologist Edward Hall
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Questioning 2Based on the understanding of
learning that emerged in questioning 1, what can
we say about the essential nature of human being?
Under what conditions are we most human?
Real learning gets to the heart of what it means
to be human. Through learning we re-create
ourselves. Through learning we become able to do
something we never were able to do. Through
learning we re-perceive the world and our
relationship to it. Through learning we extend
our capacity to create, to be part of the
generative process of life. There is within each
of us a deep hunger for this type of learning. -
Peter Senge, The Fifth Discipline The Art and
Practice of the Learning Organization
In truthprecisely nowhere does man today any
longer encounter himself, i.e., his essence. -
Martin Heidegger, The Question Concerning
Technology
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Questioning 3Lets think about the
institutional challenges to learning within our
organizations.

• Management by measurement
• Focusing on short-term metrics
• Devaluing intangible
• (You can only measure 3 of what matters
  W.E. Deming)
• Compliance-based culture
• Getting ahead by pleasing the boss
• Management by fear
• Managing outcomes
• Management sets targets
• People are help accountable for meeting
  management targets (regardless of whether they
  are possible within existing system and
  processes
• Right answers vs. wrong answers
• Technical problem solving is emphasized
• Diverging (systemic) problems are discounted

• Uniformity
• Diversity is a problem to be solved
• Conflict is suppressed in favor of superficial
  agreement
• Predictability and controllability
• To manage is to control
• The holy trinity of management is planning,
  organizing, controlling
• Excessive competitiveness and distrust
• Competition between people is essential to
  achieve desired performance
• Without competition among people there is no
  innovation (Weve been sold down the river by
  competition W.E. Deming)
• Loss of the whole
• Fragmentation
• Local innovation do not spread
• - Peter Senge, The Fifth Discipline The Art and
  Practice of the Learning Organization

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Questioning 4What are some of the broader
systems that can inform an understanding of
health and health care?
Not only is the disaffected worker more likely
to recall regional back (or arm) pain, he or she
is more likely to find the morbidity so
insurmountable that recourse is sought in
workers compensation insurance schemes. We
in medicine need to understand the toll that
marginal employment and disaffection can take on
any of our patients I believe that the crown
jewel of capitalism is not the accumulation of
wealth it is the creation of sustaining jobs. -
Nortin Hadler, MD, Laboring for Longevity
Journal of Occupational and Environmental Medicine
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Questioning 4What are some of the broader
systems that can inform an understanding of
health and health care?
Technological medicine takes human beings out of
the natural order, and does so increasingly as
new technologies develop. To save lives which
would in the course of nature have ended by means
of drugs is one thing it is a much greater thing
still to save lives by assisting the function of
failing organs by mechanical means, as in renal
dialysis or the use of heart pace-makers it is
going yet further to save lives by replacing the
organs altogether by other organs, taken from
other human beings or even from animals of other
species. Each of these marks a step further from
the natural order, from the governance of
processes by impersonal laws of nature, with
which human beings can only cooperate, to an
order constructed by human beings. Eric
Matthews, Medical Technology and the Concept of
Health, The University of Aberdeen
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