Teach EBP? An introduction to Complexity theory!
- 1. Teach EBP? An introduction to Complexity theory!
- 2. Mechanistic / Cause and effect view of life • I lead – you follow • I say – you do • I manage – you do • I teach – you learn • You teach – I pass
- 3. Complex systems • Complex systems consist of a large number of elements • These interact in a dynamic way • Each element influences the others and is influenced in turn • Most interactions are short range • But complex systems do interact with their environment
- 4. Complex systems contd • There are loops in the interactions which can have a +ve or –ve effect • Complex systems are not in equilibrium – only survive through a constant flow of energy • Present and future behaviour partly determined by past • Elements in the system react to local info and are ignorant of behaviour of system as a whole
- 5. (After Stacey, Stephenson & Greenhalgh) low a g r e e m e n t high high low certainty
- 6. low a g r e e m e n t high high low certainty
- 7. environment low chaos a g r e e m complexity task e n t order high high low certainty
- 8. environment low Don’t go here! a g r e e Zone of m complexity task e n Capability t Competence high high low certainty
- 9. Competence - what individuals know or are able to do in terms of knowledge, skills and attitude. Capability - extent to which individuals can adapt to change, generate new knowledge and continue to improve their performance
- 10. Complexity systems and education • The system and its environment is never constant • Individuals are independent and creative decision makers • Uncertainty and paradox are inherent within the system • Problems that can’t be solved can nevertheless be moved forward
- 11. Complexity systems and education contd • Effective solutions can emerge from minimum specification • Small changes can have big effects • Behaviour exhibits patterns • Change is more easily adopted when it taps into these patterns
- 12. RCA Problem Narrative cases based Problem based learner Change EBP Management Audit Ethics “Process based learning”?
- 13. Process based learning Learning driven by needs Characterised by – •Dynamic and emergent PLP with explicit goals •Protected time •Mentoring and peer support •Written log or record
- 14. References “The challenge of complexity in health care” Plesk and Greenhalgh - BMJ 2001; 323: 625-8 “Coping with complexity: educating for capability” Fraser and Greenhalgh - BMJ 2001; 323: 799-803 “Complexity and clinical governance:using the insights to develop the strategy” Sweeney and Mannion - BJGP; 52(suppl): S4-S9