Is Knowledge Translation In Health Too Important to Leave to Health Professionals?
Posted: April 24, 2013 Filed under: education & learning, innovation, journalism, knowledge translation | Tags: communication, health communication, health systems, journalism, knowledge exchange, knowledge integration, knowledge translation, librarians, social media, storytelling, teachers 7 Comments »
Knowledge translation — and its affiliated terms knowledge exchange, knowledge integration and knowledge mobilization — was coined to describe a process of taking what is known into what is done in health across the spectrum of science, practice, policy and the public’s health. As health issues become more complex due to the intertwining of demographics, technology, science, and cultural transformations the need to better understand evidence and its impact on health has never been higher. Questions remain: has demand met supply? How are the health professions dealing with this equation?
Translating knowledge
The Canadian Institutes of Health Research (CIHR), one of the earliest champions of the concept of knowledge translation in research, define it as:
a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians (sic), provide more effective health services and products and strengthen the health care system.
These ideas are expanded below:
Synthesis – Synthesis, in this context, means the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods. It could take the form of a systematic review, follow the methods developed by the Cochrane Collaboration, result from a consensus conference or expert panel or synthesize qualitative or quantitative results. Realist syntheses, narrative syntheses, meta-analyses, meta-syntheses and practice guidelines are all forms of synthesis. Resources related to synthesis are available.
Dissemination – Dissemination involves identifying the appropriate audience and tailoring the message and medium to the audience. Dissemination activities can include such things as summaries for / briefings to stakeholders, educational sessions with patients, practitioners and/or policy makers, engaging knowledge users in developing and executing dissemination/implementation plan, tools creation, and media engagement.
Exchange – The exchange of knowledge refers to the interaction between the knowledge user and the researcher, resulting in mutual learning. According to the Canadian Health Services Research Foundation (CHSRF), the definition of knowledge exchange is “collaborative problem-solving between researchers and decision makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between knowledge users and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decision-making.”
Ethically-sound application of knowledge – Ethically-sound KT activities for improved health are those that are consistent with ethical principles and norms, social values, as well as legal and other regulatory frameworks – while keeping in mind that principles, values and laws can compete among and between each other at any given point in time. The term application is used to refer to the iterative process by which knowledge is put into practice.
In short, knowledge translation is about taking what we learn and know from evidence, sharing that knowledge with others and assisting them to make useful health choices in practice and policy through KT.
This often involves communicating across contexts, disciplines, and roles between and from scientists, clinicians, policy makers and to the public alike. In a health environment that is increasingly becoming complex, the ability to communicate across boundaries is no longer an advantage, it’s an essential skill. While we may not always have the right language, we can translate meaning through stories.
But if stories are to be effective they need to be valued.
The value of storytelling
I’ve seen health professionals — scientists and clinicians — roll their eyes when you mention storytelling in a work context. It is as if the only legitimate role for stories is to communicate with children (which University of Alberta researchers are exploring as a tool for sharing health knowledge with parents). Yet, it is through stories that most people share what they know in every other context; why would it be different in health?
Perhaps it is the connotation that stories are ‘made up’ like children’s bedtime tales, but one need only look to journalism to find that we’ve been making ‘stories’ a central part of our life every day. We listen to drive-time radio for stories about the traffic conditions, we watch, download and listen to news stories filed by professional journalists and citizen bloggers alike on mainstream media, Twitter, YouTube, Facebook along with myriad sources across the web. Last week we were glued to various sources to learn stories — some of them false — and create stories about the events of the Boston Marathon bombings.
Stories are what conveys multiple information threads and puts it in a coherent context.
Stories are coherence engines.
Valuing knowledge translation
If knowledge translation is important then it should be reflected in research priorities and evidence for its impact on the system across different disciplines. Dr Shannon Scott and her U of A team recently conducted a systematic review of knowledge translation strategies in the allied health professions and found that the field was full of low quality studies that made it impossible to make firm statements on which methods were best among them . That team has recently proposed a systematic review looking at how the arts and visual methods can further contribute to KT in practice, although it likely the same issue with methodological quality might come into play here, too.
What she and her team are doing is looking at the process of sharing stories and, from a research perspective, sharing stories appears to not have been worth investing in scientifically. At least, not enough to generate a lot of studies and good evidence.
One could argue that knowledge translation is still new and that it takes time to generate such evidence. That is partly true, but it is also an easy prop for those who want to avoid the messiness that comes with communication (and its problematic research context), learning from others, and creating more equitable information spaces, which is what knowledge translation ultimately does. Knowledge translation has also been in use for almost 20 years so in that time — even with the most dismal assessment of the length of time it takes to put knowledge into practice — we should be seeing some decent research published.
KT is fundamentally about sharing. Journalists’ are rewarded for sharing — the more they share and the more people who they share with (as measured by readers, listeners, viewers etc..) the more successful they are in their work. Teachers are rewarded for sharing because that means that they are teaching people. Librarians are rewarded for sharing because that means people are checking out books and using the resources in their library.
We don’t apply the same standard to academic research, even though we have some crude metrics to measure reach and impact, and there is roughly no metric for the degree to which clinicians share among themselves. Maybe this needs to change.
I have scientific colleagues who are fierce in the face of their most strident academic critics and have delivered keynotes to auditoriums filled with researchers that are nearly paralyzed in the face of speaking to the public. This is not fear of public speaking, its fear of speaking to the public.
Should they be? I don’t think speaking to the public should be expected to be enjoyable for everyone, but neither are doing statistical calculations, completing ethics applications, or presenting posters at conferences, but we still expect scientists to do that. We still expect nurses, doctors, psychologists, medical technicians and social workers to traverse complex social problems to talk to their patients in an open and honest way.
Why is it when scientists are speaking to policy makers, clinicians to scientists, policy makers to the public, or any professional to another from another discipline, speciality or division we decide its not critical for them to make the effort?
Why don’t we do the research to support it?
Why is it OK not to do KT because its uncomfortable, awkward, difficult or confusing?
Declining interest, rising demand
It is perhaps for reasons like this that knowledge translation is so poorly understood and taken up as a focus for research. Looking at Google NGram data (which tracks mention of specific topics in books and publications) we see a steady rise in citations until about 2003 followed by a levelling off. Keep in mind that the leveling begins before social media became known. In the years after Twitter, Facebook and YouTube — arguably the most powerful communications media we have for doing knowledge translation widely (but perhaps not deeply) — there is roughly no sharp increase.
Below are the citations for the terms knowledge translation, knowledge exchange, and knowledge integration from 1996 (when the Web first started gaining wide use beyond academia and the military) and 2008, the latest year for which there is available data. Note that the numbers reflect general mentions as a percentage of overall terms, so they are relative, not absolute values.
Figure 1: Google NGram Data for KT, KE & KI: 1996-2008
Is there so much other stuff to talk about in 2013 that the relative importance of knowledge translation is diminished?
A look at Google Trend data using the same terms finds that not only are these concepts not growing, their mention is actually shrinking.
Looking at the three terms we see that all three concepts have declined over time. During these years — 2004-2013 — we saw not only the birth of social media, but the rise of Internet-enabled handheld devices to allow knowledge to be shared anywhere there is a data signal. We now have apps and nearly all of the Internets resources in our pockets and we are seeing a decline in the use of these terms.
Figure 2: Google Trend Data for KT, KE & KI: 1996-2013
Where to?
So to review: We have a body of evidence in KT that is problematic and incomplete at the same time we have a decrease in use of the terms, while at the very same time we have a sharp rise in available tools and technologies to share information quickly and a continued, steady demand for more information to make decisions for health providers, patients, policy makers and insurers.
Yes, the data presented here are not perfect. But does it not make sense that there should at least be some trend upward if knowledge translation is valued? Should we not see some shift to more research, better research evidence, and greater interest given the tools and scope of communications we have through social media?
This begs the question: is knowledge translation in health too important to leave to health professionals?
In future posts this question will be looked at in greater depth. Stay tuned.
* Blog has been updated since original post
Normative Complexity: Breaking Up is Hard To Do
Posted: March 26, 2013 Filed under: complexity, innovation, psychology, systems thinking | Tags: complexity, design, jeans, mental health, mindfulness, minimum specifications, normative behaviour, psychology, psychotherapy, Russell Ackoff, social innovation Leave a comment »
Normative behaviour is what we expect from others operating in the world around us. It is what defines the world “normal”. It’s based on a complex array of history, social conventions, mores, values, context and timing, but it is the reason we know weird or odd from something else. Weird, is by definition, something that is not normal.
What I Learned From Denim
Many years ago I saw a TV special looking at the world of fashion and was struck by the process of designing denim jeans for men. The audience was told that jeans are often designed based on the prototype of the ‘average’ man and then worked out from there. What struck me was that they also said the ‘average’ man has a size that matches about 1 in every 7500 men. So the average — the normal — is not average at all. Indeed, he is particularly rare. Male models who represent this size do very well in their profession.
While there is a norm of social behaviour, there are actually very few people who are wholly ‘normal’ in their actions, nor are there obvious cases where normal is indeed, then norm in social systems. Why? Because social systems are complex by their very nature. They bring together diverse, overlapping, dynamic elements together operating at different scales simultaneously. This is complexity.
Just as individuals we bring our familial history, education, gender, sex, age, faith (if it exists), height, race (which might be highly mixed), experience, physical abilities, fashion choice, body type, vocal acuity, energy level and on to every single interaction we have. Every one of those factors — of this limited group — bring with it a set of unique attributes that individually and socially have differing weight and ‘normality’ depending on the circumstance. To imagine that there is a place where all of these line up with everyone else is utterly absurd if not statistically impossible.
Yet, we cling to the idea that normal exists and might even be something to aspire to. We push a conformity on to our expectations of each other and our research that is unreasonable and often harmful.
It’s not unexepcted. From our earliest days in the society we belong there is pressure to conform. Norms are what hold societies together. They are what creates culture. But where the confusion comes in is with the treatment of norms as truly common things that is universally positive (if attainable).
It is the often mis-attributed following quote to many that still stands out as true:
There is nothing so uncommon as common sense
In complexity science, norms are not disregarded, but are only minimally useful in helping understand patterns of activity. There are path dependencies, which guide certain activities and point to the importance of knowing where things start to help trace the manner in which they project outward. There are things called minimum specifications, often referred to as ‘simple rules’, that can help us create certain conditions within boundaries to shape behaviour. Yet, no matter how we shape these, the normative condition is not and will not be normal in any sense like your favourite pair of jeans.
What Relationship Break-Ups Can Teach Us About Complexity
Psychology and Psychotherapy, when operating at its best, helps people to understanding their true selves independent of, although interdependent with, the world around them. It falls short when it pushes people to conform to social norms apart from their true self. This is a shame.
Ask anyone who has endured a particularly heartfelt breakup of a relationship about normal and you’ll see the pain caused when we ascribe normative behaviour to complex systems. Sensemaking in a breakup is hard to do because of the massive cultural and social baggage we attach to them. Marriages, engagements, boy/girlfriend partnerships, affairs, flings, and flirts all bring socially normative expectations (and taboos) with them. And yet, if you think to any of those relations you’ve had I suspect that you’ll find that at its core there was relatively little ‘normal’ actually going on. Each relationship has its own cadence, pattern and normalness to it.
The best relationships have their own way of creating patterns that are unique to themselves, which is why we can’t replace or hope to replace one with another. They are irreplaceable for the very reason they are special. Not necessarily better or worse — but perhaps more congruent, happy, loving and so on — but different. The things that turn one person on are not the same as some one else and this is what makes relationships hard, but also exciting. This is what a complex adaptive system is like in real life.
Unless there was some obvious punctuated event like an affair or assault or major crime, most relationships don’t end because of a single thing. There might not even be a clear sense of what the “thing” that caused the breakup was. Sometimes people drift apart, sometimes the spark disappears, other times individuals forget who they are, while in some cases people discover themselves to be altogether new. Even still, sometimes this all happens at the same time, over time, in ways that neither couple can see until they are too far apart to connect. A complex system.
Treat this like a linear system and you may find potentially catastrophic consequences and hence the drama that TV and film introduce in their break-up scenes. For a funnier, but no less important take on this, see the video below from Dave Snowden.
This happens with lovers, spouses and friends all the time. A look to popular psychology or media will suggest that there are ways to handle this and no doubt efforts will be made to show how ‘healthy’ people transition and what they do to do so. These ‘healthy’ people will represent the ‘norm’. They’ll take time out for themselves, they’ll ‘get back up on the horse’, they’ll do the Eat, Pray, Love journey.. All of these might work, but they are based on an assumption that whomever is recommending these strategies knows the complexity of the individual’s case to whom they are referring.
Some therapists do, many do not. If you’re in for two or three sessions it will undoubtedly fall to the latter.
This is parallel to what we do in our efforts to inspire systems change. We look to the norms of our society, our discipline, our sector, our community and so on and we hire people for the equivalent of one to three to five sessions to tell us what to expect and do. What we get is Dr. Phil, which sounds great, allows us to boil enormous complications into a one hour soundbite or self-help book, and feel good because we are doing something that matches society’s expectation and we end up with what Russell Ackoff suggests as doing the wrong things righter.
Minding Our Norms
We expect to go into these encounters being the 1 in 7500 male model for jeans, when we are our own model for our our denim.
Work in complexity means breaking up with normative expectations and becoming mindful of what our own unique ones are as well as what the minimum specifications are that link us to that common thread of humanity — society, discipline, family, community, whatever. This is not easy. Mindfulness is very hard, but remarkably simple.
The more mindful we are of the rules and norms we live by or try to live up to, the better we can understand where they fit and where they collide against our own specific condition and setting and better craft strategies and design opportunities for real, genuine social innovation and not a caricature.
We need to be the model for our own jeans. When we do that, the fit will be both bespoke and very fashionable.
Photo by Muffet Used under Creative Commons Licence
Handbook of Systems and Complexity in Health
Posted: January 16, 2013 Filed under: complexity, innovation, public health, systems science, systems thinking | Tags: book, Carmel Martin, complexity, health, Joachim Sturmberg, public health, systems thinking, wicked problems 3 Comments »
Handbook of Systems and Complexity in Health
A brilliant and comprehensive new book has been launched that brings together the best scholars working in the area of systems thinking and complexity and applying it to health.
The book description can be found here along with a link to the abstract for a chapter I co-authored with Andrea Yip looking at the overlap between design thinking and systems science and complexity. This chapter takes a design lens on previous work developing the CoNEKTR model for engagement in complexity and health.
It’s a big book, but well worth a look if you’re wrestling with complexity and systems thinking in health and social innovation.
The Knowledge Metric in Education
Posted: January 9, 2013 Filed under: education & learning, evaluation, innovation, science & technology, systems thinking | Tags: design, education, educational design, evaluation, higher education, journalism, knowledge integration, knowledge translation, learning, professional education, social innovation, teaching, universities, university 5 Comments »
Higher education is asking itself some big questions and making substantive changes to the way it sees itself and produces value for society. Education is increasingly being rationalized, which calls into question the metrics that are being used to judge how resources should be allocated. In a previous post, I looked at the jobs metric. Now, it’s time to look at the knowledge metric.
Just the facts
Education writer and teacher Will Richardson‘s TED Book Why School is a provocative read for those connected to teaching or just interested in schooling. While it focuses largely on grade school, the issues are the same for universities and colleges particularly as the primary and secondary students of today are tomorrow’s graduate and professional learners. Richardson questions the role of the school as institution in its current form suggesting that if the status quo — one characterized an information delivery warehouse — is maintained there is little need for schools to exist at all. Yet, if the education within schools is focused on asking better questions and learning when to apply knowledge, not just what knowledge to apply, there is hope.
The current trend in school reform is towards Common Core Standards, which emphasizes specific forms of knowledge, ‘facts’ and asks that students be able to recall such content when required. Under this model, the role of the teacher is one of content manager and facilitator rather than guide or mentor and students are prepped for the tests of their knowledge (memory) rather than be asked to demonstrate its application to anything outside of the test. It is this model that many proponents of online education embrace, because the Internet is a fabulous content delivery system and education can be literally programmed and delivered to students directly without the ‘noise’ that teachers introduce to the signal. Under this model, educational content can be delivered cheaply and widely to support uniform intended effects among learners.
Richardson argues for reforming schools to something closer to the alternative model that was advanced by educational reformer and philosopher John Dewey. Richardson writes:
“In this version of reform, schools and classrooms are seen as nodes in a much larger learning network that expands far beyond local walls. Students are encouraged to connect with others, and to collaborate and create with them on a global scale. It’s not “do your own work,” so much as “do work with others, and make it work that matters.” To paraphrase Tony Wagner, assessments focus less on what students know, and more on what they can do with what they know. And, as Dewey espoused, school is “real life,” not simply a place to take courses, earn grades, amass credits, and compete against others for recognition. There lies the tension.
This second path is simply not as easy to quantify as the first. Developing creativity, persistence, and the skills for patient problem solving, B.S.-detecting, and collaborating may now be more important than knowing the key dates and battles of the Civil War (after all, those answers are just a few taps on our phones away), but they’re all much more difficult to assign a score to. I’m not saying that a foundation of content knowledge isn’t still important. To communicate, function, and reason in the world, students need effective reading and writing skills, as well as a solid foundation in math, science, history, and more. But I’m convinced we must revise the overreaching coursework requirements we place on students — requirements created at a time of scarcity, by the way. And we desperately need to revisit the thinking we’ve developed around assessment that, as Harvard researcher Justin Reich says, “optimizes the measurable at the risk of neglecting the immeasurable.””
Facts vs Problems
The knowledge metric is flawed because it assumes that content solves problems. It also presumes that the curriculum teaches the right knowledge for the right problems and that those problems can be known in advance. Let’s look at these.
One need only look to cigarette smoking as an example of how knowledge alone doesn’t always solve or prevent problems. One would be hard pressed to find anyone over the age of five who doesn’t know that sticking a lit tube of anything in their mouth and sucking on it isn’t at least somewhat unhealthy (and most know it is very unhealthy). An individual’s knowledge of smoking’s effects on physical health may not be complete, but it is often sufficient to inform the decision to quit or not start the unhealthy habit. And yet, citizens in highly educated countries like the United States, Canada and the U.K. smoke more than 1000 cigarettes per year per capita (and over 2700 per capita in places like Russia). These are not countries lacking in information on tobacco and health.
Using students’ ability to recall content makes the presumption that what is contained in a curriculum is what they need to know when they leave their program of study (at least as a start). While it may be somewhat true for students in the humanities and languages, it becomes highly problematic for those in dynamic fields or emergent areas of practice, which is becoming more normal than rare. There is no doubt that a corpus of key concepts, skills and ‘facts’ is useful, but the manner in which this knowledge can and may be applied is changing dramatically. For example, social media has upended communications in ways that very few health professionals are trained for. Journalists are particularly aware of the role that Twitter and related tools have had on their profession.
It also presumes that the content itself is relatively static. Certainly, curriculum renewal is something that most learning institutions engage in, but the primacy of content itself as the driver of education also assumes that the foundation for that knowledge is solid and can be applied today in the manner it was applied yesterday. In dynamic conditions, that isn’t often true. Further, the relevance of knowledge is framed by the problems to which that knowledge is applied. Genetic information, for example, can be incredibly useful when framed against tests that have high confidence, predictability and value to people, yet without such a context it is largely useless to those non-scientists who have it.
Areas of social innovation — which are expanding dramatically in number and scope — illustrate the problem of changing context well. This is a field characterized by problems, problem solving and novelty (which is what innovation is all about). Standard approaches don’t apply easily or at all when we are faced with high levels of novelty. Thinking and re-thinking the problem frame, knowing what to find, where to find it, and the skills to integrate relevant knowledge together is something that is not captured in the knowledge metric. Yet, it is those skills that will lead innovation. Knowledge translation professionals know this and so do knowledge brokers.
Are we designing our educational programming to advance on the kind of design issues of problem framing, finding and solving that our world is facing? Or are we simply taking content that can be obtained through books, the Internet and other materials, repackaging it and creating expensive warehouses of information that take learners out of the world and out of context in the process?
I don’t suggest that universities and continuing education programs stop delivering content, but if knowledge is the metric by which they are judging their success then it behooves educational administrators and funders to justify why they can do it better than other tools. What made sense when content was a rare commodity makes little today when it is overflowing in abundance for little or no cost. Universities and post-graduate training programs have an opportunity to re-imagine education and have the tools to do it in a way that makes learning more powerful and relevant for the 21st century should they choose to change their metrics of success.
Designing education
How might we take the enormous talent trust that exists among university faculty (and their students) who co-locate (physically, virtually or in some combination) in a school and develop the skills to not only address problems of today, but prepare everyone for possible challenges in the future?
How might we integrate what we know, identify the knowledge we need, and create systems to take advantage of the talent and creativity of individuals to make universities, colleges, and post-professional training venues for innovation and inspiration rather than just content delivery vehicles?
What kind of metrics do we need to evaluate this kind of education should we choose to develop it?
These are questions whose answers might yield more learning than those focused on what knowledge students have when they graduate.
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Image source: Shutterstock.
The Job Market Metric In Education
Posted: December 30, 2012 Filed under: design thinking, education & learning, evaluation, innovation | Tags: complex systems, complexity, contemplative inquiry, continuing medical education, design thinking, developmental evaluation, disruption, education, educational design, evaluation, foresight, jobs, journalism, learning, learning organization, mindfulness, path dependence, professional education, resilience, teaching, university 2 Comments »
Post-secondary and continuing education is continuing to be rationalized in ways that are transforming the very foundation of the enterprise. Funding is a major driver of change in this field: how much is available, when it flows, where it comes from, what is funded, and who gets the funding are questions on the minds of those running the academy.
At the centre of the focus of this funding issue is the job market. Training qualified professionals for the job market in various forms has been one of the roles a university has played for more than a century. Now that role has become central.
Let’s consider what that means and what it could do in shaping the various possible futures of the university. This second in a series looking at the post-secondary and continuing education focuses on the metrics of jobs.
“What are all these people going do?”
The employability of graduates is now the holy grail of education industry statistics. Earlier this year I was sitting on the stage at an academic convocation with a senior colleague staring out at a sea of soon-to-be-graduates when he leaned over and asked the question quoted above. Staring at a sea of masters and doctoral graduates numbered in the hundreds and knowing that this ceremony was held twice per year, the question stuck and remains without an answer.
Maybe there were enough jobs for that cohort, but this process gets repeated twice each year at universities around the world and each year that I’ve been a professor those numbers (of graduates) seem to go up. Some of our programs in the health sciences are admitting three times the number of students than they were just ten years ago. There is much demand for education (as judged by departmental applications), but are there jobs demanding this kind of education in its current form?
Yes, the Baby Boom is moving into an age of retirement and increasing needs for health services, but do we need to graduate 80+ Physical or Occupational Therapists to meet this need this year? Do we need a few dozen more epidemiologists or health promotion specialists to add to the pool? How about psychologists or social workers: how many of those do we need? The answer from my colleagues in these fields is: We don’t know.
Chasing the Wind
Jobs are a red herring. It’s one thing to have a job, but is it the job that you trained for? (And is having that job even a reasonable goal?) Being employed is not the same as building a career. What if you were trained perfectly for a job that no longer existed? Imagine a Blacksmith in the 20th century or a Bloodletter. These questions are not asked, nor is much asked about quality of education relative to the pressures of recruitment, cost-cutting and educational rationalization. Most of us don’t know what quality education is in real terms because we are measuring it (if we are measuring anything at all besides jobs) by standards set for the jobs of the past, not the future (or even the present?).
“Skate where the puck is going, not where it’s been.” – Wayne Gretzky
Jobs are living things and very few in 2013 will resemble what they did even 10 years ago. The citizens of the developing world are entering this rapidly changing job market ready for change (See also McKinsey Global Institute report on future of work in advanced economies) because they don’t have the old ways to rely on. They are primed for change and if professional education is to meet the needs of a changing world, it needs to change too. It means getting serious about learning.
If education is rationalizing itself to focus more on jobs, then it also needs to get serious about clarifying what jobs mean, defining what ‘success’ looks like for a graduate, and whether those jobs are designed for where the proverbial puck is now or for where it is going.
Disruptive Learning / Disturbed Education
“The Only Thing That Is Constant Is Change -” ― Heraclitus
I’ve pointed out that learners have an uneasy relationship with learning principally because it means disrupting things. This is a topic I’ll be covering in greater depth in a future post, but if one considers how our social, economic, and environmental systems are changing it is not unreasonable to call this the age of disruption .
Change in complex systems is often logarithmic, not linear. It may be massively punctuated like a Lévy Flight or it could be closer to a random walk. In environments with a change coefficient that is large the level of attention must be more fine-grained than 5-year reviews. It requires developmental evaluation methods and learning organizations, not just conventional approaches to generating and assessing feedback. It requires mindful attention and contemplative inquiry to guide a regular reflective practice if one is to pay attention to the subtleties in change that could have enormous impact.
For example, if journalists and news media waited every five years to assess the state of their profession, they would have missed out on Twitter and come late to blogging, two of their (now) powerful sources of competition and tools of the trade. Some have waited, which is why they are no longer around. Metrics for journalism education today might consider the amount of exposure and proficiency in social media use, digital photography, use of handheld tools for communication, and real-time reporting skills. Metrics of the past might focus on newspapers and radio broadcasting. Which mindset, skillset and toolset would you rather be trained in today?
Questions for educators, learners (and evaluators):
Whether health sciences, journalism, human services or any field, what might some questions be that can help determine the role of job training in professional education? Here are five starters:
1. What is the state of your profession right now and are you training people for existing in this state? Are you preparing people for the next evolution?
2. Where is your field of practice going? What are the possible futures for your profession in the next 5, 10, and 20 years? Will it still exist? Are you a blacksmith looking for more horses in the automobile age or Steve Jobs waiting to attract people to a new graphical user interface?
3. Is your mindset, skillset or toolset in need of re-consideration? Does it still do the job you’ve hired it to do?
4. What do people need that your skills can help with? What unfilled needs and expectations are there in the world that your mindset, skillset and toolset could solve?
5. What would happen if your field of practice disappeared? How else could you apply what you know to making the contribution you wish to make and earn a living? What other skills, tools and ways of thinking would you need to adapt?
Design thinking can greatly help shape the way that one conceives of a problem, works through possible options, and develops prototypes to address the needs of the present and the future. Foresight methods help lay additional context for design and systems thinking by providing ways to anticipate possible futures for any given field. Lastly, knowing what the state of things are now and how they got to where they are now can help determine the path dependencies that education may have fallen into.
We can’t change what we don’t see and better foresight, hindsight and present sight is critical to better ensuring that education outcomes are not imagined, but based on something that can actually improve learning.
Nature Nurtures Creativity After Four Days of Hiking
Posted: December 14, 2012 Filed under: innovation, psychology | Tags: creativity, Keith Sawyer, Outward Bound, wilderness Comments Off
I just read about a fascinating new study* that examined 56 people who went on an Outward Bound wilderness expedition. No electronic devices were allowed on the trips. Of the 56 people, 24 took a creativity test before they left for the trip. The other 32 took the test out in the wilderness, on the fourth day of the trip...after four days disconnected from the grid.
Reflecting on Gratitude and Going Beyond Thanksgiving
Posted: November 22, 2012 Filed under: education & learning, health promotion, innovation, psychology | Tags: gratitude, inspiration, learning, mindfulness, positive psychology, research, Robert Emmons, teaching, Thanksgiving Comments Off
Today is the day that Americans come together to celebrate Thanksgiving, a day dedicated to gratitude (in Canada, we celebrate Thanksgiving in October, to traditionally align with the harvest).
What a wonderful holiday concept: spending time focused on gratitude for what one has.
There are many good reasons for giving thanks. Psychologist Robert Emmons and other researchers working within the emergent field of positive psychology have looked intently at the psychological effects of gratitude and found it positively correlates with well-being and goal-attainment. For example, Emmons and McCullogh (2003) conducted a series of experiments comparing those with a grateful outlook to those who did not and found those who expressed gratitude more often reported higher levels of subjective wellbeing in some of those studies. (For those interested, Emmons’ 2007 book Thanks! is an accessible primer on the research on gratitude).
Giving thanks is a way of introducing a small disruption in the everyday and inspiring reflection on the present moment. Gratitude is a part of many meditiation and yoga practices, as well as mindfulness practice (PDF – example).
So in solidarity with my American friends who are giving thanks on this day and all of us who take time to express gratitude on any day, I offer a departure from the usual post and share some things I am thankful for (in no particular order):
- To Artists. Those who share their creative outputs with the world openly and encourage us to see and think differently. Artistry can be aesthetic, part of performance and innovation (says Hilary Austen), and something that Seth Godin believes we all are, when we listen to what is important. Its the writers, performers, teachers, journalists, and engaged audiences that are all part of the creative tapestry around us when they choose to make their art available.
- To those scientists and researchers who spur exploration and share what they learn widely and openly and make the world better through making their work accessible, including supporting open access of scientific knowledge. The world has too many hoarders. We are all standing on the shoulders of giants because they bent down to help us up.
- To everyone who is willing to fail, get up again, improve and work to succeed and tell others about their story so others can be inspired to fail and succeed in new ways.
- To teachers (and that doesn’t have to be the person at the front of the class). To those who take the time to help others to learn, really learn, and understand material. This could be trainers, classmates, or grandparents — anyone who cares that I learn something and tries to help myself and others toward that goal.
- To students of life. Those who are willing to be taught, to learn, to adapt and to innovate when necessary. This includes clinicians and scientists using the best evidence to make decisions and pointing out where it doesn’t exist (and taking action on filling the gaps). It’s people asking hard, but important questions — including those about their own closely held beliefs. It’s those who see learning as fun and seek to infect that sense of joy in their fellow knowledge travellers. It also includes all of those who work in knowledge translation and exchange to help the learning process along in professional and personal life.
- To the organizers, funders, sponsors and participants behind and in front of TED, Thinkr, the RSA, Google Zietgeist Minds and all the organizations and individuals out there sharing stories of success, creativity, and inspiring us all to think in new ways. It’s easy to take all this for granted so today, I am not.
- To every person that smiles freely and often (and at me!). Smiles are contagious (PDF – example)
- To everyone who takes the time to listen and seeks to understand . We all don’t agree, but if we try to truly understand each other by listening, cultivate empathy, and mindfully reflect on our impact on the world, those differences can be sources of learning and creativity than unproductive conflict, hatred and ignorance. Too much of that and in a world of the 140-character sound bite, it’s too easy to be seduced by quick outrage and self-supported misconceptions.
- To the individuals who work at inspiring others to be their best selves through compassion and creation. The diverse voices of people like Seth Godin, Jonathan Fields, Brene Brown, John Maeda, and Jon Kabat Zinn who all provide means of making sense of human life and inspiring a greater appreciation of what happens along its journey.
- To the Internet and every person and organization responsible for developing it, delivering it, and maintaining it and fighting for the rights, freedoms and responsibilities that come with having so much knowledge, information and entertainment at our fingertips. It’s easy to take this enormous treasure trove of knowledge and services for granted.
- To every administrator or department chair who marshalls power to change the structure of the workplace to make it more humane, by rewarding earnest effort while providing the space to slow time to pause and think, nurture the organization’s collective mental health, and allow everyone to genuinely learn and share their best with those they engage with. Work takes up a lot of our lifetime — imagine if it buoyed us and sustained us rather than trapped us?
- To every person who says, means and listens to the message that we are all enough. The rat race is for rats and the human race is intended for human beings, not human doings.
- To everyone who feeds us — from farm to market to fork to the earth. Most of us have little comprehension of where our food comes from, travels to, goes through, or ends up and if we did, we might act a little (or a lot) differently. We have the luxury of ignorance in North America, but should we? Spend time with a farmer and you’ll be amazed at what you don’t know about the very things that sustain us.
- To every blogger and Tweeter out there who takes the time to share their thoughts and promote positive, critical thinking about topics that inspire new thinking. Thanks to the amazing blogosphere and Twittersphere, I have made a lot of wonderful friends I’ve never met in person, but who inspire me every week.
Thanks to everyone out there making the world better. Today is the day I give thanks to all of you.
What are you grateful for?
Photo By Marjory Collins, photographer for Farm Security Administration. [Public domain], via Wikimedia Commons
Designing Spaces for Creativity
Posted: October 21, 2012 Filed under: art & design, innovation | Tags: architecture, creativity, design, Keith Sawyer Comments Off
I've just spent two stimulating days with a small group of architects, university professors, and creativity researchers, at a beautiful old lakeside estate called Marigold Lodge, in Western Michigan. Our goal: To collect everything we know about how to design spaces that maximize learning and foster creativity. With funding from the Sloan Foundation and from the legendary furniture company Herman Miller (which now owns Marigold Lodge), our task is to write a report that will advise university administrations and architecture firms, to guide how new university buildings are designed.
The Mindful Socially Innovative Organization
Posted: October 16, 2012 Filed under: complexity, emergence, evaluation, innovation, social systems, systems thinking | Tags: awareness, consciousness, contemplative inquiry, mindfulness, organizational development, organizational psychology 2 Comments »
Mindful Eye on the Organization
In complex systems there is a lot to pay attention to. Mindfulness and contemplative inquiry built into the organization can be a way to deal with complexity and help detect the weak signals that will make it thrive and be resilient in the face of challenges.
Most human-centred social ventures spend much of their time in the domain of complexity. What makes these complex is not the human part, but the social. As we interact with our myriad beliefs, attitudes, bases of knowledge, and perceptions we lay the foundation for complexity and the emergent properties than come from it. It’s why we are interesting as a species and why social organizing is such a challenge, particularly when we encourage free-flowing ideas and self-determination. Because of this complexity, we get exposed to a lot of information that gets poorly filtered or synthesized or missed altogether. Yet, it is in this flotsam and jetsam of information that keys to future problems and potential ‘solutions’ to present issues might lie. This is the power of weak signals. But how to we pay attention to these? And what does it matter?
The Strength of Weak Signals
A human social organization, which could mean a firm, a network, or a community — any collection of people that is organized by itself or other means — most likely generates complexity, sometimes often and sometimes occasionally. If we consider the Cynefin Framework, the domain of complexity is where emergent, novel practice is the dominant means of acting. In order to practice effectively within this space, one probes the environment, engages in sensemaking based on that information, and then responds appropriately. Viewed from another perspective, this could easily be used to describe mindfulness practice.
Mindfulness is both a psychological state and activity and a psychospiritual practice. I am using this in the psychological sense, even if one could apply the psychospiritual lens at the same time if they wished. Bishop and colleagues (2004) proposed a two-component definition of mindfulness:
The first component involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one’s experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance (p.232)
Weak signals are activities that when observed across conditions reveal patterns that provide beneficial (useful) coherence that has meaningful potential impact on events of significance, yet yield little useful information when observed in discrete events. In other words, these are little things that get spotted in different settings, contexts and times that when linked together produce a pattern that could have meaningful consequences in different futures. By themselves, such signals are relatively benign, but together they reveal something potentially larger.
One reason weak signals get missed is the premature labelling of information as ‘good’ and the constrained definition of what is ‘useful’ based on the current context. Mindfulness practice allows you to transcend the values and judgements imposed on data or information presented in front of you to see it more objectively.
Mindfulness involves quieting the mind and focusing on the present moment, not the past or the possible implications for the future, just the here and now. It is not ahistorical, however. Our past experience, knowledge and wisdom all come to bear on the mindful experience, yet they do not guide that experience.
Experience provides a frame of reference to consider new information, not judge it or apply value to it. It is what allows you to see patterns and derive meaning and sense from what is out there.
Building Mindful Organizations
A review of the research and scholarship on mindfulness finds a nearly exclusive focus on the individual. While there is much literature on the means of using mindfulness and contemplative inquiry as means of being active in the world, this is done largely through mechanisms of individuals coming together as groups, rather than the organizations they form as the focus of analysis.
There is an exception. Social psychologists Weick and Sutcliffe (2007, summarized here and here – PDF) wrote about resiliency in the face of uncertainty using a mindfulness lens to understand how organizations make better sense of what they do and experience in their operations. In their manuscript, Organizing for High Reliability: Processes of Collective Mindfulness (PDF), they lay down a theory for the mindful organization and how it increases the reliability of sensemaking processes when applied to complex informational environments.
They describe the conditions that precipitate mindfulness in organizations this way (p.38):
A state of mindfulness appears to be created by at least five processes that we have induced from accounts of effective practice in HROs (High Reliability Organizations) and from accident investigations:
1. Preoccupation with failure
2. Reluctance to simplify interpretations
3. Sensitivity to operations
4. Commitment to resilience
5. Underspecification of structures
It is notable that the aim here is not to reduce complexity (or impose simplicity), nor is it to focus on ‘positivity’, rather it is focused on events that help contribute to moving in particular direction. In that regard, this is not neutral, but it is not active either. It enables organizations to see patterns, focus on structures and information that encourages resilience to change, and contemplates what that information means (sensemaking) in context. Doing so provides useful information for decision making and taking action, but doesn’t frame information in those terms a priori.
Seeing Beyond Events
At issue is the development of consciousness of what is going on within your organization moment-to-moment, rather than punctuated by events. Events are the emergent properties of underlying patterns of activity. When we spend time attending to events without understanding the conditions that led to those events, we are doing the equivalent of changing the dressing on a wound in the absence of preventing or understanding its cause.
A mindful organization, like the image of the Buddha above, can emphasize the eye, but not at the expense of the rest of the picture. It is attuned to both simultaneously, noting events (e.g., like the square highlighted eye above), but that it is only through the underlying pattern beneath it that the highlighted context makes sense (the rest of the pictured squares). Yet, the only way the organization can learn that the yellow square is different or to ascertain its meaningful significance is through a sense of the whole, not just the part and that is social.
The Curious Organization
Mindfulness and its wider-focused counterpart Contemplative Inquiry both have a root in attending to the present moment, but also in curiosity about the things that is brought to the mind’s attention. It’s not just about seeing, but inquiring. What makes it distinct is that it does not impose judgement on what is perceived not seeking to change it while in that state of mindful awareness. This judgement and imposition of value on to what is going on is where organizations can get trapped.
In complex systems, the meaning of information may change rapidly and is likely uncertainty. The wisdom of experience, shared among others contemplating the same information without judgement, allows for a sensemaking process to unfold that does not impose limitations, yet also keeps a focus on what is going on moment-to-moment. Gathering this data, moment-to-moment, is what developmental evaluation with its emphasis on real-time data collection seeks to do and can serve as a valuable tool for organizing data to allow for a mindful contemplative inquiry into it that will illuminate weak signals.
Creating an organizational culture where open sharing, questioning, experimentation, and attention to the adjacent possibles that come from the data and experiences from operations is the foundation for a mindful organization. This means slowing down, valuing non-doing instead of the constant push to action, cultivating contemplative inquiry and reflection, while also being clear about the directions that matter. Thus, strategy in this case is not divorced from mindfulness, rather it gently frames a directionality of effort. In doing so, it creates possibilities for innovation, attention to quality, and a mechanism for building resiliency within organizations and those working with them and within them.
In creating these mindful systems we move closer to making sense of complexity and better prepare ourselves for social innovation.
Image Saddha by gnosis1211 from Deviant Art used under Creative Commons Licence
The Business Model of Social Media: Who Owns the Presses?
Posted: October 1, 2012 Filed under: business, innovation, social media | Tags: advertising, business model, capitalism, Facebook, innovation, Karl Marx, marketing, markets, social media, socialism, Twitter Comments Off
What power do citizens of these communities have?
When Karl Marx asked: Who owns the presses? he was referring to the ability of wealthy private individuals to control the means of knowledge production and dissemination and thus, influence society as capital owners, not as citizens. The unequal voice of the bourgeoisie over the proletariat was what gave them undue social power. But what happens when the owners and generators of wealth (knowledge, information) shift and the result is a community that relies on the medium of production without the control of it?
Owning the presses
Social media presents something quite unusual when it comes to the traditional views of ownership and wealth creation. It also upends the traditional perspectives of journalism and marketing, where the content is co-created and edited, emergent and distributed through a mesh of networks, uncontrolled. It is a new space for which traditional models of ownership, rights, responsibilities, and governance are all joined up in something that is similar enough to have familiarity, yet different enough to be alien at the same time. It’s not a wicked problem, but it does contain some problem wickedness.
With social media, the messages are that of the users, arguably creating the most democratic (or at least free) environments for communication. Although hosts such as Facebook, Google, and Twitter have occasionally squelched certain users’ voices for reasons of legality, politics or questionable fit with their “community values”, most of what happens on these platforms is up to its users. That is what makes social media as powerful as it is. Social media is nothing without its users’ content.
My definition of social media is:
Social media is any networked electronic media that derives its principal value from user participation
Yet, this does not render Marx’s question about press ownership irrelevant when updated to today, rather it changes the answer.
It’s paradoxical in that the very market forces of competition that can seed innovation and the mechanisms provided by venture capital and capitalist investment is the reason we have the social media platforms we do, yet the manner in which it is governed is much like that of socialism at best, communism at worst. Investment of private financial capital has helped raise the profile and capability of social media companies to leverage social capital. It is why open source, community-owned or shared tools like Diaspora* or Identi.ca have come nowhere close to replacing Facebook and Twitter respectively. The free market creates the tools, yet it is not the free market that sustains the community created by those tools, nor can it fully account for how to grow the capability of those tools.
It is also because these companies operate within markets rather than as national projects, that they can disseminate globally with relative ease. Thanks to this dissemination, citizens living in oppressive media environments can reach out and connect with those outside of such spaces allowing things like the Arab Spring and increased freedoms in Myanmar to emerge with greater outside support than had these tools not been available.
The cost of free
While social media has done much to enhance democracy movements, human rights watches, and access to information, there is a slight problem . The most widespread social networks are all free to use, which means that they need to generate revenue from sources other than user fees, which usually means advertising. And advertising means clutter, clutter leads to confusion and that turns people away (witness the loss of viewership from TV at a time when perhaps the highest quality productions are being aired ). But unlike television, there is a social cost to free with social media. Human capital in the order of millions of hours of time and a similar amount in dollars is spent creating the very content that allows social media to survive and thrive.
With the relaunching of MySpace we are reminded of how far social media platforms can go up and down. Just a few years ago, MySpace was the darling of social media with millions of users and lots of press. Hundreds of thousands of hours of individuals’ time went into making and maintaining MySpace pages, resources that are now, ironically (given Justin Timberlake’s involvement in the platform) Dead and Gone.
It can be argued that similar deep investments of time in building and maintaining Facebook pages, timelines, and Tweet projects exist. What if these go away?
Or what if they become unusable? Anyone who has spent time on Facebook (which is a few hundred million people strong) has seen the steady creep of unsolicited content emerging in their news feed. This includes notices about pages you may like, game invitations, increased posts from companies or services you chose to “like” and more. Facebook needs revenue to justify its initial valuation and a big focus now is on the mobile experience where an increasing amount of its traffic is now generated from. The problem is that mobile ads are even more distracting than those on other systems because of the smaller screen size and different interface. It is difficult enough to surf the content on a laptop, let alone a handheld device. If you think your desktop version of Facebook is cluttered, imagine what the mobile version of that could look like?
Facebook is rapidly becoming a ‘necessary evil’ for me and others like me. I have few other means of communicating with certain people other than Facebook. This should be a good thing for Mark Zuckerberg and company, right? Maybe not. For some, there is little joy in using Facebook anymore as it gets swarmed with messages and the endless quest for likes and attention from those who are not even your friends. The result is that more people in my circles are reducing their use of Facebook or breaking from it altogether largely because it holds far less esteem than other brands such as Apple or Google. There is a brand cost to Facebook’s decisions.
The brand is not the only thing that costs; there are hidden social costs as well. Among those vying for likes and attention are charities, non-profit, health and social service groups who have opted to spend precious resources on building up profiles on social media, curating content and relying on platforms like Facebook and Twitter for building their brand, relationships or using it as part of their internal and external communications. They are doing this because that is where the most people are and they feel the pressure to go where those numbers are, even if they are fickle (see MySpace).
Should we care?
The business model of social
One answer is: it doesn’t matter. Social media companies are businesses and it is their prerogative to make money. However, there are real social costs associated with this drive for profit in the social mediasphere. If people start fleeing Facebook or can’t manage Twitter because of restrictions or choices made based on that company’s market optimization plan (e.g., advertising, relaxed privacy etc..), then the social capital created through those services decreases, requiring the increase in new social and financial capital to support something else. For those that sought to dive into social media this means retraining staff, retooling media platforms, redesigning messages, and in some cases rebranding entirely to suit the next big thing. This costs real money.
While it is bad enough that individuals lose their social investment, this has bigger implications for health care and protection providers, charitable organizations, social service groups and alike others who all rely partly on social media for communications and relationship development. A recent paper in the Journal of Medical Internet Research looked at the factors influencing social media adoption among physicians. In that study 58% of physicians surveyed said that social media enabled them to look after patients more effectively, and 60% said it improved the quality of the patient encounter. It has taken a long time to get health care professionals on board, but the stability and relative ubiquity of platforms like YouTube, Facebook, and Twitter have made investment in social media a safer bet.
Sure, media changes and evolves, but what we are seeing with social media today (particularly the largest players) is something never seen before. There is a global scale that has fundamentally altered the communications landscape. Facebook and Twitter are not just tools, they are platforms not unlike email and that makes them different.
Virtually every successful social media platform has started out as free, uncluttered and focused on building a user base. And every one of those faces the question: what is the business model? Advertising will only go so far and the efforts to engage in ‘promoted’ anything (tweets, videos etc..) can run the risk of turning a medium based on authenticity into something much less so.
What alternatives? More questions.
We face a situation where the very entrepreneurial spirit and funding through capitalism has produced a somewhat self-governed media system run by workers who produce the knowledge, which is like socialism. All ‘ism’s’ aside for the moment, there is benefit to having conversations about the ownership and control of the social media presses in an era where the media is more than just the messages and now integral to many of the operations and livelihoods of organizations and individuals who do not work for social media. There is a disjuncture between ownership, the means of production, the workers, and the product that doesn’t fit any previous model posed by Marx, Adam Smith or anyone.
Unlike the coal miner and their families that lose when the mine shuts down, there is some foresight available to them knowing that they are in a particular industry. For social media users, their communications are just part of their life not a part of their industry.Put another way, consider email. Right now, if your email service is failing you or fails as a business you have the ability to get a new one without disrupting your experience of and access to the medium itself. Gmail, Yahoo! or any corporate mailserver will generally produce the same thing even if the interface and management of that experience varies. We don’t have real alternative to Facebook or Twitter right now. When over a billion people use these services it is time to ask: should we? Can we? Is that a good idea?
Is social media getting to be an ‘essential service’?
Does social media belong in the commons? If so, will that inhibit the necessary innovation sparks that led to the development of the current tools in the first place? Who would manage it?
If these went away, what would replace it? Or will we see a bubble and lose so much trust in a collapse that these tools fail to regain interest?
Should we pay for social media in exchange for better usability and less clutter? Will anyone who had it for free do this? And who is left out of those social worlds if they can’t pay? Right now social media’s great asset is that anyone can join and join to anyone else who allows it. Nationalism, politics, financial means, sex, race, gender all don’t matter in terms of fundamental access, but that could change.
Would my Twittersphere be less if only people like me were on it? What kinds of conversations wouldn’t take place?
If we all provide the content and labour, should we have a say in who owns (or runs) the presses in a world of social media?
What would Marx and Adam Smith think of all of this? Maybe if they were here today they could Tweet a debate on it.
