Contact tracing is one of the most powerful tools we’ve got to interrupt transmission of infectious disease, including COVID-19.
Plus, contact tracers are in the position to add knowledge to future health communication and public health workforce development efforts.
It’s obvious that contact tracers should be well prepared and supported. But I’m going to show you one not-at-all-obvious thing that can get in the way of the effective training of contact tracers. If you educate anyone–contact tracers or not–you may find this helpful.
Today’s episode is about contact tracing, contact tracers. It’s also a story about how things we don’t realize we’re doing can get in our way and sometimes make it harder for us to do the thing we’re trying to do. So if you educate patients or clients or the public in any way, I’m going to share something that might be helpful to you.
Welcome, everybody! This is 10 minutes to Better Patient Communication from Health Communication Partners and I’m Dr. Anne Marie Liebel. Today’s episode brought to you by Maven Roth Group. Giving your patients the healthcare experience they need, deserve, and expect starts with strong branding. Maven Roth Group uncovers the core values that make up your brand, then helps you communicate that brand to the world. Visit MavenRoth.com today, start your unique branding journey.
So COVID-19 and the coronavirus aren’t going anywhere soon. We’re looking at another peak in cases here in the US. And much is still unknown. But there’s much that is known about contact tracing. It’s not new; I think that book is still open and still being written. Some places are now doing forward and backward contact tracing.
But in today’s episode I want to talk about removing obstacles, the things that get in our way. And I’m going to focus on obstacles right now that are close to us, like inside jobs. Some of the ways that we work that are just part of our field that we inherited. Customary ways of going about things.
That’s because sometimes these can present obstacles, or get in the way, slow things down, have unwanted side effects. And we typically don’t know this is happening because it’s the way our people in our field have always done things.
I wrote an article recently that was published in the Journal of Communication in Healthcare. It’s open-access, I’ll put the link in the notes. And in that I talk about some of the ordinary kind of common sense, taken-for-granted ways that contact tracing gets thought about and talked about, and how that could unintentionally be getting in the way of effective contact tracing (and a bunch of other good goals, too).
So I’m not going to rehearse what I said in the article, I hope you go read it, because I want to talk about something else. Another obstacle. But like the ones I talked about in the article, the what I’m going to talk about today can be removed or worked around. And it’s one I want to tell you about if you educate people.
But first: why do I have the right to talk about this? I’m not a contact tracer. I’m not an expert on contact tracing. I’m not an epidemiologist. I am not that kind of researcher, right? But professional learning across the lifespan is a big part of my background, and of my current work. I educate lot of people in the health sector: Physicians, clinicians, public health professionals, students, health educators, obviously health communication.
And contact tracing is an enormously complicated teaching and learning context and set of practices. So that’s where I come in.
And the thing I want to talk about from my experience that can get in the way is what my mentor Susan Lytle and her collaborative partner Maryland Cochran Smith call the expert vs. novice or the expert/novice duality. Now experts and novices are not a problem, but this relationship between them can be an obstacle when we take it too far, or we lose sight of the fact that it’s there. And if you’re an educator this might be interesting to you.
I’m going to give you three examples from contact tracing that show ways that the expert/novice Duality could mess things up and we usually don’t know that this is happening.
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Alright, number one is in the training of the tracers. How the tracers are positioned in their training. This is not unique to contact tracers. Most professional learning is based on the expert and novice relationship at so deep a level that it’s unquestioned. Yes, there are experts. You are experts in things. I am an expert in things. We’re all novices in things, too, right?
Having experts and novices isn’t itself a problem. But some problems can arise when the experts are assumed to be the only ones who know the things worth knowing. And, when it’s assumed that everything worth knowing is already known–by the experts.
There’s a lot of contact tracer training out there. But if training relies uncritically on this expert/novice Duality, it can have the unintended side effect of implying that the experts already know everything there is to know about contact tracing. And that everything worth knowing about contact tracing is already known. Neither of these is the case, nor do I think that the experts and those who designed the training have any intention of implying these things. But because most professional learning is based on the expert/novice duality, there might not be room for the novices to be recognized as potentially contributing to what’s known.
Right: certainly much is known about contact tracing. And sure, there will be some on-the-job learning. Because in some ways contact tracing for COVID will be similar to contact tracing for H1N1, or other diseases, right. But today’s context is new, and unique in many ways. So although tracers will be using known tools from contact tracing, they’re going to be applying them in novel situations. That’s when you get new insights! That’s when discoveries are made. That’s when new knowledge is created!
So it would seem we’d all benefit if contact tracers were equipped to be learners or students while they’re contact tracing. Learning from the practices of contact tracing. Because they’re the ones doing it!
All right I’m going to move to a second way that the expert/novice Duality can get in our way if we don’t keep an eye on it. And that’s the person on the other end of the line with the contact tracer. That’s right: the public! Now when the tracers are finished their training, and they pick up the phone, it’s not as if they do this magic flip where suddenly now they are the holders of all of the knowledge. And the public are positioned as the ones who don’t have any knowledge worth sharing, or don’t know if things worth knowing.
But in effect that’s what happens, right! The tracers go from being that taker in of information when the training is going on, to the deliverer of information when they pick up the phone.
So in this way, training can have the unintentional side effect of forgetting to position the public as people who know things worth learning from. And again it’s not clear if there’s space for these things, or for the contact tracers to learn from the public, or from the work of contact tracing, or from each other. But I’m arguing for it!
And the good news is: there are known ways to do this. If you know me, you know my acronym BRIDGES. I’m always about building bridges. And the B in BRIDGES for me stands for bi-directional. This is a great example! Contact tracing involves bi-directional teaching, and bi-directional learning.
Contact tracers are in the perfect spot to teach and learn, and generate some of the most powerful knowledge on one of the most important issues we’re all facing! I think this is a teaching and learning event of my lifetime!
But it hinges on this: the number three way the expert and novice duality can show up, and that’s in the role of the experts themselves. How much are the experts in contact tracing willing to be learners? Whoever holds the book of contact tracing, whoever the gatekeepers of that knowledge base, are they willing to let the contact tracers in? And let the contact tracers be allowed to help write the next chapters in the book of contact tracing? From the ones I’ve talked to so far, I think so! I bet they are!
If you educate at all, I invite you to think about how the expert/novice Duality might be limiting what you and those you’re educating are able to do and be and think and generate. If your organization is involved in contact tracing where is responsible for the training of contact tracers, please get in touch!
This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel.