Stories

Category: Learning strategy

  • What is the pedagogy of Teach to Reach?

    What is the pedagogy of Teach to Reach?

    In a rural health center in Kenya, a community health worker develops an innovative approach to reaching families who have been hesitant about vaccination.

    Meanwhile, in a Brazilian city, a nurse has gotten everyone involved – including families and communities – onboard to integrate information about HPV vaccination into cervical cancer screening.

    These valuable insights might once have remained isolated, their potential impact limited to their immediate contexts.

    But through Teach to Reach – a peer learning platform, network, and community hosted by The Geneva Learning Foundation – these experiences become part of a larger tapestry of knowledge that transforms how health workers learn and adapt their practices worldwide.

    Since January 2021, the event series has grown to connect over 21,000 health professionals from more than 70 countries, reaching its tenth edition with 21,398 participants in June 2024.

    Scale matters, but this level of engagement begs the question: how and why does it work?

    The challenge in global health is not just about what people need to learn – it is about reimagining how learning happens and gets applied in complex, rapidly-changing environments to improve performance, improve health outcomes, and prepare the next generation of leaders.

    Traditional approaches to professional development, built around expert-led training and top-down knowledge transfer, often fail to create lasting change.

    They tend to ignore the rich knowledge that exists in practice – what we know when we are there every day, side-by-side with the community we serve – and the complex ways that learning actually occurs in professional networks and communities.

    Teach to Reach is one component in The Geneva Learning Foundation’s emergent model for learning and change.

    This article describes the pedagogical patterns that Teach to Reach brings to life.

    A new vision for digital-first, networked professional learning

    Teach to Reach represents a shift in how we think about professional learning in global health.

    Its pedagogical pattern draws from three complementary theoretical frameworks that together create a more complete understanding of how professionals learn and how that learning translates into improved practice.

    At its foundation lies Bill Cope’s and Mary Kalantzis’s New Learning framework, which recognizes that knowledge creation in the digital age requires new approaches to learning and assessment.

    Teach to Reach then integrates insights from Watkins and Marsick’s research on the strong relationship between learning culture (a measure of the capacity for change) and performance and George Siemens’s learning theory of connectivism to create something syncretic: a learning approach that simultaneously builds individual capability, organizational capacity, and network strength.

    Active knowledge making

    The prevailing model of professional development often treats learners as empty vessels to be filled with expert knowledge.

    Drawing from constructivist learning theory, it positions health workers as knowledge creators rather than passive recipients.

    When a community health worker in Kenya shares how they’ve adapted vaccination strategies for remote communities, they are not just describing their work – they’re creating valuable knowledge that others can learn from and adapt.

    The role of experts is even more significant in this model: experts become “Guides on the side”, listening to challenges and their contexts to identify what expert knowledge is most likely to be useful to a specific challenge and context.

    (This is the oft-neglected “downstream” to the “upstream” work that goes into the creation of global guidelines.)

    This principle manifests in how questions are framed.

    Instead of asking “What should you do when faced with vaccine hesitancy?” Teach to Reach asks “Tell us about a time when you successfully addressed vaccine hesitancy in your community.” This subtle shift transforms the learning dynamic from theoretical to practical, from passive to active.

    Collaborative intelligence

    The concept of collaborative intelligence, inspired by social learning theory, recognizes that knowledge in complex fields like global health is distributed across many individuals and contexts.

    No single expert or institution holds all the answers.

    By creating structures for health workers to share and learn from each other’s experiences, Teach to Reach taps into what cognitive scientists call “distributed cognition” – the idea that knowledge and understanding emerge from networks of people rather than individual minds.

    This plays out practically in how experiences are shared and synthesized.

    When a nurse in Brazil shares their approach to integrating COVID-19 vaccination with routine immunization, their experience becomes part of a larger tapestry of knowledge that includes perspectives from diverse contexts and roles.

    Metacognitive reflection

    Metacognition – thinking about thinking – is crucial for professional development, yet it is often overlooked in traditional training.

    Teach to Reach deliberately builds in opportunities for metacognitive reflection through its question design and response framework.

    When participants share experiences, they are prompted not just to describe what happened, but to analyze why they made certain decisions and what they learned from the experience.
    This reflective practice helps health workers develop deeper understanding of their own practice and decision-making processes.

    It transforms individual experiences into learning opportunities that benefit both the sharer and the wider community.

    Recursive feedback

    Learning is not linear – it is a cyclical process of sharing, reflecting, applying, and refining.

    Teach to Reach’s model of recursive feedback, inspired by systems thinking, creates multiple opportunities for participants to engage with and build upon each other’s experiences.

    This goes beyond communities of practice, because the community component is part of a broader, dynamic and ongoing process.

    Executing a complex pedagogical pattern

    The pedagogical pattern of Teach to Reach come to life through a carefully designed implementation framework over a six-month period, before, during, and after the live event.

    This extended timeframe is not arbitrary – it is based on research showing that sustained engagement over time leads to deeper learning and more lasting change than one-off learning events.
    The core of the learning process is the Teach to Reach Questions – weekly prompts that guide participants through progressively more complex reflection and sharing.

    These questions are crafted to elicit not just information, but insight and understanding.

    They follow a deliberate sequence that moves from description to analysis to reflection to application, mirroring the natural cycle of experiential learning.

    Communication as pedagogy

    In Teach to Reach, communication is not just about delivering information – it is an integral part of the learning process.

    The model uses what scholars call “pedagogical communication” – communication designed specifically to facilitate learning.

    This manifests in several ways:

    • Personal and warm tone that creates psychological safety for sharing
    • Clear calls to action that guide participants through the learning process
    • Multiple touchpoints that reinforce learning and maintain engagement
    • Progressive engagement that builds complexity gradually

    Learning culture and performance

    Watkins and Marsick’s work helps us understand why Teach to Reach’s approach is so effective.

    Learning culture – the set of organizational values, practices, and systems that support continuous learning – is crucial for translating individual insights into improved organizational performance.

    Teach to Reach deliberately builds elements of strong learning cultures into its design.

    Furthermore, the Geneva Learning Foundation’s research found that continuous learning is the weakest dimension of learning culture in immunization – and probably global health.

    Hence, Teach to Reach itself provides a mechanism to strengthen specifically this dimension.

    Take the simple act of asking questions about real work experiences.

    This is not just about gathering information – it’s about creating what Watkins and Marsick call “inquiry and dialogue,” a fundamental dimension of learning organizations.

    When health workers share their experiences, they are not just describing what happened.

    They are engaging in a form of collaborative inquiry that helps everyone involved develop deeper understanding.

    Networks of knowledge

    George Siemens’s connectivism theory provides another crucial lens for understanding Teach to Reach’s effectiveness.

    In today’s world, knowledge is not just what is in our heads – it is distributed across networks of people and resources.

    Teach to Reach creates and strengthens these networks through its unique approach to asynchronous peer learning.

    The process begins with carefully designed questions that prompt health workers to share specific experiences.

    But it does not stop there.

    These experiences become nodes in a growing network of knowledge, connected through themes, challenges, and solutions.

    When a health worker in India reads about how a colleague in Nigeria addressed a particular challenge, they are not just learning about one solution – they are becoming part of a network that makes everyone’s practice stronger.

    From theory to practice

    What makes Teach to Reach particularly powerful is how it fuses multiple theories of learning into a practical model that works in real-world conditions.

    The model recognizes that learning must be accessible to health workers dealing with limited connectivity, heavy workloads, and diverse linguistic and cultural contexts.

    New Learning’s emphasis on multimodal meaning-making supports the use of multiple communication channels ensuring accessibility.

    Learning culture principles guide the creation of supportive structures that make continuous learning possible even in challenging conditions.

    Connectivist insights inform how knowledge is shared and distributed across the network.

    Creating sustainable change

    The real test of any learning approach is whether it creates sustainable change in practice.

    By simultaneously building individual capability, organizational capacity, and network strength, it creates the conditions for continuous improvement and adaptation.

    Health workers do not just learn new approaches – they develop the capacity to learn continuously from their own experience and the experiences of others.

    Organizations do not just gain new knowledge – they develop stronger learning cultures that support ongoing innovation.

    And the broader health system gains not just a collection of good practices, but a living network of practitioners who continue to learn and adapt together.

    Looking forward

    As global health challenges have become more complex, the need for more effective approaches to professional learning becomes more urgent.

    Teach to Reach’s pedagogical model, grounded in complementary theoretical frameworks and proven in practice, offers valuable insights for anyone interested in creating impactful professional learning experiences.

    The model suggests that effective professional learning in complex fields like global health requires more than just good content or engaging delivery.

    It requires careful attention to how learning cultures are built, how networks are strengthened, and how individual learning connects to organizational and system performance.

    Most importantly, it reminds us that the most powerful learning often happens not through traditional training but through thoughtfully structured opportunities for professionals to learn from and with each other.

    In this way, Teach to Reach is a demonstration of what becomes possible when we reimagine how professional learning happens in service of better health outcomes worldwide.

    Image: The Geneva Learning Foundation Collection © 2024

  • Brevity’s burden: The executive summary trap in global health

    Brevity’s burden: The executive summary trap in global health

    It was James Gleick who noted in his book “Faster: The Acceleration of Just About Everything” the societal shift towards valuing speed over depth:

    “We have become a quick-reflexed, multitasking, channel-flipping, fast-forwarding species. We don’t completely understand it, and we’re not altogether happy about it.”

    In global health, there’s a growing tendency to demand ever-shorter summaries of complex information.
     
    “Can you condense this into four pages?”

    “Is there an executive summary?”

    These requests, while stemming from real time constraints, reveal fundamental misunderstandings about the nature of knowledge and learning.

    Worse, they contribute to perpetuating existing global health inequities.

    Here is why – and a few ideas of what we can do about it.

    We lose more than time in the race to brevity

    The push for shortened summaries is understandable on the surface.

    Some clinical researchers, for example, undeniably face increasing time pressures.

    Many are swamped due to underlying structural issues, such as healthcare professional shortages.

    This is the result of a significant shift over time, leaving less time for deep engagement with new information.

    If we accept these changes, we lose far more than time.

    Why does learning require time, depth, and context?

    True understanding and the ability to apply knowledge in diverse contexts demands deep engagement, reflection, and often, struggle with our own assumptions and mental models.

    Consider the process of learning a new language.

    No one expects to become fluent by reading a few pages of grammar rules.

    Mastery requires immersion, practice, making mistakes, and gradually building competence over time.

    The same principle applies to making sense of multifaceted global health issues.

    5 risks of executive summaries

    Here are five risks of demanding summaries of everything:

    1. Oversimplification: Complex health challenges often cannot be adequately captured in a few pages. Crucial nuances and context-specific details get lost. Those ‘details’ may actually be the ‘how’ of what makes the difference for those leading change to achieve results.
    2. Losing context: Information that can be easily summarized (quantitative data, broad generalizations) gets prioritized over more nuanced, qualitative, or context-specific knowledge. 
    3. Stunting critical thinking: The habit of relying on summaries can atrophy our capacity for deep, critical engagement with complex ideas.
    4. Overconfidence: It assumes that learning is primarily about information transfer, rather than a process of engagement, reflection, and application. Reading a summary can give the false impression that one has grasped a topic, leading to overconfidence in decision-making.
    5. Devaluing local knowledge: Rich, contextual experiences from health workers and communities often do not lend themselves to easy summarization.

    The expectation that complex local realities can always be distilled into brief summaries for consumption by decision-makers (often in the Global North) perpetuates existing power structures in global health.

    The ability to demand summaries often comes from positions of power.

    This can lead to privileging certain voices (those who can produce polished summaries) over others (those with deep, context-specific knowledge that resists easy summarization).

    This knowledge then gets sidelined in favor of more easily digestible but potentially less relevant information.

    10 ways to value and engage with knowledge in global health

    Addressing the “summary culture” requires more than better time management.

    It calls for a fundamental rethinking of how we value and engage with knowledge in global health.

    Instead of defaulting to demands for ever-shorter summaries, we need to rethink how we engage with knowledge.

    Here are 10 practical ways to do so.

    1. Prioritize productive diversity over reductive simplicity: Sometimes, it is better to engage deeply many different ideas than to seek one reductive generalization.
    2. Value local expertise: Prioritize knowledge from those closest to the issues, even when it does not fit neatly into summary format.
    3. Value diverse knowledge forms: Recognize that not all valuable knowledge can be easily summarized. Create space for stories, case studies, and rich qualitative data.
    4. Improve information design: Instead of just shortening, focus on presenting information in more accessible and engaging ways that do not sacrifice complexity.
    5. Create new formats: Develop ways of sharing information that balance accessibility with depth and nuance.
    6. Pause and reflect: What might be lost in the condensing? Are you truly seeking efficiency, or avoiding the discomfort of engaging with complex, potentially challenging ideas? Are you willing to advocate for systemic changes that truly value deep learning and diverse knowledge sources?
    7. Challenge the demand: When asked for summaries, push back (respectfully) and explain why certain information resists easy summarization.
    8. Foster critical engagement: Encourage professionals to develop skills in quickly assessing and engaging with complex information, rather than providing pre-digested summaries.
    9. Educate funders and decision-makers: Help those in power understand the value of engaging with complexity and diverse knowledge forms.
    10. Rethink the economy of time allocation: Advocate for systemic changes that value time spent on deep learning and reflection as core to effective practice and leadership.

    Image: The Geneva Learning Foundation Collection © 2024

  • The capability trap: Nobody ever gets credit for fixing problems that never happened

    The capability trap: Nobody ever gets credit for fixing problems that never happened

    Here is a summary of the key points about the capability trap, from the article “Nobody ever gets credit for fixing problems that never happened: creating and sustaining process improvement”.

    What is the capability trap?

    • Many companies invest heavily in process improvement programs, yet few efforts actually produce significant results. This is called the “improvement paradox”.
    • The problem lies not with the specific tools, but rather how the introduction of new programs interacts with existing organizational structures and dynamics.
    • Using system dynamics modeling, the authors studied implementation challenges in depth through over a dozen case studies. Their models reveal insights into why improvement programs often fail.

    Core causal loops

    • The “Work Harder” loop – managers pressure people to spend more time working to immediately boost throughput and close performance gaps. But this is only temporary.
    • The “Work Smarter” loop – managers encourage improvement activities which enhance process capability over time for more enduring gains, but there is a delay before benefits are seen.
    • The “Reinvestment” reinforcing loop – successfully improving capability frees up more time for further improvement. But the reverse vicious cycle often dominates instead.
    • The “Shortcuts” loop – facing pressure, people cut corners on improvement activities which temporarily frees up more time for work. But this gradually erodes capability.

    The capability trap

    • Short-term “Work Harder” and “Shortcuts” decisions eventually hurt capability and require heroic work efforts to maintain performance, creating a downward spiral.
    • However, because capability erodes slowly, managers fail to connect problems to past decisions and blame poor worker motivation instead, leading to a self-confirming cycle.
    • Even improvement programs just increase pressure and drive more shortcuts, making stereotypes and conflicts worse. This “capability trap” causes programs to fail.

    The “capability trap” refers to the downward spiral organizations can get caught in, where attempting to boost performance by pressuring people to “work harder” actually erodes process capability over time. This trap works through a few key mechanisms:

    1. Facing pressure, people cut corners and reduce time spent on improvement activities in order to free up more time for immediate work. This temporarily boosts throughput.
    2. However, this comes at a cost of gradually declining process capability, as less time is invested in maintenance, training, and problem solving.
    3. Capability erosion then reduces performance, widening the gap versus desired performance levels.
    4. Managers falsely attribute this to poor motivation or effort from the workforce. They lack awareness of the capability trap dynamics, and the delays between pressing people to “work harder” and the capability declines that eventually ensue.
    5. Management increases pressure further, demanding heroic work efforts, which causes workers to cut even more corners. This spirals capability downward while confirming management’s incorrect attribution even more.

    Key takeaway for learning leaders

    Learning leaders must understand the systemic traps identified in the article that underly failed improvement initiatives and facilitate mental model shifts. This help build sustainable, effective learning programs to be realized through productive capability-enhancing cycles.

    Key takeaway for immunization leaders

    It is reasonable to hypothesize that poor health worker performance is a symptom rather than the cause of poor immunization programme performance. Short-term decisions, often responding to top-down targets and donor requirements, hurt capability and require, as the authors say, “heroic work efforts to maintain performance, creating a downward spiral.” Managers then incorrectly diagnose this as a performance problem due to motivation.

    How to escape the capability trap

    The key to avoiding or escaping this trap is therefore shifting the mental models that reinforce the incorrect attributions about motivation. Some ways to do this include:

    • Educating managers on the systemic structures causing the capability trap through methods like system dynamics modeling
    • Allowing time for capability-enhancing improvements to take effect before judging performance
    • Incentivizing quality and sustainability of throughput rather than just short-term volume alone
    • Seeking input from workers on the barriers to improvement they face

    With awareness of the structural causes and delays, managers can avoid erroneously attributing blame. Patience and a systems perspective are critical for companies to invest their way out of the capability trap.

    • Shift mental models to recognize system structures leading to the capability trap, rather than blaming people. Then improvement tools can work.
    • A useful example could be system dynamics workshops that achieved this shift and enabled successful programs, dramatically enhancing performance.

    Reference

    Repenning, N.P., Sterman, J.D., 2001. Nobody ever gets credit for fixing problems that never happened: creating and sustaining process improvement. California management review 43, 64–88. https://doi.org/10.2307/41166101

    Illustration: The Geneva Learning Foundation Collection © 2024

  • Pandemic preparedness through connected transnational digital networks of local actors

    Pandemic preparedness through connected transnational digital networks of local actors

    What is the link between pandemic preparedness, digital networks, and local action? In the Geneva Learning Foundation’s approach to effective humanitarian learning, knowledge acquisition and competency development are both necessary but insufficient. This is why, in July 2019, we built the first Impact Accelerator, to support local practitioners beyond learning outcomes all the way to achieving actual health outcomes.

    What we now call the Full Learning Cycle has become a mature package of interventions that covers the full spectrum from knowledge acquisition to implementation and continuous improvement. This package has produced the same effects in every area of work where we have been able to test it: self-motivated groups manifesting remarkable, emergent leadership, connected laterally to each other in each country and between countries, with a remarkable ability to quickly learn and adapt in the face of the unknown. Such networks have obvious relevant for pandemic preparedness.

    In 2020, we got to test this package during the COVID-19 pandemic, co-creating the COVID-19 Peer Hub with over 6,000 frontline health professionals, and building together the Ideas Engine to rapidly share ideas and practices to problem-solve and take action quickly in the face of dramatic consequences of the new virus on immunization services (largely due to fear, risk, and misinformation). By January 2021, over a third of Peer Hub members had successfully implemented their immunization service recovery project, far faster than colleagues who faced the same problems but worked alone, without a global support network. Once connected to each other, these country teams then organized inter-country peer learning to help them figure out “what works” for COVID-19 vaccine introduction and scale-up.

    Such a holistic approach is about mobilizing and connecting country-based impact networks for pandemic preparedness that reach and involve practitioners at the local levels, as well as national MoH leaders and planners – quite different from conventional approaches (whether online or face-to-face) to building capacity and preparedness.

    TGLF’s global health network and platform reach significant numbers of practitioners at all levels of the health system. It is not only the number of people who participate (47,000 as I write this) but also the depth of engagement and diversity of contexts that they work in. Globally, 21.2% face armed conflict; 24.5% work with refugees or internally-displaced populations; 61.6% work in remote rural; 47% with the urban poor; 35.7% support the needs of nomadic/migrant populations. This is across 110 countries, with over 70 percent in “high burden” countries. Many have deep experience in responding to epidemic outbreaks of all kinds. Health professionals who join come from all levels of the health system, but most are (logically) from health facilities and districts, the bottom of the health pyramid.

    Through the network and platform, they build lateral connections, forging bonds not only of knowledge but also of trust. They do this not because they are from the same profession, but primarily (we believe) because they face similar challenges and see the benefit of sharing their experience in support of each other. Engagement is voluntary (ie people opt in and contribute because they want to), with no per diem or other extrinsic incentives offered. The concern for both epidemic outbreak and pandemic preparedness is shared.

    Individuals develop and implement corrective actions to tackle the root causes of the challenges they are taking on, drawing on both peer learning and the best available global guidelines. For the IA2030 Movement, our largest initiative so far, participants are simultaneously implementing 1,024 projects in 99 countries, learning from each other what works, sharing successes, lessons learned, and challenges. Here are four examples of what collective action through digital networks looks like :

    • In Ghana, TGLF’s alumni (including national and regional MoH EPI directors) decided to organize online sessions country-wide to share the latest information about COVID-19 with local staff, starting in April 2020. They had learned how to use digital tools to find the best available global knowledge and to combine it with their local expertise and experience to inform collective action.
    • In Burkina Faso, the national EPI manager entrusted the first “masked” vaccination campaign to the TGLF alumni team, which has organized itself country-wide, with over half of alumni working in conflict-affected areas. He told me no one else had the network and the capacity for change to figure out quickly how to get this right.
    • In the Democratic Republic of Congo, the TGLF alumni team is increasingly being asked by national EPI to contribute to various activities, due to their effectiveness in connecting and coordinating. The alumni network is country-wide and includes many from very remote areas. When Monkeypox was reported in Europe and North America, we were already seeing a steady stream of information through the DRC and other country networks.

    We believe that this continuous learning and action is actually the definition of pandemic preparedness. Trying to imagine preparedness and response to new pandemics using old, failed methods of training and capacity building – whether face-to-face or online – is both dangerous and irrational.

    Image: Remote villages illuminated by rays of light, with mountains beyond mountains in the background. The Geneva Learning Foundation Collection.

  • Reinventing the path from knowledge to action in global health

    Reinventing the path from knowledge to action in global health

    At the Geneva Learning Foundation (TGLF), we have just begun to share a publication like no other. It is titled Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers.

    You can access the full report here in French and in English. Short summaries are also available in three special issues of The Double Loop, the Foundation’s free Insights newsletter, now available in both English and French. The report, prefaced by Heidi Larson who leads the Vaccine Confidence Project, includes DOI to facilitate citation in academic research. (The Foundation uses a repository established and maintained by the Geneva-based CERN for this purpose.)

    However, knowing that academic papers have (arguably) an average of three readers, we have a different aspiration for dissemination.

    As a global community, we recognize the significance of local action to achieve the global goals.

    The report documents vaccine confidence practices just weeks before the introduction of COVID-19 vaccines. It is grounded in the experience of 734 practitioners from local communities, districts, regions, and national teams, who developed case studies documenting a situation in which they were able to successfully lead individuals and groups toward better understanding and acceptance of the benefits of vaccines and vaccination.

    Immunization staff from all levels of the health system became citizen scientists, active knowledge-makers drawing on their personal experience of a situation in which they successfully overcame the barriers to vaccine acceptance in the community.

    Experiential learning offers a unique opportunity to discover unfiltered experiences and insights from thousands of people whose daily lives revolve around delivering immunization services. But what happens once experience has been shared? What is to be done with what we learn?

    Sharing this report, we have found, has triggered remarkable dialogue and led to the co-creation of a steadily growing collection of new practices actually used to build vaccine confidence (as opposed to the many theoretical frameworks on the topic), submitted through our new Insights system. New stories and their analysis are being shared back with local practitioners and with TGLF’s Insights partners, fostering continuous learning that is an action imperative of a strong learning culture. (For Insights, we work with Bridges to Development, the Centre for Change and Complexity in Learning (C3L), and the International Vaccine Access Center at Johns Hopkins.)

    In the coming weeks, we will be inviting 10,000 leaders of the Movement for Immunization Agenda 2030 to share this report to their colleagues, teams, and organizations (in both ministries of health and civil society organizations). They will be sharing back their own insights on how the findings can be used to improve demand for vaccines – and colleagues who listen to their presentation of the report will also be able to share back what they learn, connecting with each other through our Insights system.

    Then, the Foundation’s Impact Accelerator will track if and how insights from this report are linked to reported positive outcomes, and we should be able to document this, at least in some cases. This will not only foster double-loop learning but also explicitly link learning to implementation and results.

    In this way, local practitioners will be putting to use global knowledge grounded in their local experiences, for their own needs. We believe that this provides a complementary, more organic mechanism than current top-down processes for developing normative guidance driven by global assumptions and priorities.

    As Kate O’Brien, WHO’s Director of Immunization, said during a recent Insights Live session: “The global role on immunization is actually to bring together everything that is known by people at the grassroots level. That’s where the action is. Global guidance is basically one means to share knowledge and expertise that’s coming from the grassroots level around the world with others who may not have had that experience yet.”

    What we are doing with this report is part of a larger initiative to build the IA2030 Movement Knowledge to Action Hub. New knowledge produced by local practitioners will be available as both static and living documents that local and global practitioners can add their inputs to, at any time. This Hub will be launched at Teach to Reach 7 on 14 October 2022, with over 13,000 local practitioners registered for this event.

    Image: Many paths to moving mountains. The Geneva Learning Foundation Collection.

  • Learning for Knowledge Creation: The WHO Scholar Program

    Learning for Knowledge Creation: The WHO Scholar Program

    Excerpted from: Victoria J. Marsick, Rachel Fichter, Karen E. Watkins, 2022. From Work-based Learning to Learning-based Work: Exploring the Changing Relationship between Learning and Work, in: The SAGE Handbook of Learning and Work. SAGE Publications.

    Reda Sadki of The Geneva Learning Foundation (TGLF), working with Jhilmil Bahl from the World Health Organization (WHO) and funding from the Bill and Melinda Gates Foundation, developed an extraordinary approach to blending work and learning. The program started as a series of digitally offered courses for immunization personnel working in various countries, connecting in-country central planners, frontline workers, and global actors. The program was designed to address five common problems in training (Sadki, 2018): the inability to scale up to reach large audiences; the difficulty in transferring what is learned; the inability to accommodate different learners’ starting places; the need to teach learners to solve complex problems; and the inability to develop sufficient expertise in a timely way to ensure learning is greater than the rate of change (Revans, 1984).

    The approach grew out of work with Scholar, an innovative learning platform, developed at the University of Illinois by Bill Cope and Mary Kalantzis. As the technology implementation of their ‘new learning’ theory, Scholar emphasized seven affordances of learning in a digital age that look at how new technologies change the way knowledge is created and how people connect and socialize (Cope & Kalantzis, 2016). The elements of the Scholar approach include: community-building functions and resources, such as dialogue area surveys and social media; and knowledge creation functions, including a collaborative publishing and critiquing space and tools such as language checkers, annotation functions, and a number of analytics including grade-level writing scores (see Figure 11.3).

    Figure 11.3. Scholar pedagogy framework
    Source: Cope, Bill and Mary Kalantzis, “Assessment and Pedagogy in the Era of Machine-Mediated Learning,” pp. 350–74 in Education as Social Construction: Contributions to Theory, Research, and Practice, edited by Thalia Dragonas, Kenneth J. Gergen, Sheila McNamee and Eleftheria Tseliou, Chagrin Falls OH: Worldshare Books, 2015.

    Learning in this digital milieu is very different, not because it is new (given decades of experience with the internet), but because of the rapid rate of change compared to traditional courses that rely on a fixed understanding of how we learn when we share physical space. Published work is often generated by the learners themselves either from their existing libraries or what they produce within the course – which may also become available to other courses; from internet searches, source documents within their work, etc. Project-based learning is not new either, but the scale, the speed, and the meaning of such connections (i.e., how they are experienced) are. Learning contributions of this kind reduce the need for subject matter experts and are both convincing and situated in real-life contexts. Complex cases demonstrate the problems at the center of the course. Group dialogue and the development of proposals to solve real problems build a shared knowledge base. Participants develop action plans of how they will address the problems that are in their workplace. Finally, peer critiquing and support enable everyone to improve their plans from whatever starting place.

    Deliberate efforts are made to create a learning community using tools that are already embedded in daily practice (keeping in mind that these tools are constantly changing) and structured activities like randomized coffee trials (Soto, 2016) through which learners meet outside of class to get to know one another socially (i.e., ‘to be human together’). Learning is scaffolded by a human knowledge network (Watkins & Kim, 2018) with peer review, staff support, expert resources, and a unique Scholar alumni cadre of former students who volunteer as ‘accompanists’ to support new learners in navigating the technology and whatever else creates a barrier for novices. Peer review is based on an expert rubric and facilitated by the Scholar team. This approach is scalable, with more than 800 learners in each cohort and 400 alumni volunteering to serve as accompanists. A small project team manages multiple cohorts at a time, with a duration of six to 17 weeks, depending on the course.

    Recently, the Scholar team developed the Impact Accelerator, an extension to the courses that supports the implementation of course projects and encourages participants to develop new initiatives through collaboration. The Accelerator combines weekly webinars and assemblies, regular check-ins on implementation status, and support for developing in-country teams. Participants share best practices and challenging problems, for which peers provide help, responding as a culture without requiring prompting or intervention to do so. Initial findings from an evaluation of the Accelerator indicated faster implementation of action plans and improved collaboration among participants.

    Over 20 country groups formed. In a short time, alumni documented that, as a result of what they learned and implemented, immunization coverage in their region improved. Learning involves a unique blend of a traditional format – an e-learning delivery platform – and consistent and deliberate use of actual work challenges and plans to generate improved workplace performance through a combination of peer support, healthy peer competition, and mentoring and coaching.

    Sadki’s approach has been called ‘magic’. He disagrees. He says: ‘Learners are transmuted into teachers, leaders, and facilitators. In some countries, learners are self-organizing to take on issues that matter to them, evolving course projects into a potentially transformative agenda.’ He says success comes ‘from modestly intersecting the science of learning with real, lived learning culture and from reframing education as philosophy for change in the Digital Age. That, and a lot of elbow grease’ (Sadki, 2019). Sadki believes that impact is possible – even tangible – when educators connect the dots among the course, the individuals, and their context. His approach combines informal and incidental learning with conscious restructuring of context. The goal of his courses is knowledge creation focused on creating change in the workplace. The approach has gained sufficient momentum that ‘Scholar’ is more a movement than a learning approach. Sadki, a lifelong social entrepreneur and activist, has invented a new approach to learning and changing individuals and organizations. Table 11.2 summarizes features of the initiative map against the framework of learning in terms of separation, coterminous, seamlessly integrated or learning based work.

    Cope, B., Kalantzis, M., 2016. Conceptualizing e-Learning. Common Ground Publishing, Chicago.

    Revans, R. (1984). The origins and growth of action learning. London, England: Chartwell- Bratt.

    Sadki, R. (2018). Peer learning support capacity building with Scholar. Poster presented at the Teach to Reach Conference, Bill and Melinda Gates Foundation, Dar es Salaam, Tanzania.

    Sadki, R. (2019). Magic. Retrieved from: https://stories.learning.foundation/2019/03/25/magic/

    Siemens, G. (2007). Connectivism: Creating a learning ecology in distributed environments. In Hug, T. (Ed.). Didactics of micro- learning. Concepts, discourses and examples (pp. 53–68). Munster, Germany: Waxmann verlag GmbH.

    Soto, M. (2016). A simple tool to help M&A integration: Randomized coffee trials. Retrieved from: https://blogs.harvard.edu/ msoto/2016/01/26/a-simple-tool-to-help-ma-integration-randomised-coffee-trials/

    Watkins, K. & Kim, K. (2018). Current status and promising directions for research on the learning organization. Human Resource Development Quarterly, 29(1), 15–29. doi:10.1002/hrdq.21293

  • What is the value of strategy in the middle of a global crisis?

    What is the value of strategy in the middle of a global crisis?

    A new global vision and strategy titled ‘Immunization Agenda 2030: A Global Strategy to Leave No One Behind (IA2030)’ was endorsed by the World Health Assembly less than a year before the World Health Organization declared COVID-19 a Public Health Emergency of International Concern.

    Today, the cumulative tension of both urgent and longstanding challenges is stretching people who deliver vaccines. Challenges include immunization service recovery, COVID-19 vaccine introduction, and the persistence of epidemic outbreaks of diseases that can already be prevented by vaccines.

    Is this the right time to launch a global strategy – especially one developed before the pandemic – to achieve the immunization goals?

    Yes, immunization staff the world over – and the societies we live in – are still reeling from the shock of the COVID-19 pandemic.

    Nevertheless, in times of crisis, thinking and acting strategically can help each of us stay focused on the global immunization goals, keeping us on the path to equitable immunization coverage for everyone. In fact, my conviction is that it is this focus that could make the difference between short-term Pyrrhic recovery and building back better.

    Immunization was already recognized as a success story, saving millions of lives every year. The incredibly rapid development of vaccines to protect from the coronavirus has brought the significance of immunization to the entire world’s attention. Is it exaggerated to claim that vaccines – and the people who deliver them – are now saving the world?

    Global partners accountable for Immunization Agenda 2030 are hoping to generate a “groundswell of support” or even a “social movement” to ensure that immunization remains high on global and regional health agendas in support of countries.

    One good starting point is for global partners to take time to listen to the people who carry out the daily work of vaccination – and for immunization staff from countries to be empowered to share their challenges, lessons learned, and successes with each other. For such listening to be more than a quaint or condescending exercise requires a strategic focus and commitment to respond to these challenges. That, again, is how Immunization Agenda 2030 may be read and applied – if it is interpreted not as a prescriptive guideline-from-above but as a call and openness to new and flexible forms of action.

    Image: Towards Language, by Arve Henriksen – Groundswell.

  • Accountability in learning

    Accountability in learning

    What if you were the key internal resource person with learning expertise?

    What if you advocated, recommended, and prescribed low-volume, high-cost face-to-face training?

    What if your advocacy was so successful that global partners invested hundreds of millions of dollars in what you prescribed – even in the absence of any standard to determine the return on that investment?

    What if your recommended approach resulted in zero measurable impact?

    What if partners nevertheless kept spending on training, entrenching perverse incentives like per diem to substitute for motivation, evidence, and results?

    What if you ignored and then dismissed, for as long as you possibly could, the relevance and potential of digital networks to support learning?

    What if you then managed to replicate the worst, least effective kinds of training through sterile digital formats of slides with voiceovers and a quiz at the end?

    What if you kept badgering managers to get their people to stop work in order to learn?

    What if you responded to the disconnect between learning and work with convoluted competency frameworks and elaborate performance management “solutions” that changed nothing?

    What if you used your internal position as gatekeeper to stifle innovation, to ridicule and undermine those advocating new approaches?

    What if you then felt threatened when these new approaches began to show results that you have never been able to achieve?

    What if you were held accountable for any or all of the above?

    Image: Defoe in the Pillory (Wikipedia Commons).

  • What lies beyond the event horizon of the ‘webinar’?

    What lies beyond the event horizon of the ‘webinar’?

    It is very hard to convey to learners and newcomers to digital learning alike that asynchronous modes of learning are proven to be far more effective. There is an immediacy to a sage-on-the-stage lecture – whether it is plodding or enthralling – or to being connected simultaneously with others to do group work.

    Asynchronous goes against the way our brains work, driven by prompts, events, and immediacy. But people get the benefit of “time-shifting” their TV shows and “on demand” is the norm for media consumption now.

    Most webinars still require you to show up at a specific time. With live streaming of the Foundation’s events, we are observing growing appreciation for asynchronous “I’ll watch it when I want to” availability of recorded events. The behavior seems different from the intention of viewing a recorded webinar, which almost never happens. (This is, in part, the motivation question: does anyone watch recordings of webinars without being forced to?)

    It is wonderful that the big video platforms immediately make the recording available, at the same URL, after a livestreamed event. Right now, this is better than Zoom, which does not (yet) offer a simple, automated way to share the recording with everyone who missed a live session, nor a mechanism for post-event viewers to contribute comments or questions.

    Image: Time travel (Wikipedia Commons).

  • Can the transformation of global health education for impact rely on input-based accreditation?

    Can the transformation of global health education for impact rely on input-based accreditation?

    Burck Smith wrote in 2012 what remains one of the clearest summaries of how accreditation is based primarily on a higher education institution’s inputs rather than its outcomes, and serves to create an “iron triangle” to maintain high prices, keep out new entrants, and resist change.

    It is worth quoting Smith at length (summary and references via this link) as we think through the proposal that the transformation of global health education for impact should rely solely on accredited institutions. Global health efforts are focused on outcomes and aim to achieve impact. The focus on results makes the prevailing input-based accreditation criteria unlikely to be the most useful ones to help achieve global health goals. This calls for rethinking a broad swath of fairly fundamental issues, from how to construct education to what philosophy should underpin what we design and develop.

    The call for a “revolution” in education for public health is unlikely to be answered by institutions that form a protected monopoly. It is critical to understand how accreditation, intended to guarantee quality in education, serves to buttress a protected monopoly. The most exciting and promising innovations in education are happening on the fringes of the education landscape, in bootcamps, edtech startups, and other non-traditional organizations that are catalyzing change. Such change remains primarily seen as a threat by established institutions that, in a protected market buttressed by accreditation, are seeking to preserve gross margins that hover at around sixty percent in the United States.

    Of course, there is a very real problem with the proliferation of degree mills and other shady profit-first organizations that sell the promise of career development and opportunities but cannot deliver them. Unfortunately, many such outfits are, it turns out, accredited ones. This explains why, alongside accreditation, a parallel industry of quality labels and certifications is supposed to help potential “customers” make better purchasing decision.

    Instead, we should rethink what determines the value of a credential. Moving toward competency-based degrees is one necessary but insufficient step that has already been explored. Could we invent a “lifelong credential” that would increase in value over time, as its holder applies what was learned in order to progress and ultimately achieve measurable impact? The tools (blockchain, AI, etc.) to support this already exist. A reductive obsession with legitimacy based on accreditation and the prestige and rankings it supposedly confers will only serve to hinder those of us who are working toward new forms of credentialing, grounded in the needs of people working in countries and guided by what will actually save lives and improve health.

    Image: Walled garden, New College (Oxford). Photo by Elaine Heathcote on Flickr.