Systemic work as a teaching method in medical school

Salome, how did you come across systemic work?

“I have always worked in academia. I graduated as an epidemiologist and pursued my PhD in that field. That’s how I became a scientific researcher. Gradually, my role shifted. When I started leading research projects, I suddenly became a program manager. But how does that actually fulfil such a role? And are the dynamics within a team?

Personally, I find systemic methods immensely interesting. That is why I chose this route to learn more about how teams work. By attending various courses at the Bert Hellinger Institute, I gained new insights to use in my daily practice. I learned to look at situations differently, and that knowledge helped me improve and accelerate my understanding of the teams I manage.”

How did you incorporate those insights into your other work?

“In addition to doing research, I had also started teaching. I was already used to supervising and teaching students, but how I was also asked to contribute to a new curriculum for the medicinal program. I explained what systemic work had taught me. I wanted to pass on those skills to our students.”

How can medical students benefit from systemic work?

“Specifically medical students deal with a number of well-known challenges, such as having to do long internships (called “co-schappen” in Dutch). During 3 years of internships, you work in various departments and wards. You are constantly learning: How does this team work and what is my place in that team? You also have to deal with the prevailing values, standards and beliefs of experienced medical colleagues. Do these match with your way of thinking? The study program is tough and intense, and can also make you very insecure. And that remains a relevant question during your career: How do you ensure you don’t lose sight of yourself and how do you stay ‘in love’ with your job?

These are well-known challenges, for which there isn’t really a solution. I saw opportunities at a systemic level, and wanted to offer that knowledge as part of the curriculum. However, systemic work is not a common method used by academics. Their scientific approach immediately raises all kinds of questions: How does it work and why should we apply it? You have to be well prepared and able to substantiate what the added value is.

I went looking for ways to explain it in their own language. It took me a few years, and I regularly conferred with a number of trainers from the Bert Hellinger Institute.”

How did you find that common language?

“I started with situations that many medical students encounter and find hard during their studies or in their career. The systemic view can really achieve great changes.

Take the socialization process at university, for instance. You gain knowledge and skills, but also develop an attitude. You learn about standards, beliefs and values. In this environment you are bombarded with a lot of information and rules. Sometimes you get so pushed into a certain ‘mould’, that you lose a part of yourself. At the same time, you also want to keep your authenticity, the ability to reflect on what you do. This is a problem that will sooner or later cause friction for medical students or doctors.

How can you change that? How do you stay close to yourself? How do you read what is happening in a team and determine your role in it? That for me became the path to systemic work.”

What do you teach students about systemic work?

“Systemic thinking is primarily about zooming out. Being aware of the wider context and seeing where you fit in. Students are used to zooming in. That’s actually the crux. Once you can zoom out, everything changes. Then you see the context of the group you mix with, the dynamics within that group. And you see yourself.

Taking the time to reflect on prevailing beliefs is a very interesting part of this system. When we do a constellation with a group, this is often the start of interesting conversations. Is this what you actually believe, what we believe, or what I believe? Or have we agreed, unconsciously, without noticing, that this should be our belief?

The systemic view also helps your personal development. Look at yourself. What am I actually doing? Where am I, and how did I get here? And how does that affect me?

Being allowed to feel is another important point. You don’t have to approach everything rationally. When you feel tension and anxiety, you are allowed to take that feeling seriously. It’s an important observation, even if you can’t explain it right away.

That broader view, that awareness, reflecting more on the wider context and on yourself as part of it: that is the key. We don’t teach students how to do constellations, the systemic view is enough.”

How does it benefit students?

“You become more effective when you can understand dynamics in teams, organizations and the wider social context. And you can stay closer to yourself. This way, you can grow and develop your career with much more enjoyment and satisfaction. In fact, it is valuable knowledge for any student, regardless of their field of work.”