Our opening pathways team, other than our PI Dana, had been working together for years before Eric and Dana first spoke at the 2016 Quantified Self symposium. I began working with Eric Hekler in mid-2013, with Erik Johnston in early 2014, and Sayali Phatak joined Eric Hekler’s Designing Health lab at ASU in mid-2014. Before beginning our collaboration with Dana, we (meaning, for the remainder of this post, the Opening Pathways team other than Dana) worked on a variety of projects together, including Phoenix’s 2015 T2050 transportation plan. Reflecting on this history, I realized that the culture we had established in our previous work is an important part of the context that is likely helping in this Opening Pathways project. My perception is that integrating Dana into our existing working relationships as a new leader was smoother than it would have been for a team forming among people who hadn’t previously worked together.
This post will highlight a few aspects of the established culture that preceded this grant. I’ll explore how they have supported this work, in an effort to foreground them, and not take them for granted, as drivers of what has been achieved through this work.
For members of the Academy, our team had developed an a strong and explicit focus on social impact as our main success criterion, over impact in other domains, such as publications. The T2050 work mentioned earlier is an example of this, having had a material and award-winning impact on decades of transportation in Phoenix. The ability to directly help people in the real world was a primary appeal of working with Dana, reflected in constructing this Opening Pathways project to bring data science support to research questions sourced in the Type-1 diabetes community. Of course, other academics care about social impact, but many are dissuaded from its pursuit because it is invisible in their evaluations, which for pre-tenure faculty have very high stakes.
We also had experience working with partners outside academia. Beyond collaborating with the City of Phoenix on T2050, Eric Hekler contributed to PACO (an app developed by Bob Evans while he worked at Google), and Erik Johnston developed models with the AZ Heat Relief Network. These experiences helped our team learn to listen and understand the context and perspectives of people in different sectors, and incorporate those into our work. Working with Dana, this has meant acknowledging the norms and dynamics of academia that we might take for granted, and about which Dana has asked questions. I think our preceding practices of self reflection to facilitate external partnerships prepared us to better hear Dana, and explain how our experiences in academia have shaped our expectations (of timelines, products, communications, etc.).
Before this grant, our teams have generally had a pretty flat hierarchy. As a PhD student and postdoctoral scholar, I have been, and am, afforded a lot of decision-making authority and project responsibilities. Erik and Eric have ceded some formal hierarchical authority based on their roles as professors, and our work has been organized around the necessary skills and roles, not seniority, status, or credentials. Two examples of this are empowering an undergraduate student to contribute to PACO’s github repository, and a masters student to design the maps that would appear on Phoenix’s ballot initiative for T2050. This perspective on power has been crucial for our work with Dana, because she is the PI, and the normative power dynamics of collaborating on grants from inside and outside academe would not necessarily preference her thoughts and opinions (“as a non-PhD holding patient researcher”). However, for our team, empowering the right person for the role, regardless of credentials or status, has been standard practice, and (I hope, please correct me if I am wrong Dana) has manifested in this grant as consistent yielding to Dana for directing grant activities and making final decisions. This also resulted in our advice to Dana at the start of the grant, regarding each individual’s strengths, with recommendations about who might be best suited for various aspects of the project.
For example, Eric has a strong grounding in design, and has always encouraged our work to be flexible and iterative, rather than planned and fixed. One method to encourage creative design is “yes, and,” which is a tool from improv(isational comedy) that meets ideas with a positive and additive responses. I am admittedly not the most adept at this, but Eric and Erik have been strong and consistent examples to me of how yes, and can turn negative feedback into opportunities. For the Opening Pathways team, “risky” ideas (such as our baggage claim activity) have consistently been met with yes, and, and those additive moments have been catalysts for some of the posts on this blog. Rather than defensiveness and territoriality, “yes, and” offers a creative, iterative platform to collaboratively explore the emergent ideas of our Opening Pathways work.
Another way that we have embraced emergent ideas is by being outcome agnostic. Rather than choosing outcomes based on our values, and building processes to achieve those outcomes, we have worked to understand the values of our partners (e.g. city staff and committee members), and build transparent, fair, and information-rich processes for decision-making. For this work, it meant we were easily dissuaded (by Dana) from an assumption of a static PDF product for our (ultimate, not yet created) output of a toolkit for other patient innovators, in favor of something that is open source and more flexible to future contributions and adaptations by that community of innovators. I’ll leave this here, as Dana requested a reminder to dig into ideas about process and outcomes in a post of her own.
One of my favorite personal moments from this work was Dana explaining to me that she found herself surprised that she didn’t have to jump in aggressively to be heard on our calls. Rather than being consistently interrupted, ignored, or lacking airtime, Dana realized that the culture our team had built coming into this grant included listening, and not interrupting. I pride myself on this as a skill developed through interviews as a relationship building tool for stakeholder engagement. Eric Hekler ran his lab meetings by giving the most junior members airtime first, and Erik Johnston consistently waits and listens before adding one or two thoughtful comments whenever we are in a meeting together. When the Opening Pathways team has had hard and deep conversations about our rhetoric, assumptions, and language choices, every team member has worked hard to listen and understand, leading to emotionally powerful moments and stronger team cohesion.
That team cohesion also draws on explicit and generous accomodations for family and personal life. Before Opening Pathways, both Erik and Eric had built and maintained a culture of team expectations that we are people first. They put work in the context of life offering paternity leave, vacation, off-limits nights and weekends, support for distributed collaboration, reminders to enjoy the summers, and inquiries about what team members need. For teaming up with Dana, work in the context of life has meant scheduling in various time zones based on her moonshot travel schedule, learning about celiac disease for our in-person meetings, and learning that attention to her phone isn’t the distraction it would be for other people, it’s usually related to diabetes management.
Even when we were just collaborating from Phoenix and Tempe (adjacent municipalities), Eric Hekler would often suggest to me that we meet via video chat. I had already worked on projects at UCSD and with the University of Tokyo, and developed comfort with distributed collaboration as part of my standard practice. With Sayali attending some working meetings from India, and Erik Johnston’s travel schedule, our team had already created expectations and used tools (zoom, google docs) to organize distributed collaboration with sensitivity for balancing time zone differences. With Dana in Seattle, Erik in Tempe, myself near Boston, and Eric and Sayali in San Diego, having existing comfort and familiarity with working in a spread out team was an important factor for getting off the starting line.
Another example of existing comfort and familiarity is Paul Tarini, our (great) Opening Pathways Program Officer. Not coincidentally, he was previously Eric’s Program Officer for Agile Science. Paul’s help in understanding the RWJF process, flexibility to the (person formerly known as) patient-PI model, and support and guidance throughout proposal development and implementation has been crucial to this Opening Pathways work. I think the existing relationship between Eric and Paul was a necessary ingredient for making this unusual (unprecedented?) grant-making model possible, given the legal, institutional, and cultural factors at play.
Lastly, I’d like to note that Eric, Erik, Sayali, and I have different training and come from different disciplines with different vernacular. To communicate, we often resort to metaphor or accessible examples, rather than disciplinary jargon. This interdisciplinary experience and practice lends itself to other broader collaborations, such as this Opening Pathways work with Dana. That is, the practice of using new metaphorical language helps with new collaborations. However, there is also the potential for old in-jokes and decontextualized references to create feelings of exclusion or confusion (hat-tip to Dana for pointing this out). Thus, encouraging all team members to ask about languages, acronyms, or references when they’re unknown or unfamiliar is a powerful part of our team culture, too.
I hope these cultural carryovers reveal some of the implicit factors and hidden drivers of how this Opening Pathways team works. One goal of this post is to highlight possible stumbling blocks for future travelers of a path like this, i.e. without some of the above, a collaboration such as this could have been very different. To wrap this up, I’d like to invite readers to share any of their own insights with us, in the comments here or on Twitter, about how old dogs (teams) learn new tricks (collaborations).
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