Monthly Archives: March 2011
Harvard Business Review is running a multi-part series looking for answers to the question: Can Technology Re-invent education? While there are lots of answers, perhaps more importantly is considering whether that is the right question in the first place.
Technology captures our collective attention like few other social and technical artefacts. Whether it is robots, flying cars, jet packs, cold fusion, or sub-orbital rockets, we love our technology and expect that it will solve all kinds of social problems. Except, most often, these predictions of utopia are far off the mark.
Computers were supposed to make our lives easier, yet I don’t know many colleagues that find their lives easier — rather the opposite has come true: we live much more complicated lives, which are impacting our hearts and our health (even for public health professionals). Our faster computers do allow us to do more with less energy, yet somehow we manage to fill the time saved with more work (PDF), leading to an overall increase in work rather than a decrease.
So it is not a surprise that Harvard Business Review is asking the question about whether technology will reinvent education. If we could just use education the “right way” and to its fullest potential, imagine what we could do? Imagine how much time we could save? What kind of productivity gains we could achieve? It would be amazing.
It would be amazing, because it is unlikely that we are going to see much in the way of improved learning because of technology. We might be better at gathering information, distributing it, sharing it, and reaching people in new ways, but I am skeptical that we’ll see any real “reinvention” of education through technology. Do things different? Absolutely. Better? That’s not the right question.
To be fair, the author of the lead post in the Advanced Leadership Initiative for HBR, Robin Willner, doesn’t believe in a techo-utopia and, remarking on the success of Watson the computer against human Jeopardy champions, states:
It’s time to think systemically about the long standing barriers to school improvement and education reform.
Technology alone is never the answer — that’s the main lesson from Watson’s Jeopardy win. Technology supporting innovative teachers and school leaders will be the solution for our students.
Yet, the title of the series belies at least some faint hope that the problem of learning and educating can be solved with technology. If we just implemented the right tools we could solve the problem. Willner is writing on the issue of school improvement, not education and it is an important distinction.
As I’ve discussed before, the current model for schools do little to support learning relative to the apprenticeship-style models that they replaced. Most of this is due to a conflation between information provision and education. Computers and technology are excellent at providing information, and even displaying it in ways that enable learners to interact with it. Technology does not provide great opportunities to take content into social contexts where we apply lessons with real people or physical artefacts that are not machines. The complexities of the encounters — having conversations for example — are not easily mimicked by computers and thus, provide only weak substitutes. In short: technology is not about eduction, just better information delivery.
Simulations, one of the areas where technology offers much promise for learning, are often designed for particular purposes, thus enhancing specific skills, but less about general ones. But this is only one narrow use of technology for education, although certainly promising.
But all of this gets us away from the question itself, which focuses on technology’s ability to reinvent education. Education is a human endeavour and a social one at that. Technology may aid in our strategy development, implementation of certain tactics for teaching, but it will not provide the grist for improving the social component of learning. Just as Facebook friends are (mostly) extensions of the friendships we create in everyday life without technology, so is learning. Technology is an aid, not the purpose and thus, focusing on the aids as the means for reinvention sidesteps whether we’re educating effectively in the first place and risks us doing what Russell Ackoff calls doing the wrongs righter. Without questioning the very system in which that technology is deployed, we will continue to do just that and this is where asking new, bigger questions comes into play.
Design uses a language that at once seems inviting and human-centred while at the same time rather alien when considered in the realm of practice.
One of the great ironies of working in a field that is about human wellbeing and survival — public health — is how dehumanized the language we used is. Medicine is worse. It seems that the closer we get to those areas of human existence that deal with our vulnerability and potential the further our language gets from reflecting our humanity. That is one of the things I find about design that is so refreshing.
Designers use a language that speaks to the human condition much more than health sciences does, with terms like participation, empathy, listening, storytelling and understanding figuring prominently in many design texts.
While this design language refreshing, there is a part of the health sciences culture (particularly that of health promotion) that is appropriate to bring to bear to this issue and that is critical, reflexive, practice. It is here that I find a disconnect between the language used in design and the meaning of the words in a real sense.
Take empathy for example. The Oxford English Dictionary refers defines empathy as:
empathy |ˈempəθē| noun . the ability to understand and share the feelings of another.
Design giant IDEO refers to the concept of building empathy heavily in their work and has figured the concept prominently in its new plans for a non-profit start-up. A look throughout the literature on design and you’ll find this concept peak through the text and presentations and noted as something that defines good design practice.
Looking at the above definition of the word it is worth asking: can we really build empathy? What does building something imply? And who is the builder in this model?
Perhaps the definition here is problematic. Taking a look at Wikipedia, one finds a slightly more expanded definition:
Empathy is the capacity to recognize and, to some extent, share feelings (such as sadness or happiness) that are being experienced by another semi-sentient being. Someone may need to have a certain amount of empathy before they are able to feel compassion.
It’s interesting that design rarely uses the concept of compassion, just empathy; just building empathy. Or as the above image suggests, create empathy.
Why does all this matter?
The use of the term is important if we seek to understand the underlying motivation for design and the values that guide it. Building something implies a builder. A builder implies active construction of something, yet the definitions above refer to ability, something that might not be so amenable to building per se. It also is suggestive of a level of control and manipulation to create something from nothing. When building empathy, how that being constructed and for what purpose and who is asking the question and who is having their empathy built? These are concepts that are not always problematized or questions asked, but probably ought to be.
What can be built or designed are situations that allow people to tap into their empathic skills and apply them. Drawing from research in cognitive psychology, opportunities to apprentice and learn with others and copying others may be the way to engender empathic responses. It is certainly the case with infants (PDF):
Imitative experience with other people serves as a “discovery mechanism” for social cognition, engendering interpersonal understanding that outstrips the innate givens and leads to empathy, perspective-taking, and theory of mind. (Meltzoff, 2002)
This imitative experience comes through engagement with material, not participation. Participation is another odd concept in design, health promotion, and community development that seems to be easy to use, but harder to define, and problematic in how it gets used. What does it mean to participate in something? Is it, as Woody Allen suggests, just showing up? Or is it true engagement with the material and others in a manner that creates these discovery mechanisms as Meltzoff refers to?
What this line of thinking gets us to is the crux of what makes design and health promotion different, but necessary complements for working in health. Without the critical questioning of the terms and the application of values in a particular way, you can get a Wizard of Oz like problem: one has all heart, but no brain, while the other has a brain without a heart, and courage is needed to bring the two together with the optimism that it can be done.
Empathy and compassion involve using your heart. Critical inquiry about empathy means using your brain to see the concept more clearly in terms of its purpose. Having the courage to put these into practice in a professional realm and the optimistic hope that we can do this to make things better for everyone is not just a fantasy, but a possibility. It is at the crux of social innovation, but also at the core of good, responsible, integral and authentic practice. Say what we mean, mean what we say.
In doing so, we can make these real, important concepts more meaningful in a real sense, not in some marketing, feel-good speak that we have now. By being much more authentic, we’ll also help build the credibility of these methods and ideas beyond design and beyond health.
Today marks the 100th anniversary of International Women’s Day prompting some reflection on how we design for sex and gender in a world that often fails to consider either seriously enough.
Sex is important and it deserves attention in designing for health. Today the global community recognizes one half of the world’s population, their challenges, struggles and successes and I can think of fewer causes more worthy of such attention. Although sex is biological and brings its own issues with health, gender has social overlays incorporating role and identity that create more complex determinants of health, that require attention when designing programs and policies.
This attention to sex, gender and health requires problematizing the issue in the first place and recognizing that one-size-fits all approaches to social planning and policy do little to address the complexity of how these social determinants manifest themselves and interrelate. Gender is one determinant that is highly knotted up with other health issues such as economic security and employment (PDF), safety, and education. It’s complexity and pervasiveness demand that we consider this as something worthy of attention in our design and health promotion work if we wish to create a more equitable, healthy society.
Designing for health requires that we pay attention to these issues and consider them deeply in all of our work. Sex issues manifest themselves in ways that are unacknowledged, unconscious, or may be at odds with our intentions for promoting better health. It is rare that I’ve seen designers speak of sex and gender in discussing their work. And while health promoters bring sex and gender issues into prominence in their work, yet do not explicitly refer to design principles in such discussion, missing an opportunity to more intentionally shape their actions.
Design is taking some steps to make this a bigger priority. Yesterday’s announcement that global design leader IDEO was creating a non-profit arm that would focus on developmental issues, many of which are related to women’s needs, is a place to put hope for design. Health promotion’s foray into design issues has been on the built environment and on promoting equitable policies for access to health care, which is itself a start.
Bringing both of these fields closer together has the potential to do women and everyone better by considering the locations — social and physical — in which sex influences health and wellbeing and consciously designing situations that improve it. Doing so also means acknowledging where both design and health promotion knowledge come from, ensuring gender equity not only in society, but specifically within the fields of health promotion and design. Can you think of many “rock star” designers that are women? Those numbers are few. And while women are well-represented in the field of health promotion, the key texts and theories largely are male-authored. How this translates into equitable policies and practices for both genders is unclear, but the absence of discussion of these issues in much of the design and health discourse is less so.
While ensuring better design for health equity and promotion it is important to also add health equity and promotion to design through an empowered woman-friendly environment for learning and practice in these two areas.
So as you celebrate this International Women’s Day, consider ways to make sex and gender more conscious in your work and how we might design for both at a foundational level and not just as a means of ameliorating problems that manifest from poor design.
If everything humans create is designed then bringing design into the conversation about human health is imperative. It is a wonder that the world of health and that of design seem so far apart.
Seth Godin, the plain spoken entrepreneur and source of much personal inspiration, released a new book this week. It’s a non-traditional format being offered through Amazon and designed more for small-bursts of reading, linking and digital consumption than a traditional book. In Poke the Box and the accompanying (free) workbook, Godin demonstrates as he has many times before the power of generosity and knowing your audience — building relationships with them – as a key to success in turbulent times.
I mention him because his key message is that the world is changing fast and we have to adapt, change our business models, take risks, and do things different (and consciously) lest we have change thrust upon us. Seth’s message is: design your future or have it done for you.
Our health systems are in this state right now. I use systems in plural because the most common thing that people think of when I say that I work on issues of health is the health care system. I work in health promotion — that branch of public health that seeks to keep people healthy, prevent illness, and design ways to help everyone achieve their best. I use design here consciously, because much of what health promotion does is seek to shape the conditions in which health is created, maintained or compromised – even if that word isn’t used explicitly. Many of these are what are called the social determinants of health. These include one’s level of education, race, relative income, employment opportunities, and access to health care, among others.
Yet, design is a foreign concept in public health. To many of my colleagues, design is something related to product development or something to that extent. Even as public health begins to embrace art as a means of engaging people, design and design thinking remain somewhat unknown. This is in spite of the fact that much of what public health does is design-oriented; it is the conscious shaping of settings, conditions and human activity to promote health and protect people from harm.
I’ve often said that my course on health behaviour change is about training public health professionals on ways to overcome bad (unhealthy) design in our communities, policies, and programs.
What I have been seeking to do is introduce the concept of design to a wider audience within the health professions and have been pleased with the early uptake. Speaking with colleagues in a variety of public health areas, there seems to be a growing discontent with the way things are being done and how our programs and policies are being created. The idea of engaging the public is something not unfamiliar to public health, yet it is something done out of a sense of values and respect, and less about purposive design. What health promotion adds is its explicit statement of values, while design adds value through its conscious application of strategic planning to the creative process.
There is a growing movement of design for health, including: conferences devoted exclusively to this idea, the engagement of major design firms in the development of health care institutions, and international health programs focused on better design. While exciting, these initiatives focus on either health care or product support for health promotion and very little on the social development of healthful conditions.
While designers have taken to contribute to social determinants like education, there has been much less attention paid to the ways in which people learn, the sources of that knowledge, who accesses education in the first place, and the literacies required to fully benefit from modern information production landscapes. This is the domain of health promotion. It is also where we can make the most impact.
Consider something like tobacco use, where more than 500 million people alive today are expected to die from it. From the cigarettes themselves to the ways in which they are used, sold, regulated and marketed are all designed solutions.
We are on the cusp of major food price increases and potential shortages on a global scale. How we address these problems in ways that don’t exacerbate the gap between the rich and poor or create further unintended consequences is important. Without consideration of the ways we design our markets, our policies and the opportunities for people to engage in the decision making process, the creation of the solutions, and the discussion about what not just how such interventions can instill health we are losing an opportunity to get the best of design into health.
At the same time, we need design to go beyond simple end-user participation into true engagement with the public on a level that goes beyond strategy and tactics and more towards values.
Complex problems like chronic disease, health inequity, access to health care, civic engagement, global migration, and food security are ones that require a diverse set of perspectives, abductive (design) thinking, systems perspectives and ways to bring them all together. Design is a way to do that. Health promotion, rather than health care is the focus that will get us from treating problems to developing solutions.
One of the principal challenges for program evaluators and researchers is overcoming design limitations imposed by programs that fail to account for time and development. What might it look like if we took this path and what does it mean to engage in developmental design?
If you are like me, climate change scares you. I live in Canada, so in some ways (particularly these cold winter days), the thought of having the season be a little warmer has some appeal. But complex systems don’t work quite that way as there are intense costs projected with the privilege of having more days of the year wearing a light jacket or shorts than an overcoat or parka. What makes climate change an interesting example from the perspective of service programming, design and evaluation is that it provides a look at a real-world way to conceive of development over concepts like improvement and takes change in a whole new direction.
Humans are rather paradoxical creatures in that we are both attuned to moving forward (consider the design of the body: everything is oriented to one direction) and a perfect example of a developmental system.
A developmental system is one that evolves and adapts to changing inputs and transforms itself over time as more information is added to it (i.e., it is a complex adaptive system). From a programming standpoint, it means things don’t “get better” or “improve” per se — those are value judgements places by us — but rather, they build adaptive capacity.
Concepts like developmental evaluation, introduced and discussed in this space before, are ways to respond to this from an evaluation standpoint. DE provides a method of feedback generation that can enable programs to adapt and evolve by using the principles of complexity science with program evaluation methods to create a platform to detect and monitor emergent conditions and support innovation. And while there are some questions to ask of a program to see if it is suited to a developmental evaluation, we often forget to ask whether the program was designed to develop in the first place. What if we placed that at the centre of our discussion and started with development in mind?
My previous post looked at designing for time and space, but designing for development takes this one step further. Social media and technology-delivered program spaces provide an example of an environment where development is most obvious. Facebook was designed to expand and evolve, although one might challenge how well they’ve really developed. If you consider how effective, long-lasting software and services survive, they develop over time. In some cases, this development was designed into the process. Many open source software platforms are designed with this in mind — the Firefox browser and even Google’s Chrome are examples of tools that were built to be developed on. The originators designed the basic foundation with the idea that they would evolve into something else.
This doesn’t happen very often with human services. There are few programs that are designed with development in mind. When it is acknowledged that things will change, it is done so reluctantly. Program in this context refers to any organized effort to change behaviour and produce products for human need. In public health, the further irony is that programs aimed at changing behaviour — whether it is supporting healthy eating, smoking cessation, mental health promotion or others — are often designed with rigid controls built in. We develop manuals, create ‘best practice guidelines’, amass evidence and create toolkits that can be applied to any circumstance, without attention to context or adaptation.
Indeed, when you relax these controls, many get concerned.
Having conducted a few social media trainings and presentations over the years, the most consistent question I am asked by those in public health is: how do I control the message. The answer is: you don’t. This can lead to questions about evaluation, which gets into problems of research design and trusting the findings, because research typically applies rigid controls for quality assurance.
With social media, what can be done is to use a process of developmental design by engaging with the audience/client/public in an authentic manner with the explicit thought that the program that launches today will not be the one that people engage with in a year, or a month or sooner. Support this evolution through developmental evaluation (which I would include as a part of the developmental design process) and you’ll have a feedback mechanism that encourages shifts over time.
Developmental design takes into account the complexity of the environment in which a product or service takes place and enlists a continued process of engagement with stakeholders over time — a true relationship (which is why social media can serve as a good example). Rather than take a static design brief, a living design brief would be used and constantly revisited and tweaked over time. Paying attention to changes in the brief over time would also enable program developers to detect weak signals that could precede large shifts in behaviour and potentially support strategic foresight and planning. Developmental design, as I’ve conceived of here, is attuned to complexity and innovation in human systems and designs for it and adapts with it, rather than assuming the opposite.
Applying developmental design may get us past the inevitable square-peg-round-hole problem that many evaluators, program planners and policy makers find themselves in as they seek to get greater value from their programs and demand more return on their investments. Evaluation and research is sought as the means to do it and with programs designed for evolution from the start, perhaps we won’t be surprised when the metaphorical ice sheets start to fall apart (as seen above) and see it as a developmental step to a new reality.
** Photo Nature Antarctica 17 by Christian Revival Network used under Creative Commons Licence.