Category: knowledge translation

complexityeducation & learningevaluationinnovationknowledge translation

You Want It Darker?

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It is poetic irony on many levels that weeks after Leonard Cohen releases his album about the threat of death that he passes on, mere days after we saw the least poetic, most crass election campaign end in the United States with an equally dramatic outcome. This points to art, but also to the science of complexity and how we choose to approach this problem of understanding– and whether we do at all — will determine whether we choose to have things darker or not. 

A million candles burning for the love that never came
You want it darker
We kill the flame

Canadian-born and citizen-of-the-world poet, literary author, and songwriter Leonard Cohen passed away last night and the words above were part of his final musical contribution to the world. It is fitting that those words were penned at time not only when Cohen was ill and dying, but also as we’ve witnessed the flames of social progress, inclusion, and diversity fall ill.

Donald Trump is the president-elect of the United States, a fact that for many is not only unpalatable, but deeply troubling for what it represents. A Trump presidency and the social ills that have been linked to his campaign are just the latest sign that we are well into a strange, fear-ful, period of history within Western democracies. His was not a win for ideas, policy, but personality and as a vector for many other things that simply cannot be boiled down exclusively to racism, sexism, celebrity, or education — although all of those things played some part. It was about the complexity of it all and the ability for simplicity to serve as a (false) antidote.

No matter what side of the political spectrum you sit, it’s hard to envision someone less suited to the job of President of a diverse, powerful nation like the United States than Donald Trump using any standard measure of leadership, personality, experience, personal integrity or record of public conduct. Yet, he’s in and his election provides another signal that we are living in complex times and, like with Brexit, the polls got it very wrong.

We are seeing global trade shrink at a time when globalization is thought to be at its highest. We are witnessing high-profile acts of hatred, discrimination and abuse at at time when we have more means to be socially connected across contexts than ever before. We are lonely when the world and connection is at our fingertips.  It is a time of paradox and when we have so many means to cast light on the world, we seem to find new ways to kill the flame.

It is for this reason that those who deal with complexity and seek positive social change in the world need to take action lest things get darker.

Complexity just got real

The election of Donald Trump and the Brexit vote are two examples that should serve to wake-up anyone who seeks greater accounting of complexity in the making of social decisions.

This is not about voting for a Republican President or for citizens wanting greater control of Britain, it’s about understanding the premise of which those decisions were based on. The amount of cognitive dissonance required to assume that Donald Trump has the qualities befitting a leader of a country like the United States is truly astounding. And just like Brexit, the theories and models proposed post-event by the same people who predicted the opposite outcome pre-event will be just words, backed with too little understanding of complexity or why things actually happened.

Those who understand complexity know that these simplistic explanations are likely to be problematic. But that doesn’t make us better people, but it does mean we have certain responsibilities.

Complexity rhetoric vs science

For those who rely on complexity science as a means of understanding these kinds of events its now time to start matching the science to our rhetoric so we can back up the talk. In crude, but truth-speaking pop culture parlance: “This shit just got real“.

As complexity and systems thinking has gained attention in social science and policy studies we are seeing much more attention to the idea of complexity. Yet, the level of rhetoric on social complexity has overwhelmed any instances of evidence of how complexity actually is manifest, emergent, harnessed, or accounted for in practical means.

This isn’t to say that the tenets of complexity for understanding social systems aren’t true, but rather we don’t know that it’s true for sure and to what extent in what situations. I write this as a true-believer, but also as one who believes in science. Science is about challenging our beliefs and only if we cannot refute our theories through our best efforts can claim something is true. Thus, if we can’t show consistently how the principles of complexity are employed to make useful choices and inform the documentation of some of the outcomes related to our actions based on those choices, we are simply making fables not flourishing organizations, communities and societies.

Showing our work

Without something more than rhetoric to back our claims up we become no better than a politician claiming to make America great again because we’ve got great ideas and will be the greatest president ever because we have great ideas.

This is not about reverting to positivist science to understand the entire world, but about responsible practice in evaluation and research that allows us to document what we do and explore the consequences in context. Powered by complexity theory and the appropriate methods, we can do this. Yet, too often I hear reference to complexity theories in presentations, discussions and papers without any reference to how its been used in real terms (and not just extracted from some other realm of science like bee colonies, natural ecosystems and simulation models) to influence something of value beyond serving as an organizing framework.

Like little kids in math class: we need to show our work.

How did complexity manifest in practice in this case? What methods were used to systematically document the process? How does this fit / challenge the theories we know? These are questions that are what responsible scientists and evaluators ask of their subjects and its time to do this with complexity, regularly and often. No longer can we give it the relatively unchallenged ride it’s been given since first being introduced as a viable contributor to social theory about 20 years ago.

The reasons have to do with what happens when we stop trying to understand complex systems.

Evaluators and social sciences’ new moral imperative

As the US election was unfolding I became aware of some prescient, wise words that were uttered by former US Supreme Court Justice David Souter speaking at a town hall prior to the last election. His words were chilling to anyone paying attention to the world today. In the quote and interview (see link) he says on the matter of government and democracy:

What I worry about is that when problems are not addressed, people will not know who is responsible.

His words are not just about the United States or even politics alone. The further we get from understanding how our social, economic, political and environmental systems work the more we all become vulnerable to the kind of simplistic thinking that leads us to someone that embodies H.L. Mencken’s mis-paraphrased words*:

There is always an easy solution to every human problem — neat, plausible, and wrong

It is our duty as scientists and evaluators to show the world the work of the programs, policies and initiatives that are aimed at changing systems — no matter what that system is. We need to be better at telling the story of programs using data and communicating what we learn to the world. It’s our role to show the work of others and to let others see our work in the process. By doing so we can make a contribution to helping address what Justice Souter meant about people not knowing who is responsible.

And like Mencken’s message, our answer won’t be one that is all that neat, but we if we approach our work with the wisdom and knowledge of how systems work we can avoid Mencken’s trap and avoid presenting the complex as simple, but we will go further and illustrate what complexity means.

It is our moral duty to do this. For if not us, who?

People do understand complexity. Anyone with a child or garden knows that there is no ‘standard practice’ that applies to all kids or any years’ crop of vegetables all the time in all cases. It’s evident all around us. We have the tools, theories and models to help illuminate this in the world and a duty to test them and make this visible to help shed that light on how our increasingly complex world works. Without that we are at risk of demagogues and the darker forces of our nature taking hold.

We have the means for people to see light through the work of those who build programs, policies and communities to illuminate our world. In doing so we not only create the candles as Leonard Cohen speaks of, but the curiosity and love that keeps that flame burning. We can’t kill the flame.

And we could use some love right now.

Thanks Leonard for sharing your gifts with us. I hope your art inspires us to reflect on what world you left to better create a world we move to.

*Mencken’s original quote was: “Explanations exist; they have existed for all time; there is always a well-known solution to every human problem — neat, plausible, and wrong.” Alas, this doesn’t make as pithy, Powerpoint worthy comment. Despite the incorrectness of the paraphrased quote attributed to Mencken, it’s fair to say that in many organizations we see this as a true statement nonetheless.

Image Credit: Shutterstock, used under licence.

knowledge translationsocial systemssystems thinking

When More is Less: The Information Paradox

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There is a point at which information ceases to increase knowledge and understand and begins to undermine it, creating a paradox. When information on nearly anything is more abundant than ever the choices we make about how to engage it become more important than ever. 

The Information Age has been described as the period where industrial production was replaced by knowledge production as the key driver of social and economic benefit for society. Underpinning the thinking behind the information age (and the digital revolution that accompanies it) is that having more information, more access to it and improved tools to use it to solve problems will improve life for everyone. Presented with a choice to have access to more information or less people will almost always choose more.

More information leads to more options, which equals more choice and more choice is about freedom and that is seen as an inherent social good derived from the capitalist system, which further leads to better choices, more freedom and greater happiness overall. At least, this is what we’ve been led to believe and Barry Schwartz explains this quite eloquently in the opening of talk embedded later in this post.

This is the theory of change that underpins information theory as its played out in modern capitalist societies. It’s also the source of many of our modern paradoxes and problems.

Systems of influence: The case of the ePatient

I’ve stopped going to health-related hackathons and design jams altogether for the simple reason that one can almost always guarantee that one third or more of the solutions generated will be some form of app or information-focused tool. These well-meaning, creative tools are part of a consumer health movement that is all about putting information in the hands of patients with the idea that putting information in the hands of patients is the key to empowerment and better health outcomes, except they rarely lead to this promised land.

Few are better at explaining — and indeed living — this reality than Dave deBronkart or ‘e-Patient Dave’ who has been a tireless advocate for better information tools, access and engagement on health for patients. His Ted Talk captures the spirit of the movement nicely.

With all due respect to the positive sentiments around what the ePatient movement is about, it is based on a series of assumptions about health systems, patients and health itself in ways that don’t always hold. For certain patients, certain conditions, and certain contexts having more information delivered in the right format is indeed empowering and may be life saving as deBronkart’s story illustrates. But what’s often missing from these stories of success are the many layers of assumptions and conditions that underpin information-driven healthcare.

A few years ago I interviewed a patient who spoke about his experience with health care decision-making and information technology and his response was that having more information didn’t make his life much better, rather it made it even more complicated because with more access to more information he had more responsibility related to that information.

“I don’t know what to do with it all and there’s an assumption that once I know (this health information) I am in a position to do something. I don’t have the foggiest idea what to do, that’s why I am going to see (the health professionals) because that is what their job is for. They are the ones who are supposed to know what is to be done. It’s their world, not mine.”

This case is less about deferral to authority, but about resources (e.g., knowledge, skill, time, networks, etc..) and expectations around what comes with those resources. When you are unwell the last thing you want is to be told you have even more work to do.

The assumptions around personal health information and decision-making are that people have:

1) access to the data in the first place, 2) time, 3) information gathering tools, 4) knowledge synthesis tools, 5) skill and knowledge of how to sift, sort, synthesize and sense-make all the information obtained (because it may be in different formats, incomplete, or require conversions), 6) access to the people and other knowledge and skills required to appropriately sense-make the data, 7) the resources to act on whatever conclusions are drawn from that process, 8) a system that is able to respond to the actions that are needed and taken (and in a timely manner), 9) the personal willpower, energy, and resolve to persist through the various challenges and pushback from the system to resist the actions taken, 10) social support (because this is virtually impossible to do without any support at all) and 11) the motivation and interest in doing all of this in the first place.

Dave deBronkart and his peers are advocating for patient engagement on a broader level and that includes creating spaces for patients to have the choice as to what kind of information they use or not. This also means having choice to NOT have information. It’s not about technology pushing, but having a choice about what to access, when and how. That’s noble and often helpful to those who are used to not having much say in what happens, but that, too has problems of its own.

The paradox of choice

Barry Schwartz’s work (pdf) doing and synthesizing research on consumer decision-making puts truth to this lie that more choice is better. Choice options add value only to a certain point after which they degrade value and even subvert it altogether. The problem is that choice options are often ‘all or nothing’ and may be addictive if left unconstrained as we’ll see below.

Schwartz addresses the matter of decision-making in healthcare in the above video and points to the shifting of responsibility away from experts to everyone. Perhaps it is not surprising that we are seeing an incredible backlash against expert-driven knowledge and science in a way that we’ve not seen in over a hundred years. This is at a time when the public has access to more scientific data — the same data that scientists and other experts have — through open data and open access scientific publications to validate the claims by experts.

As discussed in a previous post, another feature of this wealth of information is that we are now living in what some call a post-truth political climate where almost anything goes. Speaking on the matter of science and climate change former Alaska Governor and Vice Presidential candidate Sarah Palin suggested that, when compared to Dr Bill Nye (the Science Guy and a rocket scientist — yes, a real rocket scientist ), she is as much of a scientist as he is.

Why have science when you can have opinion?

Distracted driving on the information superhighway

Recent data from Canada shows that year-over-year growth in smartphone use at 24% to over two thirds of the population with 85% reporting some form of mobile phone ownership. One of the key features of modern smartphones is the ‘always on’ nature of their tools and alert systems allowing you to bring maps, address books, a digital library, video and audio telephony, and the entire Internet in your pocket.

The distractions that come from the tools meant to deliver information are becoming crippling to some to the point of distancing us from our humanity itself. The title of a beautiful, sad piece in New York Magazine by Andrew Sullivan put this into perspective: I used to be a human being. (We will come back to this in a future post.)

But even if one still feels human using information technology, its a different experience of humanity than it once was. Behaviour change writer and coach Tony Schwartz (I’m not sure if he’s related to Barry), writing in the New York Times magazine, noted how his use of information technology was affecting his ability to, ironically, glean information from something simple as a book.

One evening early this summer, I opened a book and found myself reading the same paragraph over and over, a half dozen times before concluding that it was hopeless to continue. I simply couldn’t marshal the necessary focus.

He goes on to explain what is being exchanged for the books he had aspired to read:

Instead of reading them, I was spending too many hours online, checking the traffic numbers for my company’s website, shopping for more colorful socks on Gilt and Rue La La, even though I had more than I needed, and even guiltily clicking through pictures with irresistible headlines such as “Awkward Child Stars Who Grew Up to Be Attractive.”

We can laugh at the last bit because most of us have been online and lured by something we thought was impossible or ridiculous and had to inquire about. Link bait is not new or particularly clever, but it works. It works for a variety of reasons, but largely because we need to inhabit the same space to work as well as to play. The problem comes when these worlds cross-over into one another.

For example, I recently was shopping for a safe (no, it’s not to store my non-existent millions, but rather protect hard drives and enhance data security) and wanted to return to a story I’d read in the Guardian for a different blog post. As I returned to pull the URL for this I found the page looking like this:

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All of a sudden I am confronted with shopping choices amidst a quest for a URL.

Information wealth: A Faustian bargain to knowledge poverty?

“We willingly accept the loss of concentration and focus, the division of our attention and the fragmentation of our thoughts, in return for the wealth of compelling or at least diverting information we receive.”

Tony Shwartz’s comments above and below point to what we know about how information works in our brain. We can try and resist, but the evolutionary reasons we pay attention to things and the biological limitations we have to processing it all are most likely to trump any efforts to resist it without substantial shifts to our practices.

Endless access to new information also easily overloads our working memory. When we reach cognitive overload, our ability to transfer learning to long-term memory significantly deteriorates. It’s as if our brain has become a full cup of water and anything more poured into it starts to spill out.

I wish I had the answers to what these are. Schwartz, has proposed a digital vacation. As beneficial as it was for him, he was also willing to admit that it’s not a perfect strategy and that he still spends too much time online, too distracted. But, its better.

Comedian Louis C.K. has taken to ‘quitting the internet’ altogether and, in a touching moment of reflection (as he often does with wit), notes how it has improved the relationship with his daughters.

It’s these relational aspects of the new information technology and how it impacts our world that concern me the most and creates the most troubling paradox: the tools that are designed to bring us together might just be making it harder to be together and pushing us apart from each other and ourselves. This is what I will look at in the next piece in this series on paradox.

Image credit: Information by Heath Brandon used under Creative Commons License and by author

 

 

behaviour changebusinessinnovationknowledge translation

The hidden cost of learning & innovation

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The costs of books, materials, tuition, or conference fees often distort the perception of how much learning costs, creating larger distortions in how we perceive knowledge to benefit us. By looking at what price we pay for integrating knowledge and experience we might re-valuate what we need, what we have and what we pay attention to in our learning and innovation quest. 

A quote paraphrased and attributed to German philosopher Arthur Schopenhauer points to one of the fundamental problems facing books:

Buying books would be a good thing if one could also buy the time to read them in: but as a rule the purchase of books is mistaken for the appropriation of their contents.

Schopenhauer passed away in 1860 when the book was the dominant media form of codified knowledge and the availability of books was limited. This was before radio, television, the Internet and the confluence of it all in today’s modern mediascape from Amazon to the iPhone and beyond.

Schopenhauer exposes the fallacy of thought that links having access to information to knowledge. This fallacy underpins the major challenges facing our learning culture today: quantity of information vs quality of integration.

Learning time

Consider something like a conference or seminar. How often have you attended a talk or workshop and been moved by what you heard and saw, took furious notes, and walked out of the room vowing to make a big change based on what you just experienced? And then what happened? My guess is that the world outside that workshop or conference looked a lot different than it appeared in it. You had emails piled up, phone messages to return, colleagues to convince, resources to marshall, patterns to break and so on.

Among the simple reasons is that we do not protect the time and resources required to actually learn and to integrate that knowledge into what we do. As a result, we mistakenly look at the volume of ‘things’ we expose ourselves to for learning outcomes.

One solution is to embrace what consultant, writer and blogger Sarah Van Bargen calls “intentional ignorance“. This approach involves turning away from the ongoing stream of data and accepting that there are things we won’t know and that we’ll just miss. Van Bargen isn’t calling for a complete shutting of the door, rather something akin to an information sabbatical or what some might call digital sabbath. Sabbath and sabbatical share the Latin root sabbatum, which means “to rest”.

Rebecca Rosen who writes on work and business for The Atlantic argues we don’t need a digital sabbath, we need more time. Rosen’s piece points to a number of trends that are suggesting the way we work is that we’re producing more, more often and doing it more throughout the day. The problem is not about more, it’s about less. It’s also about different.

Time, by design

One of the challenges is our relationship to time in the first place and the forward orientation we have to our work. We humans are designed to look forward so it is not a surprise that we engineer our lives and organizations to do the same. Sensemaking is a process that orients our gaze to the future by looking at both the past and the present, but also by taking time to look at what we have before we consider what else we need. It helps reduce or at least manage complex information to enable actionable understanding of what data is telling us by putting it into proper context. This can’t be done by automation.

It takes time.

It means….

….setting aside time to look at the data and discuss it with those who are affected by it, who helped generate it, and are close to the action;

….taking time to gather the right kind of information, that is context-rich, measures things that have meaning and does so with appropriate scope and precision;

….understanding your enterprises’ purpose(s) and designing programs to meet such purposes, perhaps dynamically through things like developmental evaluation models and developmental design;

….create organizational incentives and protections for people to integrate what they know into their jobs and roles and to create organizations that are adaptive enough to absorb, integrate and transform based on this learning — becoming a true learning organization.

By changing the practices within an organization we can start shifting the way we learn and increase the likelihood of learning taking place.

Buying time

Imagine buying both the book and the time to read the book and think about it. Imagine sending people on courses and then giving them the tools and opportunity to try the lessons (the good ones at least) in practice within the context of the organization. If learning is really a priority, what kind of time is given to people to share what they know, listen to others, and collectively make sense of what it means and how it influences strategy?

What we might find is that we do less. We buy less. We attend less. We subscribe to less. Yet, we absorb more and share more and do more as a result.

The cost of learning then shifts — maybe even to less than we spend now — but what it means is that we factor in time not just product in our learning and knowledge production activities.

This can happen and it happens through design.

CreateYourFuture

Photo credit by Tim Sackton used under Creative Commons License via Flickr.

Abraham Lincoln quote image from TheQuotepedia.

journalismknowledge translationpublic healthscience & technology

The Power, Peril and Promise of Health Journalism

Online Prescription Concept

The Toronto Star, Canada’s most widely read newspaper known for its investigative reporting gifted anti-vaccination audiences armament by using poor science to point to a spurious connection between an HPV vaccine and illness. The issue points to journalism’s power to shape the discourse of health issues and it points to the power, promise and peril associated with good (and not so good) science reporting. 

With great power comes great responsibility – Uncle Ben, Spiderman

It started with a story

On Thursday February 5th, 2015 the Toronto Star, Canada’s most widely read newspaper that has a reputation for solid investigative journalism, published an story that connected the experience of young girls and negative health effects with the receiving the Gardasil HPV vaccine. The story was immediately and widely criticized by experienced science journalists and health professionals alike, who argued that it was based on terribly flawed science.

The Toronto Star’s reaction was to defend itself, arguing in many different fora that they indeed mentioned that there was little scientific evidence that supported the link between the vaccine and the negative health effects being discussed in the article. The problem is that these links are buried deep in the article and certainly are not its focus: the hypothesized harms are.

Two days later, the Star published a follow-up op-ed letter which was authored by two health professionals and co-signed / supported by dozens of Toronto’s leading physicians condemning the original article. However, by that time the damage is likely to have been done and one more bit contribution to the fictitious ‘evidence’ for vaccine harms had been added to the anti-vaccine movement’s war chest.

Perpetuating harm

This matter of poor reporting is not a trivial issue. The fraudulent science performed by Andrew Wakefield linking autism to vaccines helped spur an evidence-thin anti-vaccination movement. Today, we are seeing the resurgence of diseases once thought to be eliminated in North America (like measles) because so many people are not having their children vaccinated. Jenny McCarthy is among the celebrities who have taken up the cause of anti-vaccination and has written about and spoken at length about what she sees as the connection between autism and vaccines, using her son’s experience as an ‘example’. Oprah Winfrey, perhaps unwittingly, gave McCarthy a platform to speak about her beliefs on her show offering wider possible credibility to something that has been thoroughly discredited in the scientific literature (PDF).

For the Toronto Star, it was bad enough that the story was published — and is now online, likely for all time in various forms thanks to the Web — but what made it worse was that the Star was so vigorous in its defence of it, unwilling or unable to recognize their role in public health. Medical evidence champion, author, physician and columnist Ben Goldacre was among the many who counter-attacked, pointing to what he called The Star’s ‘smear campaign‘ against the story’s critics.

For an interesting discussion of the issue of just how the Star got it wrong, listen to Vox health reporter Julia Belluz, interviewed on the CBC’s radio show The Current. Belluz, a past MIT Knight Journalism Fellow, is one of a dwindling number of journalists who understand the practice of reporting, science, and medicine and wrote a stellar critique of the Toronto Star article, but as importantly makes the case for why there is a need for specialized, trained, supported journalists out there doing this kind of work.

…and health

I’ve argued in the past that journalism is very much a pillar of public health. When it fails, so does public health. Journalism is not and should not be an arm of public health for the very independence that good, professional journalism strives to maintain is a reason it’s often called the fourth estate, keeping governments and other forces in check to ensure they are not abusive. Yet, that distance is also what makes it a part of public health. Public health is better for journalism and journalism certainly can benefit from health stories as they continue to be popular and sought after by readers.

As a group, scientists and many clinicians are not great at communicating what they do, why their research is important to others outside their field, and what the implications of their findings are for the public and science as a whole. Some are, most are not. It’s for this reason that the entire sub-field of health sciences focused on knowledge translation, exchange and mobilization has emerged. Just as we value the ability of a graphic designer to make visuals come alive, so too have we learned to value those with the skills to communicate information well and that is what journalists are trained and paid to do. They are a big part of this process, or at least should be.

Healthy journalism, healthy science, healthy people

Science journalism is too important to be ignored. There is much skepticism of journalists by scientists and clinicians and indeed, as the Toronto Star shows, journalists sometimes get things wrong. But its one thing to get it wrong through errors of judgement or interpretation it’s quite another to get things wrong by design. The Toronto Star has some good health reporters, but they weren’t the ones on this story. Nor did they bring in the health reporters to consult on this or other health professionals prior to publication– at least as far as one can tell.

The importance to the public’s health of good reporting requires that health and science journalists have more than a rudimentary knowledge of the topics they are covering. What’s strange is how we understand this with our sports reporting, weather forecasts and foreign correspondents. You wouldn’t watch someone who has little understanding of a sport covering it in depth, would you? It’s one thing to read scores, it’s another to provide investigative and deep coverage of a game if you don’t know the players, the rules, the criteria for quality and success and so forth.

Why do we do this with health journalism and science?

Yet, journalism is under pressure and no doubt the Toronto Star, for whatever genuine contrition they experience from what happened, have to like that they are being talked about. The reason is that journalism is under threat for market reasons, the Internet and the changing ways we get our news. It is, as Jürgen Krönig wrote way back in 2004, “A crisis of the Fourth Estate”. That crisis is only getting worse.

As anyone interested in public health, we need to take actions to ensure that the fourth estate is protected, supported and not ignored. Our health might just depend on it.

Image: iStockphoto, used under licence.

education & learningknowledge translationpsychologysystems thinking

Bullying, the market for education and the damaged quest for learning

Dark classroom, light minds

Dark classroom, light minds

A recent study found looked into the experience of cyberbullying by university professors at the hands of their students. This disturbing phenomenon points to much larger issues beyond mental health promotion and calls into question many of the assumptions we have about the systems we’ve designed to foster education and what it means to be a learner at university. 

The university is one of our oldest cultural institutions and its instructors are considered to have among societies most respected jobs, even if not always well compensated. In the past, students often approached their professors with a mixed sense of wonder, respect, curiosity and fear and that, in healthy situations, was reciprocated by faculty to create a space where people could explore ideas, learn, and challenge themselves and others to grow. That relationship has started to change as evidenced by the rise of cyberbullying in the classroom.

A recent article in Macleans Magazine looked at the changing state of the post-secondary classroom and the role of cyberbullying. Only this was not about student victims, but students as the perpetrators against their professors. The effects of cyberbullying are crippling and professors are bearing the burden of having hundreds of eyes watching them, writing about them and writing ‘consumer reviews’ about them in anonymous and sometimes unflattering, inflammatory and questionable terms on sites like RateMyProfessor.com .

Researchers at the University of California, Riverside found that as students age the incidence of face-to-face bullying decreases and cyberbullying increases, which might partly explain why we’re seeing this in university settings when face-to-face bullying goes subterranean. Yet, the notion that professors that are getting bullied by their students belies some other issues that require further investigation, namely those related to the nature of education and the role of students-as-consumers.

Consuming knowledge, producing expectations

If you pay for something, should you not expected to get something rather specific for that experience or product? Aside from some rare experiences of profane/profound personal challenge/punishment like Tough Mudder and its peers or dental work, there are few things we willingly pay for that we don’t derive pleasure from or achieve a very specific (anticipated) outcome.

Education is problematic because we might not know what we’ll get from it going in, what kind of experiences or ideas will emerge, and how our relationship to those experiences will change us. That is its great gift.

Many of us have had profound life changes because of something we experienced through our education and writing as one who has completed four different degree programs and a post-doc I can confidently say that I didn’t receive a lot of what I expected in any of those programs and I am a better person for it. Indeed, if I go to a specific learning event (aside from those focused on a specific technique or technology) I am disappointed if I actually come away with exactly what I expected.

That is part of the point. We don’t know what we don’t know.

But when you start viewing education as a thing that resembles any other market-driven product or services, you begin to focus on learning as a consumable good and your students as customers. In following this line of thought, it makes some sense to focus the delivery of this product on the desires of the consumer.

Increasingly, teachers (of various stripes) are being asked to consider a range of student-related variables in their education. Things like learning styles and preferences are now being woven into classroom instruction and students have come to learn to expect and are increasingly demanding to be taught in ways that match their unique learning preferences and styles. While there is reason to imagine that this approach is useful in stimulating engagement of students in the lessons, there is increasing evidence much of it does little to enhance actual learning. Many of the life lessons we’ve gained that shape what we do and who we are were not delivered in the manner of our choosing, conformed with our preferences and were not desired, expected or enjoyed in the moment. We risk confusing enjoyment with learning; they can be aligned but one isn’t necessary for the other to take place.

However, when we are viewing education from a consumer model, the specific outcomes become part of the contract. If I come to get a degree in X because I believe that the job market demands the skills and knowledge that X brings and I am paying tens of thousands of dollars and spending four or more years acquiring X then I feel entitled to expect all the benefits that X brings. Further, I expect that my journey to acquiring X will be enjoyable, because why would I spend more money than I’ve ever seen on something I don’t enjoy.

Particularly when that is money I don’t have.

A debt to pay

In Canada and the United States, student debt rates have dramatically increased. The Canadian Federation of Students note that Canadian’s attending post-secondary education now owe more than $15B to the Canadian federal government (PDF) as part of their student loan program, a number that doesn’t include debt accumulated from borrowing from banks, family, credit cards and other means. In Canada’s largest province, Ontario, the rate of graduate employment has decreased since 2001 and the overall youth unemployment rate continues to be the highest, despite the province having one of the most educated youth population in the country (and arguably, the world). And while Ontario universities continue to promote the fact that education is a better pathway to success, it is a hard pill for many students to swallow when many can’t apply what they trained for and paid for after they graduate.

Satirist John Oliver has an informative, humorous and distressing take on student debt and the state of consumer-oriented education for those who want to learn more.

None of these reasons are excuses for cyberbullying, but it does give a more complicated picture of those that might feel they are entitled to bully others and their reasoning behind it.

What we are seeing is a systems change in the way education is being produced, consumed and experienced. Even the mere fact that we can now reasonably use the language of consumerism to speak to something like education should give us pause and concern. I’ve been involved in post-secondary education for nearly 20 years and there has always been students who simply wanted the ‘piece of paper’ (degree) as a stepping stone to a job and little more than that from their time at school. They were willing to do the work — often the minimum possible — to graduate, but they knew they had to put the effort in to be successful. There was never an expectation that one was entitled to anything from going to school, although that might be changing.

Market identities and education systems

Belgian psychotherapist Paul Verhaeghe has explored the role of identity in market-based economies in his new book What About Me? In the book, Verhaeghe illustrates how we construct our identities as people drawing on the research that reflects (and often contradicts or obscures) the two major perspectives on personality and identity: the person-as-blank-slate and the person as a reflection of the environment. The former perspective assumes we come into the world as we are while the latter assumes the world makes us who we are and both have enormous amount of moral, cultural and evidentiary baggage attached to them.

What Verhaeghe does is point to the ways in which both have elements of truth to them, but that they are mediated by the manner in which we construct the very questions about who we are and what our purpose is. These questions are (for many cultural, historical, economic and political reasons that he elaborates on) frequently market-based. Thus, who we are is defined by what we do, what we own, what we produce, and how we use such things once out into the world and that the value that come with such ways of defining ourselves is considered self-evident. He makes a disturbing and convincing case when one stops to reflect on the way we think about how we think (metacognition + mindfulness) .

When viewed from the perspective of a market, knowledge and its products soon become the goal and not the journey. Indeed, I’ve even written about this in support of an argument for better research-to-action and knowledge translation. Much of the knowledge-to-action discourse is about viewing knowledge as a product even if the more progressive models also view this as part of a process and even more as part of a system. But it is the last part — the system — that we often give the shortest shrift to in our discussions. What Verhaeghe and others are doing is encouraging us to spend more time thinking about this and the potential outcomes that emerge from this line of thinking.

Unless we are willing to talk more about the systems we create to learn, explore and relate we will continue to support Verhaeghe’s thesis and uphold the conditions for the kind of education-as-a-product thinking that I suspect is contributing to students’ changing behaviour with their professors and creating a climate at universities that is toxic instead of inspiring.

Photo credit: Classroom by Esparta Palma used under Creative Commons License via Flickr. Check out Esparta’s remarkable work here.

journalismknowledge translationpublic healthsocial media

Sane truths in Crazy Town: What Rob Ford’s story offers politics, science and journalism

Crazy Town

Crazy Town

A new book about Toronto’s (in)famous mayor reveals a great deal more than just a story of man known more for what he smokes and says than his governance, to what kind of world we want to live in. Robyn Doolittle’s ‘Crazy Town’ goes well beyond documenting one man’s troubling behaviour and its place in the city he governs to a broader understanding of politics, science and journalism in a day when all three are under threat. 

Toronto has been my adopted home for most of last 15 years. It’s dynamic, clean, safe and North America’s 4th largest city. Toronto is a place of tremendous ethno-cultural diversity (near 1/2 of the population is foreign-born), spectacular food, a thriving arts and culture scene, great universities, home to sports fans with a near pathological faith in their hockey team, and — even with all of that — it’s sometimes a bit dull (and that’s OK).

That last bit about being dull changed dramatically after 2010 and that has to do with one man: Rob Ford, our mayor. Maybe you’ve heard of him.

The narrative arc

Toronto Star reporter Robyn Doolittle was literally at the front line of journalists covering Toronto’s Chief Magistrate and recently published a book on that experience and the story behind the story called Crazy Town. It’s a terrific book that documents the almost surreal events and people behind Rob Ford’s rise to power and current reign as one of the world’s most well-known mayors. It’s a rare work that manages to marry true crime, history, political intrigue, suspense, biography, and a journalism textbook together. I devoured it.

Yet, as a resident and politics fan I was amazed by what I read. I already knew most of the general details of what came out in the book (although chapter 12 is a complete shocker) because I lived through this news. Yet, it was only seeing all of this painted in one long narrative piece that it took a new life and in doing so brought me to a deeper understanding of many issues I’d thought I knew. The reason is largely the narrative arc that only a book (or long-form journalism) can offer.

On the surface, one could argue that what Doolittle did was piece together hundreds of stories she and others had written and compile them with a few additional quips to produce a compendium of Rob Ford’s life in the public’s eye. That in itself is a lot of work, but it doesn’t tell those who were paying attention to the story anything new. Yet, with each story that came out the backstory shows how what was reported — and picked up by others, reacted to, or ignored — was as important as what was learned about the subject and his environment. We read about how — not unlike with police work — the public is exposed to the “facts” but not how the authors chose to disclose (or not) those details and why.

When one considers what these ‘facts’ and the stories behind them entail, it is hard not to see some parallels between the world of political reporting at city hall and the world of science, social innovation, health promotion and policy that I live (and have lived) in. Crazy Town has many lessons for those not interested in Toronto, Rob Ford, politics, journalism or science, yet it is through all of those topics that such lessons are learned. The latter three stand out.

Politics

Rob Ford has defied nearly any explanation of how he has managed to maintain some form of support above 30% (as in, 3/10 polled would vote for him if the election was today). The best I’ve read is from former Canadian hockey legend, educator and parliamentarian Ken Dryden who wrote in the Globe and Mail newspaper about how Rob Ford has found a way to be visible and get the simple things done when other politicians get mired in complexity. He channels people’s frustrations and he makes his constituents feel listened to.

Doolittle’s treatment of Ford – despite the despicable treatment he’s given her, the Toronto Star and journalists overall — is fair and, in many cases, almost flattering when it comes to politics. Ford and his team have, despite appearances on the personal side of things, been very consistent and kept things simple. While Einstein might have challenged that Ford’s simple is too much so, there are lessons for all of us in this.

For those who deal in complexity, which is most human systems, it is easy to get mired in the details and interactions. Ford was steadfast in his over-arching narrative of “the gravy train” and that resonated with people. There is no reason why any other politician couldn’t have picked something similar to drive as their narrative and done much more good than Ford has, but they didn’t.

Ford made himself visible to those who mattered most: his constituents. And they have rewarded him with support.

How often do health care officials, educators, or policy leaders spend time with their key ‘constituents’ in settings that are natural to that audience? Politicos might challenge Ford’s proclivity for door-knocking and BBQ’s in an age of big data analytics, but that resonates with people. Why don’t more leaders get away from staid events in hotel ballrooms, well-crafted PR events, or their own offices to meet with their audiences where they live, work and play?

Good designers know that the design is only good if it gets used in the environment it was intended for and the only way to know that is to go into those environments. Ford knows this.

Science

To be fair, science is my term not Doolittles, but the term ‘evidence’ is one that links my term and her experience as a reporter. By science, I am talking capital ‘S’ science — the enterprise of scientific work as well as the activity.

What follows from the narrative arc that Ford delivered was the ability to frame the evidence held against him. He is masterful at reframing the arguments and keeping people focused on the messages that fit his ongoing  construction of a narrative. For a while, he was able to keep people talking about whether or not he smoked crack or drank alcohol excessively — two very serious issues — in a speculative way and away from the evidence he associated with drug dealers, violent criminals, and lied repeatedly to the press. He still does this.

In 2012 and 2013 the city spent time debating the minutiae of the law around whether or not he was in violation of conflict of interest. Lost in much of this debate was the larger pattern of Rob Ford consistently getting into trouble over all kinds of issues, big and small and how that wasn’t appropriate for any leader, political or not. Recently, Ford was in the news for being drunk in public and speaking in some faux Jamaican patois to customers at a local restaurant.

The issue as discussed in the media was the alcohol and the patois, not the fact that this is a man who, when under the public’s eye, has the judgement to: 1) get drunk in a public place 2) with the person who is accused of extortion related to the infamous crack video, 3) and then get up in front of everyone at the front of the restaurant to make a big, public proclamation.

Two weeks later, at a funeral for his friend’s mother in Vancouver, Ford decides to go to a crowded bar on a weekend night where nearly every young person there has a mobile phone and many proceed to take pictures of him or with him .

This is exactly how scientists and policy makers often behave. The intense focus on the small details leaves out the questions of relevancy and the bigger picture of what the point of the science is. Too often we get sidetracked with specifics and lose sight of a much larger set of issues.

For example, we’ll spend forever arguing the hypothetical possibility that someone might hack into an eHealth record as an argument for not allowing for easy portability and accessibility to that information (despite the fact that it can save lives, engage people, and that banks have been doing it with our life savings and credit for 20 years). (* Note that the details in science can matter a great deal, but just like walking and chewing gum, we can fret details in science and think of the big picture at the same time)

So far, people are willing to pay attention to Ford’s bigger message. Perhaps we need to consider what the bigger message is in our other enterprises and then worry about the details.

Journalism

I love ‘behind the scenes’ looks and this book provides lot to consider when thinking about how journalism is done, particularly that of the investigative kind. Doolittle has been steadfast that Crazy Town might have her name on the cover, but the investigative work that contributed to it was part of a huge team of journalists from the Toronto Star, the Globe and Mail and other outlets. Indeed, it takes a team and the kind of institutional support that the Star has put behind Doolittle.

Alas, this may be an exception. Many journalistic outlets are imploding due to poor management, change of readership habits, shifting business models, and also the public’s unwillingness to pay for things they value online. This last point is the one that we often let skate by in our discussions about media and one that Jaron Lanier has exposed as a major flaw in the modern Internet age.

Just this past week, web pioneer Mark Andreessen speculated on the future of media and — as many who have a stake in a faster, less in depth form of media often do — completely overlooked the role of the media as the a key role in communicating and uncovering key stories for society. To him, the model is dying. Maybe the business model is problematic, but unlike Andreessen I see a big need for journalism for society and as a model for science and health.

In health and science reporting, we are at great risk of losing voices like Andre Picard, Julia Belluz, Carly Weeks and Helen Branswell who have all brought to light many key issues that public health, healthcare and policy seem to forget, hide, complicate, or deny from emergent infectious disease patterns to drug regulation policy and practice.

Would we know about Rob Ford’s fitness for mayoralty if we didn’t have the Star? Would we be talking about the perversion of science and pharmaceuticals were it not for people like Ben Goldacre in the UK? What kind of knowledge would the world have about the NSA if Edward Snowden was a lone blogger and didn’t have The Guardian or New York Times to advance his disclosure? Crazy Town makes you realize what a debt we are owed to modern investigative journalism, journalists and those that support them (and are willing to pay for their products).

A bigger story

Crazy Town ends with the acknowledgement that there is much more of this story yet to be written. This is an election year and Rob Ford is one of the few who have already filed their papers to run for office again.

Crazy Town could have been told in 10,000 tweets, videos and Instagram pics. But it would have missed the point. The book is an argument for why in-depth journalism is needed and why — journalism, science, and politics — all often require a longer narrative arc to understand the bigger picture. Bigger stories don’t fit into a social media world, even if that very social media is part of the story itself.

The book is a great read whether you’re in Toronto, Ontario; Calgary, Alberta;  Madison, Wisconsin; or Phnom Phen, Cambodia. It’s a story as much about a man and a city as it is about ourselves and the world we live in. Read that way, you’ll find that not only is there more to tell of Rob Ford, there is a much bigger story to tell all around us.

behaviour changecomplexityemergenceevaluationknowledge translation

Bringing Design into Developmental Evaluation

Designing Evaluation

Designing Evaluation

Developmental evaluation is an approach to understanding and shaping programs in service of those who wish to grow and evolve what is done in congruence with complexity rather than ignoring it. This requires not only feedback (evaluation), but skills in using that feedback to shape the program (design) for without both, we may end up doing neither. 

A program operating in an innovation space, one that requires adaptation, foresight and feedback to make adjustments on-the-fly is one that needs developmental design. Developmental design is part of an innovator’s mindset that combines developmental evaluation with design theory, methods and practice. Indeed, I would argue that exceptional developmental evaluations are by their definition examples of developmental design.

Connecting design with developmental evaluation

The idea of developmental design emerged from work I’ve done exploring developmental evaluation in practice in health and social innovation. For years I led a social innovation research unit at the University of Toronto that integrated developmental evaluation with social innovation for health promotion and constantly wrestled with ways to use evidence to inform action. Traditional evidence models are based on positivist social and basic science that aim to hold constant as many variables as possible while manipulating others to enable researchers or evaluators to make cause-and-effect connections. This is a reasonable model when operating in simple systems with few interacting components. However, health promotion and social systems are rarely simple. Indeed, not only are they not simple, they are most often complex (many interactions happening at multiple levels on different timescales simultaneously). Thus, models of evaluation are required that account for complexity.

Doing so requires attention to larger macro-level patterns of activity with a program to assess system-level changes and focus on small, emergent properties that are generated from contextual interactions. Developmental evaluation was first proposed by Michael Quinn Patton who brought together complexity theory with utilization-focused evaluation (PDF) and helped program planners and operators to develop their programs with complexity in mind and supporting innovation. Developmental evaluation provided a means of linking innovation to process and outcomes in a systematic way without creating rigid, inflexible boundaries that are generally incompatible with complex systems.

Developmental evaluation is challenging enough on its own because it requires appreciation of complexity and a flexibility in understanding evaluation, yet also a strong sense of multiple methods of evaluation to accommodate the diversity of inputs and processes that complex systems introduce. However, a further complication is the need to understand how to take that information and apply it meaningfully to the development of the program. This is where design comes in.

Design for better implementation

Design is a field that emerged from the 18th century when mass production was first made possible and no longer was the creative act confined to making unique objects, rather it was expanded to create mass-market ones. Ideas are among the ideas that were mass-produced as the printing press, telegraph and radio combined with the means of creating and distributing these technologies made intellectual products easier to produce as well. Design is what OCADU’s Greg Van Alsytne and Bob Logan refer to as “creation for reproduction” (PDF).

Developmental design links this intention for creation for reproduction and the design for emergence that Van Alsytne and Logan describe with the foundations of developmental evaluation. It links the feedback mechanisms of evaluation with the solution generation that comes from design together.

The field of implementation science emerged from within the health and medical science community after a realization that simple idea sharing and knowledge generation was insufficient to produce change without understanding how such ideas and knowledge were implemented. It came from an acknowledgement that there was a science (or an art) to implementing programs and that by learning how these programs were run and assessed we could do a better job of translating and mobilizing knowledge more effectively. Design is the membrane of sorts that holds all of it together and guides the use of knowledge into the construction and reconstruction of programs. It is the means of holding evaluation data and shaping the program development and implementation questions at the outset.

Without the understanding of how ideas are manifest into a program we are at risk of creating more knowledge and less wisdom, more data and less impact. Just as we made incorrect assumptions that having knowledge was the same as knowing what to do with it or how to share it (which is why fields like knowledge translation and mobilization were born) so too have we made the assumption that program professionals know how to design their programs developmentally. Creating a program from scratch from a blank slate is one thing, but doing a live transformation and re-development is something else.

Developmental design is akin to building a plane while flying it. There are construction skills that are unique to this situation that are different from, but build on, many conventional theories and methods of program planning and evaluation, but like developmental evaluation, extend beyond them to create a novel approach for a particular class of conditions. In future posts I’ll outline some of the concepts of design that are relevant to this enterprise, but in the meantime encourage you to visit the Censemaking Library section on design thinking for some initial resources.

The question remains whether we are building dry docks for ships at sea or platforms for constructing aerial, flexible craft to navigate the changing headwinds and currents?

 

Image used under license.