My first job in T&D was as a staff development specialist at a hospital for developmentally disabled adults. Many had multiple physical, emotional, and brain-based challenges, requiring complex treatment plans and often multiple medications. Many had assorted tics or grimaces or little rhythmic gestures, which the staff all viewed as part of the whole-person package.

Medical mystery?

One Monday morning a new staff psychiatrist reported for his first day of work. Fifteen minutes into the campus tour he said: “I don’t understand what’s going on here. Everyone I see has tardive dyskinesia. Why isn’t something being done about this?”

Tardive dyskinesia—and I am grossly oversimplifying here— links to the use of antipsychotic and neuroleptic drugs. It is characterized by, yes, tics, repetitive purposeless gestures, grimaces, or other similar movements. People often misdiagnose these behaviors as related to mental illness, and treat them with … neuroleptic drugs. Prolonged use of neuroleptic drugs can lead to the increased severity or permanent manifestation of … tardive dyskinesia. It’s a nasty problem.

Please understand: There was no malpractice or terrible medical incompetence at play. It is very, very difficult to get an accurate diagnosis and perfect treatment plan for people with such myriad issues, who on top of everything else cannot communicate well, if at all. The problem was more one of familiarity: Staff interacting with people day after day just didn’t see the gradual evolution of, and increase in, the tics. Once they had it pointed out to them, there was an immediate scramble to reassess, adjust meds, and otherwise address the issue—and prevent it from recurring. But it took a stranger walking in and, in no time, just calling it out.

Ask around

I had a similar, less dramatic experience in a recent conference session. It was on eLearning design, and we were discussing the importance of not just shoveling content onto slides, but rather stopping to develop a good treatment for the material. (A great example of this is Kevin Thorn’s www.nuggethead.net treatment of types of herbicides, a military-mission style narrative delivered in a course called “Mission: Turfgrass.”)

I asked the group to throw out topics they were wrestling with. One woman said her management tasked her with developing a tutorial on the history of recordkeeping in her organization, and there was just no arguing about it. The company had been around for most of the 20th century and wanted to explain how it had tracked data from pencil and paper to magnetic tapes to floppy disks and so on.

Although it had no performance impact, and they could easily deliver it some other way, perhaps as just a few paragraphs in a document, management was adamant that they wanted a “course.” (We’ve all been there, right?) The group of perhaps 100 very diverse attendees—none whom worked with this woman or even, so far as I know, in a similar field—assembled into smaller clusters of five people to discuss possible treatments.

Most groups came up with perfectly good ideas given the dreadful content: an animated timeline, a before/after story, or a rapid-fire Common-Craft style narration. One fellow, though, said: “I’d set this up as a history of recorded communication comparable to about the time the company started, with a communication-tools metaphor. For instance, take the learner through an analogy starting with early days when we used 78 rpm records, then 33? rpm LPs, then 8-track tapes, then cassette tapes, then CDs, and then finally digital formats.” Everyone stared at him for a moment and then burst into applause.

It was exactly right.

Who you gonna call?

My point, if it’s not already clear? Sometimes we get so embedded in conversations with subject matter experts and mountains of “content” and our own small worlds and views that we may not be standing back far enough to see something clearly. Talking to people outside the problem, or who have no understanding at all of the content, or have never seen the shop floor or the processing system or the standard operating procedure, may help you find a different solution or better idea or great new approach. (By the way—this is one of the reasons I cherish my own personal learning network on Twitter, and one of the reasons I argue against locking employees inside organizational firewalls and social channels.)

Call a friend who works somewhere else. Bring in someone from a completely different work area to look at it. Ask your 14-year-old. Throw it out on Twitter. Most people like having you ask for their ideas on things like this. So, especially when you’re really struggling, ask someone to help you see the forest. You’ll probably end up with a better product for it.