Change Week wrap-up

Five days ... twenty posts on school change ... did we learn anything?


Miguel Guhlin says, "Just finished skimming your entries. . . . Now, what do I do on Monday morning?" Well, it's Monday morning. Here's what I think you do, Miguel (and others).

First and foremost, recognize that having an intentional, intelligent, systematic approach to school change makes it much more likely that your change initiative will be successful. Be proactive in considering all four of Bolman & Deal's frames. Think about the diagrams from Peter Block, Everett Rogers, and Christensen et al. and openly discuss in your change team (do you have a change team?) how you're going to handle these issues. Work on addressing Kanter's reasons for resistance to change before your new initiative begins. Utilize the concepts of The Tipping Point, Good to Great, and The Knowing-Doing Gap to give yourself the best chance of success. And so on. Sure, this all takes time, but failure to take the time almost certainly equals failure of your initiative.

Second, if you want to be a successful change agent, ground yourself deeply in the change literature. The more you know, the more you know. Read deeply, don't skim; there are no shortcuts here. I recommended some books to get you started. The free IBM Change Toolkit also has a wealth of tools and information and is intentionally designed to walk school leaders through each step of the change process.

Finally, understand that school change is the proverbial giant hairball. One of the reasons that change is so difficult to scale up is because it's so local. Each organization has its unique strengths, weaknesses, opportunities, and threats. You must know your organization well and be able to adapt all of this to your local setting.

Good luck! You'll need it!

For those of you who'd like quick links to everything from last week...

  1. Change Week introduction
  2. Change frameworks
    1. Diffusion of innovation (Rogers)
    2. Bolman & Deal frameworks
    3. Can schools change? (Christensen et al.)
    4. Agreement and trust (Block)
    5. Resistance to change (Kanter)
    6. Change quotes (thank you, Seth Godin!)
      1. There are two kinds of organizations
      2. Change your organization's instinctual location on the curve
      3. The time to panic is today
      4. One, two, or three steps?
      5. We can't handle this much change
      6. Change diagrams (thank you, Kathy Sierra!)
        1. The zombie function
        2. Give them the chance to be f'n amazing
        3. Death by risk aversion
        4. Leave them with the "I Rule!" feeling
        5. Incremental vs. revolutionary improvements
        6. Change resources
          1. The Knowing-Doing Gap
          2. Good to Great (and Good to Great and the Social Sectors)
          3. First, Break All the Rules
          4. The Tipping Point
          5. Scaling Up Success
          6. Diffusion of Innovations (5th ed.)
          7. Reframing Organizations (3rd ed.)
          8. The Empowered Manager
          9. IBM Change Toolkit
          10. The Big Moo
          11. Made to Stick (bonus resource!)
          12. Execution (bonus resource!)
          13. Change Week wrap-up
          14. Results of Change Week poll
          15. Vovici Online Survey Software

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            Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

            Still from John Stephenson's 1999 rendition of Animal Farm.
            Surprising Science
            • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
            • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
            • The research raises many ethical questions and puts to the test our current understanding of death.

            The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

            But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

            What's dead may never die, it seems

            The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

            BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

            The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

            As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

            The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

            "This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

            An ethical gray matter

            Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

            The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

            Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

            Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

            "This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

            One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

            The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

            "There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

            It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

            Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

            The dilemma is unprecedented.

            Setting new boundaries

            Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

            She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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