Delizonna, Laura. (2017). High Performing Teams Need ...

Using Integrated Behavioral Health as a Template for Organization Development

Javier Luna, PhD

Carl Heard, MD, MMM

References

Argyris Chris. (1991). Teaching Smart People How to Learn. Harvard Business Review. May-

June 1991 issue.

Bennett, Nathan & Lemoine, G, James. (2014). What VUCA Really Means for You. Harvard

Business Review. January-February F1401C.

Delizonna, Laura. (2017). High Performing Teams Need Psychological Safety. Here’s How to

Create It. Harvard Business Review. Online. Accessed October 2017

Edmondson, C. Amy. (2015). The Kinds of Teams Healthcare Needs. Harvard Business Review.

Online. Accessed October 2017.

Fleming, Andy (2016). The Key to Adaptable Companies is Relentlessly Developing People.

Harvard Business Review. Online. Accessed on March 2018.

Gawanda, Atul. (2011). Personal Best. Top Athletes and Singers Have Coaches. Should you?

The New Yorker. October 2011.

Kegan, Robert, Lahey, Lisa, Fleming, Andy. (2014). Does Your Company Make You a Better

Person? Harvard Business Review. Online. Accessed March 2018.

Laloux, Frederic (2014). Reinventing Organizations: A Guide to Creating Organizations Inspired

by the Next Stage of Human Consciousness. Nelson Parker.

Simon, S.N. (2012). Applying the Cape Cod Model to Coaching, Gestalt Review, 16 (3).

Zak, J Paul. (2017). The Neuroscience of Trust. Harvard Business Review. January-February

edition 2017. R1701E.

Psychological Safety Survey

1. If you make a mistake on this team, it is often held against you.

(Not at all in Agreement); (Somewhat in Agreement); (Moderately in Agreement); (Very in Agreement); (Extremely in Agreement)

2. Members of this team are able to bring up problems and tough issues.


3. People on this team sometimes reject others for being different.


4. It is safe to take a risk on this team.


5. It is difficult to ask other members of this team for help.


6. No one on this team would deliberately act in a way that undermines my efforts.


7. Working with members of this team, my unique skills and talents are valued and utilized.


Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science

Quarterly, 44, 350-383.

by philip preville

Engagement techniques that work

THE

LEARNING HANDBOOK

2 tophat.comThe Active Learning Handbook

3 Introduction: The Pulpit Problem

11Conclusion: The Engaging Professor13Sources14

15 About the Author: Philip Preville

4 Troubled Times for the University Lecture

6 The Rise of Active Learning

9 Academic Research on Active Learning

Best Practices for Active Learning

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INTRODUCTION

The Active Learning Handbook

Enrico Fermi, the great Italian-born physicist and 1938 Nobel Laureate, was also a captivating lecturer who earned the nickname “The Pope” for his pronouncements at the classroom pulpit. He also offered, from the perspective of his students, one of the most insightful and lasting criticisms of lecturing itself: “Before I came here I was confused about this subject. Having listened to your lecture I am still confused. But on a higher level.”

Decades later, Fermi’s words remain apt: lecturing is not always the best means of transferring knowledge from teacher to pupil. As a lecture progresses into more complex areas, students risk losing their bearings. And once that happens, PowerPoint slides may be of little help.

Today’s lost students, rather than try to find their way back into the material, often find their way into Facebook or Amazon instead. The ubiquity of campus Wi-Fi and laptops provide students with a multitude of opportunities for distraction and disengagement. These technologies have only exacerbated the problem that has been ever-present since long before Fermi’s time: the risk that students, as passive recipients of complex knowledge, will fail to fully comprehend the subject matter.

But these same technologies also represent an opportunity for professors to reach students in ways Fermi never could: a chance to implement new—and technologically enabled—teaching techniques for improved classroom engagement.

THE PULPIT PROBLEM

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4 The Active Learning Handbook tophat.com

Lecturing is the predominant mode of teaching on college campuses, largely because of its perceived efficiency: instructors feel they can cover more material if they do all the talking. But cramming more content into a course syllabus makes it more challenging, especially while making no teaching adjustments to ensure students can meet the challenge. Indeed, recent data shows that students increasingly

find postsecondary education to be a steep uphill climb—and that traditional lecturing is contributing to the problem.

According to the 2016 National Survey of Student Engagement,1 one in five first-year students had difficulty learning course material and getting help with coursework. The results prompted NSSE director Alexander McCormick to observe that “students don’t necessarily enter college knowing

FOR THE UNIVERSITY LECTURE

TROUBLED TIMES

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what it takes to be successful learners…we need to help students crack the code.”

Unfortunately, if students get off to a bad start, they may never reach the finish line. According to

a 2016 New York Times report,2 less than half of all students admitted to public universities in America manage to complete their degree. The problem is less pronounced, but nonetheless present, among private schools: of 1,027 private colleges surveyed by the

Washington, D.C. think tank Third Way, 761 reported graduation rates of less than 67 percent.

And the way students are taught has a direct impact upon their outcomes. According to a study from the University of Washington in Seattle,3 undergrads in classes with traditional sage-on-stage lectures are one-and-a-half times more likely to fail than those in classes that use a wider variety of teaching techniques.

In his seminal book, What’s the Use of Lectures?, former University of Exeter professor Donald Bligh observed, “the idea that lecturers should use the lecture method and no other for 50 minutes on end is absurd; yet it is quite a common practice.” Bligh also remarked on the surprising level of student tolerance for lecturing, given that “the effect of monotonous stimulation”—that is, boredom— “is common knowledge.”

And if monotony lies at the root of the pulpit problem, then the solution is to shake things up and make students more active participants in their education.

Undergrads in classes with traditional sage-on-stage lectures are 1.5 times more likely to fail than those in classes that use a wider variety of teaching techniques

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Twenty-five years ago, two professors from Southeast Missouri State University, historian Charles Bonwell and psychologist James Eison, laid out the first academic case for transforming lecture-based learning into something better. Their 1991 book Active Learning: Creating Excitement in the Classroom defined its title concept this way: “In the context of the college classroom, active learning involves students in doing things and thinking about the things they are doing.”

Bonwell and Eison argued that teaching should be less about

imparting information to students and more about developing skills, while also engaging students in higher-order thinking, whether by reading or writing about the task at hand or by discussing it. The central tenet of active learning is that practice matters, and that classroom time is better spent giving students opportunities to work with concepts over and over, in a variety of ways and with opportunities for immediate feedback, so that knowledge can take hold in their own minds. This is as true of the sciences as it is of the humanities: molecular biology

THE RISEOF ACTIVE LEARNING

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and philosophical inquiry are both best understood through repeated, open and social exploration.

Today, nearly every college in North America has a teaching-and-learning resource center to support faculty as they diversify their

classroom activities beyond passive lecturing. And universities are now redesigning classroom spaces to promote active learning: instead of theatre-style seating focused on a pulpit, classrooms feature circular tables that encourage small-group discussion, and wall-mounted

flatscreens that students can use to display their work and solicit feedback.

Meanwhile, the same developments that have made lecturing ever more precarious—personal technology—are also serving as a catalyst for the adoption of active learning strategies. Smartphone apps, social media and student engagement platforms such as Top Hat are making the transition to active learning classrooms easier and more efficient. Minute papers, quizzes and muddiest-point exercises (see “What An Active Classroom Looks Like” on the following page) can all be executed and tabulated online. Debate proceedings can be videotaped and posted to course websites. New technologies make it possible for instructors to design and adopt a wide range of new teaching activities and collect real-time data on student performance—without having to redesign the physical classroom itself, which is often an unrealistic goal given the tight budgets imposed on many academic departments.

Technology makes it possible for instructors to design and adopt new teaching activities and active learning techniques without having to redesign the classroom.

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WHAT AN ACTIVECLASSROOM LOOKS LIKE

THINK-PAIR-SHARE Instructors briefly pause their lecture and ask students to pair up and discuss the material that was just presented, and to be prepared to ask questions or share observations with the entire class.

MINUTE PAPERS During a brief pause, students alone or in pairs are asked to answer a question in writing about the day’s teaching. The submitted responses can be used to gauge student comprehension of the material.

QUICK QUIZZES Administered at the start of class or during a pause, not for a grade, but to assess comprehension, much like minute papers.

MUDDIEST POINT Students are asked to write down and submit which part of the course material is least understood by them.

DEBATES Having students defend different viewpoints for the class is a means of structuring class discussion and ensuring that even those in the back rows have the opportunity to speak.

CASE STUDIES AND PROBLEM SOLVING Students work in groups, applying knowledge gained from lectures or reading materials to a given situation.

PEER INSTRUCTION Have students prepare and present course material to the class.

FLIPPED CLASSROOMS Students watch pre-recorded lectures as homework, then arrive in class prepared to spend the time engaged in any number of the activities described above.

In practice, the term “active learning” encompasses a broad array of tactics and activities, ranging from quick-and-simple interventions to semester-long redesigns of course structure and delivery. While some are better suited to specific disciplines, each one can be adapted for use in any context. Debate, for instance, has its roots in philosophy and politics, but can easily be used to animate discussion in STEM classrooms.

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9 tophat.comActive Learning

Academics are often researchers as well as teachers. They leave no aspect of their environment free from observation and experimentation—including themselves and their students—delving into data on what motivates students and the best ways to engage them while tracking metrics such as retention and comprehension.

At this point the empirical data on both topics is voluminous, and the evidence is clear: active learning is good for students, in terms of both outcomes and engagement. One study found that students in active learning classrooms outperform students in lecture

classrooms by six percentage points on the same exams—which can mean the difference between passing and failing.

And, as laid out by Joel Michael of Rush Medical College in Chicago in his 2006 paper “Where’s the evidence that active learning works?,”4 the research provides instructors with useful principles for the design of active learning activities in the classroom.

Knowledge is created by each of us, not transferred from one person to another.Instructors can impart what they know, and students can receive it

ACADEMIC RESEARCH

ON ACTIVE LEARNING

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in an alert and engaged state of mind. But for effective learning to occur, students need to link what they’re being taught to what they already know, to correct their misconceptions and to construct new and lasting meaning in their own minds. That process requires discussion and exchange between students and instructors, and among students themselves—activities that are part of any active learning classroom.

Knowing “what” is different from knowing “how.”If students are expected to use the knowledge transferred in a lecture to solve problems, they need opportunities to practice—and they need feedback on their performance. This part of the learning process, typically taken up through homework, is increasingly being done during class time, with students doing problem-solving or case-study exercises and sharing their work with the professor and the class for discussion. It’s a great chance to review and go more in-depth with challenging material.

Students learn better when they learn with others, and they learn best by talking.Whether it’s called peer learning, problem-based learning or collaborative learning, the research is emphatic: it works. Even with computer-assisted learning, students learn better when paired. And the more they talk to one another, articulating how they understand certain problems, delving deeper into their own knowledge and self-correcting their misconceptions, the better they learn.

Moreover, the research shows that active learning improves student enthusiasm for learning itself. In a 2012 study,5 372 undergraduate students were provided with either passive or active instruction on information literacy from their campus library. Those who received active instruction were more time-efficient and self-sufficient in their information searches, experienced less anxiety when using library resources and reported improved perceptions of librarians’ helpfulness and value.

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BEST PRACTICESThe research is clear: active learning techniques improve student engagement and learning outcomes. And they work best when they’re used to deliberately target specific objectives. To design an effective active learning program, it helps to assess your experience in lecturing and identify the strengths and weaknesses of your current approach.

How is classroom time currently spent? How much time is devoted to each module or concept?

Which core concepts do students typically show the greatest amount of difficulty understanding?

Where do students struggle most, and where do they succeed?

Which aspects of coursework are best conducted in class, and which would best be completed at home?

Which active learning techniques would best apply to the challenges of your classroom?

What have others tried? Have their efforts been successful?

FOR ACTIVE LEARNING

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Perhaps the most crucial question to ask is: what technology can I adopt to facilitate active learning? The tools of active distraction—laptops, tablets and Wi-Fi—can be turned into tools of active learning. Personal

technology is a staple of student life, and incorporating it into an active learning platform makes it easier for students to engage. Creating course hashtags or pages on social media such as Twitter and Facebook can facilitate peer-to-peer discussion both inside and

outside the classroom. Classroom engagement platforms can tabulate quiz results in real time to provide feedback on comprehension and student progress, and do the same for minute papers and muddiest-point exercises, while also providing data on student reading habits. Interactive textbooks, with built-in exercises, videos and quizzes that instructors can edit to adapt for their courses, also facilitate active learning activity.

Finally, when implementing any active learning program, be prepared to meet with resistance. Students are just as accustomed as instructors to passive learning, which demands less of them in the classroom. Any program of active learning requires students to be more alert, engaged and active in their education—and often their first reaction to such obligations is to complain. They don’t realize that, as the research shows, active learning will engage them better, help them learn and provide them with greater satisfaction. In the early going, the persistence of their instructor will be a crucial factor in active learning’s success.

Students don’t realize that, as the research shows, active learning will engage them better, help them learn, and provide them with greater satisfaction

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CONCLUSION


For nearly two centuries, lecturing has been the mainstay of higher education, the one-size-fits-all pedagogy for any course of learning. During that time the world beyond campus has changed radically, especially in the way technology has changed how we interact with others.

Perhaps it is a comfort to students and faculty that the university classroom has remained constant throughout these years: everyone knows what to expect. But it is increasingly clear that lecturing alone is far from optimal, whether for engaging students or generating strong learning outcomes. If all that’s expected of students is to be passive recipients, it should come as no surprise that they remain passive in the face of academic challenge.

THE ENGAGING PROFESSOR

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SOURCES

1 http://nsse.indiana.edu/NSSE_2016_Results/pdf/Press_Release.pdf

2 https://www.nytimes.com/2016/06/02/upshot/why-college-students drop-out-follow-the-dollars.html?_r=1

3 http://www.sciencemag.org/news/2014/05/lectures-arent-just-boring theyre-ineffective-too-study-finds

4 http://advan.physiology.org/content/30/4/159.full

5 http://www.aserenko.com/papers/Detlor_Education_for_Information.PDF

Active learning techniques make students participants in their education, raise their grades and their self-esteem, and better impart knowledge and skills. Student engagement is not merely a function of captivating course material or of professorial wit at the pulpit. Engagement is about how students are invited to interact with course material, and smart professors are those who invite them to actively explore new knowledge until they make it their own.

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THE AUTHOR


PHOT

OGRA

PHER

: ASH

NAY

LER

PHILIP PREVILLE

Philip Preville is an award-winning journalist and a former Canadian

Journalism Fellow at Massey College at the University of Toronto.

He’s currently a member of the Professional Advisory Council

with the Department of English at Ryerson University.

https://tophat.com/

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Culture and Leadership: The Nine Principles of Agile Leadership

Agile Leadership is essential if an organisation is to affect true Agile business change. Our first paper on Culture and Leadership explained how the concepts of Communication, Commitment and Collaboration were key; now the Agile Business Consortium has developed these concepts further with the “Nine Principles of Agile Leadership” that support Agile transformations.

This table shows how the nine principles align with those key concepts of Communication, Commitment and Collaboration:

The 3C’s of Agile Leadership

Principle Guidance For

Communication 1 Developing

2 Reflecting

3 LearningCommitment 4 Inspiring

5 Engaging

6 UnifyingCollaboration 7 Empowering

8 Achieving

9 Innovating

Agile Leadership vs Good Leadership In creating these principles, we sought to identify the competencies, capabilities and capacities of an Agile Leader. The purpose is to guide the thinking of our user audience by helping them to discuss what Agile Leadership means in the context of their organisation. Many of our readers may think that Agile Leadership is just “Good Leadership” and we have just added “Agile”. We believe that this is not the case and that Agile Leadership

feels very different to, say, traditional leadership. The differences are in leadership style and the willingness to expand capacity and extend capabilities to be more Agile. This also feels very different to leadership where leaders are going through the motions of just doing Agile because of some wider directive.

We believe Agile Leadership is more than just “good leadership”; we would argue that it is “Great Leadership” that gets better! Consider the following:

Agile Leadership as a Continuum An Agile mindset does not see things in a polarised view i.e. Agile or not. Agility is not an all or nothing quality but instead should be considered on a continuum. The Agile Leader is one who adapts, yet there are many good leaders in organisations who rarely adapt. Some leaders have a command and control style of leadership, but that is not to say they are bad leaders. However, many of these leaders find it harder than others to adapt because of their mindset (See Principle 1). Agile Leadership is something that varies and improves over time. We feel the principles go some way to describing what we consider Agile Leadership to be. We have tested these principles with a wide audience of leaders and practitioners and they have assured us that while considered to be an evolving set of principles, they are a useful start for any senior executive or manager engaging in the work of transforming their organisation into an Agile one.

AgilePM and AgilePgM are registered trademarks of Agile Business Consortium Limited©2017 Agile Business Consortium Limited

Introduction

AgilePM and AgilePgM are registered trademarks of Agile Business Consortium Limited©2017 Agile Business Consortium Limited

The Nine Principles of Agile Leadership

Agile Business Consortium, International House, Dover Place, Ashford, Kent TN23 1HUTel: + 44 (0)1233 611162 | [email protected] | agilebusiness.org

1. Actions speak louder than words Agile Leadership is about not only driving and promoting change, it is also about being the change. Those who lead by example and actively engage in their own development, inspire people. This is through action rather than words; as Gandhi said, “Be the change you want to see”. Agile Leaders develop themselves to be humble and empathetic by demonstrating virtues such as compassion, kindness and care for their colleagues. Inspiring leaders work on themselves first before working on others.

2. Improved quality of thinking leads to improved outcomes Agile Leaders value high quality thinking which will result in meaningful action. Agile Leaders view problems from many different angles. They take input from those closest to the problem and this goes some way to ensuring that they are in touch with reality rather than relying solely on electronic information to inform their decision making. This also means allowing thinking time and focusing on the highest priorities at any given time.

3. Organisations improve through effective feedback Receiving feedback can often be perceived as a negative experience, so Agile Leaders lead the way by courageously soliciting meaningful, useful and timely feedback from peers and other colleagues. While requesting feedback is important, Agile Leaders take time to ensure that they are visibly responding to the suggestions made by their colleagues in order to close the feedback loop. Agile Leaders model giving effective feedback that is open, honest and respectful.

4. People require meaning and purpose to make work fulfilling Agile Leaders focus on building and sharing a common understanding and purpose. There is a vision of change that is meaningful and applicable to the organisation. The work of the Agile Leader is to be aware of what is in the hearts and minds of their colleagues, and then to unify and align those values into inspired action.

5. Emotion is a foundation to enhanced creativity and innovation Agile Leaders inspire others to bring their best selves to their work. They understand that emotion is an important part of the human experience, and when individuals work with their emotions, they achieve more of their potential. Innovation and creativity rely heavily on respect that the Agile Leader encourages by being accessible, open, honest and transparent whilst expecting the same from others.

6. Leadership lives everywhere in the organisation Agile Leadership should permeate all aspects of an organisation or change initiative. Realising the leadership potential of all its people helps accelerate the organisation’s ability to learn and adapt. The work of an Agile Leader is to develop depth in the organisation’s leadership capability by providing opportunities for their people to lead. Mentoring tomorrow’s leaders in the principles and practices of servant leadership sows the seeds for the Agile culture to thrive.

7. Leaders devolve appropriate power and authority Agile Leaders recognise that people work best when they are enabled, engaged and energised. Empowering individuals is a necessary skill of the Agile Leader as they balance the emerging needs and tensions of the organisation. Agile Leaders recognise that empowerment is not an “all or nothing” concept. Instead, it is a continuum of leadership behaviour that responds to the current context for change.

8. Collaborative communities achieve more than individuals Agile Leaders build communities based on high trust, respect and meaningful working relationships. Their role is to provide those communities with all that they need to operate efficiently but then to let them function autonomously within their boundaries. The Agile Leader understands that forgiveness, positivity, generosity and gratitude are important parts of a healthy working environment. The healthy functioning of the group together with the preservation of psychological safety allow the Agile Leader to encourage learning and development whilst also balancing sustained output and performance for the benefit of the organisation.

9. Great ideas can come from anywhere in the Organisation People who are close to a problem usually have the best ideas about how to solve it. Agile Leaders allow themselves to be open to the influence and ideas of others, regardless of their status or position. To this end, the Agile Leader stops, listens and gives time to really hear the thoughts and ideas for improvement from their colleagues. Even if some ideas are not used, the Agile Leader encourages a continuous flow of creativity by helping people to understand which ideas were useful and which were not.

Your Feedback is Welcome The work of the Agile Business Consortium is ongoing and we always welcome feedback; the continued collaboration between user organisations and the Consortium’s ‘Culture and Leadership’ stream will ensure we deliver the greatest value to our membership and the wider business community.

© 2018 Agile Business Consortium Limited

Being the ChangeIt is no coincidence that this is the first of our Agile Leadership principles. Wise leaders “pay careful attention to group processes. Such leaders know how to calm anxieties and when to arouse hopes and aspirations. They know how to transform personal needs into societal demands; they know how to liberate human energy and inspire people to positive action.”1

For many leaders some of these behaviours or ”knowings” do not come naturally. To that end, the Agile Leader is one who engages in their own personal development to further grow these skills. Personal development will of course mean different things to different people, but one thing is common to all these leaders: people cannot be expected to “do or be more” unless the leaders set an example and actively engage to embody the change that they expect to see in their colleagues. Otherwise, colleagues will lose faith and trust in leaders who do not lead by example.

Many senior leaders have great intentions when they initiate transformation programmes, but the focus is often

perceived to be somewhere below them in the hierarchy. Coaches and consultants are brought in to help bring about new behaviour changes in others, but rarely does change focus on the senior leadership. It is almost as if leaders are giving the message that the problems reside elsewhere.

This passing of responsibility causes challenges for the change initiative. Individuals who are being asked to change (again) become more and more impatient with their leaders as they seem to take a narrow, non-systems approach to the problems they are facing i.e. leadership behaviour is part of the systemic and complex problems we are facing.

Unless leadership is fully engaged in their own change efforts, there will be no effective sustainable transformation. This gives a whole new meaning to leading change:

Agile Leaders lead change by engaging in the courageous behaviour of developing themselves

Agile Leadership: Principle 1 Principle 1: Actions speak louder than words - authenticity; leader as learner; being the change; living the Agile values

Agile Leaders develop themselves to be humble and empathetic by demonstrating virtues such as compassion, kindness and care for their colleagues. Inspiring leaders work on themselves first before working on others.

Agile Leadership is not only about driving and promoting change, it is also about being the change. People are inspired by those who lead by example and actively engage in their own development. This is through action rather than words; as Gandhi said “Be the change you want to see”.

© 2018 Agile Business Consortium Limited Agile Business Consortium, International House, Dover Place, Ashford, Kent TN23 1HUTel: + 44 (0)1233 611162 | [email protected] | agilebusiness.org

Agile Leadership isn’t a destination… it’s a journeyAs the diagram shows, there are many destinations that leaders can travel to when engaging in their own personal change journey. These are just some suggestions of the types of learning that leaders can engage in. The one common theme amongst these suggestions is that they are all people related. It is strongly recommended that during times of transformation the leader has access to coaches who can help them to work on their own behaviours and mindset; this way, their development can be tailored to the individual’s own specific needs rather than being based on generic leadership guidance. One of the key advantages of engaging in a coaching programme for the organisation’s leadership, is that the leaders themselves will be held accountable for their own improvement and learning. Wise leaders will also then employ Principle 3 (Effective Feedback), taking on feedback to help their development. This is something that many leaders find very difficult if they believe that they need to be seen to be perfect and thus be above receiving feedback from anywhere lower in the hierarchy.

This is a call for humble leaders, those who can inspire people with their own presence and behaviours

Part of this personal journey should also include developing the team dynamic. Agile Leaders will expect their people to work more effectively by collaborating within their teams; this is where Agile practices really pay dividends. The notion of a high-performing team is considered to be one where the whole exceeds the sum of the parts. An element missing from the original Agile Manifesto is “Relationships”. The complexity lies in the relationships, so engaging the leadership team in building better relationships starts in their own team and ripples through the organisation.

Are true leaders born and can they be grown?The “nature versus nurture” debate has persisted in academia and leadership practice for decades. While it cannot be disputed that some people have more innate talent as leaders than others, many great leaders have had to work at being better leaders.

Any practitioner of Agile change will demonstrate the Incremental Mindset. The Incremental Mindset is prepared to make mistakes and learns to improve over time; learning is an exciting challenge and adventure bringing its own joy and fulfillment. This is in opposition to what is referred to as an Entity Mindset, which believes people are born with only a certain amount of intelligence and it doesn’t change. People with an Incremental Mindset approach change differently and are usually much better at adapting to change. Their development as leaders is important to them, and as such, they invest time and energy in developing their leadership agility.

True Agile Leaders can be grown and developed.

“Be the change you want to see” - Gandhi

Leading AgileChange

(Making Changewith a Difference)

LeadershipAgile

ComplexityThinking

MindfulLeadershipEmotional

Intelligence

(Developing AgileMindset and Psychology)

(Advanced Problem Solving)

(Developing emotionalcapabilites)

(Presence and beingin the now)

FiGure 1: “Plot your own Agile Leadership Success”

Sources1. Kets de Vries, M.F.R., 2013. The Eight Archetypes of Leadership - Harvard Business Review


Take TimeOne of the main complaints in many organisations is that there isn’t enough time. As a result, people don’t give themselves adequate time to digest information between meetings as they rush from one to another. This lack of time affects the organisation in many ways; one of the key impacts of rushing is that many people go about the business of solving problems in exactly the ways that they have done in the past. However, the world in which business operates today is much more complex than ever before. Today the activities of problem solving and decision making require much more thought, both diagnosing the problem and then crafting the solution.

The Agile Leader embraces two complementary approaches:

1. Mindfulness1

2. ComplexitythinkingandtheCynefin(pronouncedku-nev-in)framework2

Mindful LeadingPrinciple 1 states that part of the Agile Leader’s development is to become a mindful leader. There are many advantages for leaders adopting a mindful approach3. One is slowing down and building an awareness of “what is” happening rather than “what I think” is happening. Focusing attention more fully and completely ontheexternalworld(asopposedtotheinnerworldofthoughts,emotions,andsensations)buildsgreaterawareness of themes, emergent patterns, coincidences and so on.

Organisations that embark on mindfulness programmes develop leaders who have:

Improved focus, concentration and clarity

Moreresilienceandselfconfidence

A more accepting attitude

Increasedself-controlandabilitytoengage

Enhanced communication and relationship skills

Betterdecision-makingabilities

As a result, mindful leaders develop empathy with their teams and the ability to inspire trust.

Agile Leadership: Principle 2 Principle 2: Improved quality of thinking leads to improved outcomes - mindfulness; complexity thinking; taking time

Agile Leaders value high-quality thinking which will result in meaningful action. Agile Leaders view problems from many different angles. They take input from those closest to the problem and this goes some way to ensuring that they are in touch with reality rather than relying solely on electronic information to inform their decision making. This also means allowing thinking time and focusing on the highest priorities at any given time.


Cynefin FrameworkAchieving a state of mindfulness allows a leader to see what type of problem needs to be solved: simple, complicated, complex or chaoticasdefinedbytheCynefinframework.

ThediagramshowstheCynefinframework.This framework helps leaders to understand the context within which they seek to solve their problem and how to react accordingly. Forinstance,theright-handquadrantsare ordered, they are cause and effect relationships. Simple cause and effect is where the solution is self evident, predictable and repeatable. By contrast, the complicated problem requires much thought and analysis becausethesolutionisn’tself-evident.

Theleft-handquadrantsaretheunorderedtypes of problems. Complex problems are not governed by cause and effect relationships as the results are quite often unrepeatable. Chaotic problems, like complex ones, are unordered but are also unpredictable.

As the diagram shows, the context of any problem has to be approached differently. For instance, change management aspracticedinmanyorganisationstendstofollowtheapproachofSense-Analyze-Respond.Thisapproachreliesonexpertswhounderstandtheproblemandcanpredictoutcomesbasedondeepthinking.Thisapproachisflawedifapplied to the complex domain where there are too many unknowns. Instead, the complex problem should be tested withmanyexperiments(probing)tohelpmovefromunknownresponsestoknownones,i.e.tomovepartsoftheproblem back into the complicated space which has more predictability. This approach is in line with an Agile process to change as it recognises that “shift happens”.

Thinking habits that get in the wayWhile frameworks can be useful to guide thinking, leaders mustalsobeawarethatthinkingcanbecomehabit-based.Such patterns of thinking often go undetected as they occur outside of the conscious mind.

Taking time and having a more mindful approach to problem solving and decision making is a hallmark of Agile Leadership. By taking time, focusing on agreed priorities and approaching a problem from multiple perspectives,

the Agile Leader has the best chance of making the right decision – as well as giving them the opportunity to identify and change any thinking patterns that might impede performance in themselves and in others.

Frameworks are useful but don’t get stuck in them!

Sources1. Institute for Mindful Leadership - www.instituteformindfulleadership.org

2. Leader’s Framework for Decision Making - 2) Snowden, D. & Boone, M. A - Harvard Business Review (November 2007)

3. Research into mindfulness - Institute for Mindful Leadership has shown mindfulness to improve focus, personal productivity, performance under pressure, employee satisfaction, ability to prioritise.

ComplexProbeSense

RespondEmergent

ComplicatedSense

AnalyseRespond

Good Practice

ChaoticAct

SenseRespondNovel

SimpleSense

CategoriseRespond

Best Practice

Disorder


Feedback is a critical ingredient of continuous improvement and without it, little or no learning would take place in the organisation. For Agile Leaders, the emphasis in this principle is the word effective. Even when feedback has been given, much of it goes unheeded and this is due in part to ineffective delivery. The openness of the recipient is also an important factor although an effective leader will be able to work with the defensiveness of their colleagues in most cases.

Being the Model LeaderPrinciple 1 states that it is important for the Agile Leader to “be the change” for their colleagues. They can do this by demonstrating their willingness to receive and act upon feedback. Feedback is requested continually and not just when things are going well but, even more importantly, when things haven’t gone so well. It’s when plans or intentions haven’t produced the desired or expected outputs that leaders need to become more curious to discover what happened. Whilst it takes courage, this is a good way to demonstrate to colleagues what an Agile Leader would expect from others.

ING Direct Canada does a fantastic job of empowering employees. The employees have no job titles and no offices. Anyone can talk to anyone and leaders focus on removing obstacles instead of creating them. Their CEO welcomes any feedback and input from the team, whether it be negative or positive and employees aren’t policed on their collaborative environment.1

What is effective feedback?Effective feedback is defined as that which makes a meaningful difference either in the behaviours or thinking of individuals or teams who have received the feedback. It’s about helping others to develop their blind spot or Blind Area2 in the Johari window shown here. To that end, there are certain things the Agile Leader can do to improve the effectiveness of the feedback they deliver. One is to make sure the team receives feedback on all levels, such as providing task and procedural feedback (“how we did in the task”) as well as relational feedback (“how we got on while performing the task”).

Receiving feedback can often be perceived as a negative experience so Agile Leaders lead the way by courageously soliciting meaningful, useful and timely feedback from peers and other colleagues. While requesting feedback is important, Agile Leaders take time to ensure that they are visibly responding to the suggestions made by their colleagues in order to close the feedback loop. Agile Leaders model giving effective feedback that is open, honest and respectful.

Agile Leadership: Principle 3Principle 3: Organisations improve through effective feedback - levels of feedback; giving and receiving feedback; feedback as a habit


Feedback forms an integral part of the learning process. Agile Leaders make opportunities to improve the learning of their teams by giving feedback. Giving feedback at an individual level is a common occurrence, but not as frequent at the team level. This is an example of how the Agile Leader can work effectively as a coach for their team; to act as a mirror for the team to reflect on themselves.

Giving and receiving feedback strengthens trust between team members as their shared goal becomes bigger than individual or group concerns. As a result, performance is enhanced in teams where there is good communication and understanding of what they are working on and how they can get better.

Sources1. The 12 Habits Of Highly Collaborative Organizations - Jacob Morgan, Forbes, July 2013

2. The Johari window, a graphic model of interpersonal awareness - Luft, J.; Ingham, H. (1955). Proceedings of the western training laboratory in group development. Los Angeles: University of California, Los Angeles.

3. Teaching Smart People to Learn - Argyris, C., Harvard Business Review, May 1991.

Six Criteria for Effective FeedbackFinally, here are some helpful hints for the Agile Leader when giving feedback:

1. You, as the feedback provider, are credible and trusted in the eyes of the recipient

2. Your feedback is conveyed with good intentions

3. The timing and circumstances are appropriate

4. The feedback is given in an interactive way, with a chance to question

5. The feedback message is clear

6. The feedback is helpful to the recipient

What about Receiving Feedback?Feedback is a two-way communication process and sometimes the feedback will be given to someone who is unreceptive. One of the major impediments to organisational improvement is the leader who is closed off to feedback and is too concerned with self-preservation [Argyris].3

As Principle 1 outlines, Agile Leaders need to embody the change they want to see in the organisation. This means that as part of their personal development they need to become aware of how and when they are becoming defensive as well as being able to spot it in others. Being defensive leaves a leader closed to hearing feedback that could help them. Quite often a tough truth is a hard one to hear but is one that can help.

Two Models of FeedbackIn any organisation there will be a spectrum of feedback (which will inevitably vary by department and by leader) – this diagram highlights the two ends of that feedback spectrum:

The Agile Leader will introduce opportunities for continuous and open feedback, using the Virtuous Circle as their model.

Infrequentawkwardfeedback

Vicious Circle Virtuous Circle

UntimelySurprising

Demotivating

ConfusionDefensiveness

Worseperformance

Frequentopen

feedback

Understandingopenness better

performance

TimelyNo surprisesMotivating

FiguRE 1: “The Johari Window” Adapted from Luft, J., Ingham, H (1955)

Open/Free Area Blind Area

Hidden AreaUnknown Area

Known to Self Unknown to Self

Known to Others

Unknown to Others


A surprising number of people don’t find their work life fulfilling. A YouGov survey1 revealed that 37% of British workers are dissatisfied with their jobs. The survey doesn’t reveal the cause of dissatisfaction. However, the field of psychology offers an understanding of why this might be the case.

Meaning and Purpose are important motivatorsDaniel Pink identifies three important factors that improve motivation at work. These are autonomy, mastery and purpose.

“Autonomous people working towards mastery perform at very high levels. But those who do so in the service of some greater objective can achieve even more.”2

The notion of purpose however, is highly subjective, as is the meaning that individuals perceive about their experience. This often leads to tensions in teams and organisations as people make compromises on what is important to them. This results in demotivation affecting individuals and teams who may feel disenfranchised as their values are relegated or dismissed as being unimportant.

“We’re here to put a dent in the universe. Otherwise why else even be here?”

- Steve Jobs

Individual ValuesValues are the principles that guide individual and group behaviour. Values operate at many different levels as shown in the diagram here. If, as individuals, we are acting congruently with our values (our values align with our work), our lives seem to flow more easily, we are more energised, motivated and even inspired. On the other hand, if we aren’t acting in alignment with our values (incongruent) then our lives tend to be stressed, things don’t flow and we have a conscious feeling that something isn’t right, although we may not know exactly what the issue is. This is termed a “values conflict” when we are not fully aligned, or behaving according to our values. In fact, we are living out another value in place of the one we have previously identified as more important to us.

Agile Leadership: Principle 4Principle 4: People require meaning and purpose to make work fulfilling - purpose; meaning; engagement; fulfillment; motivation; values

Customer Values

Brand Values A

Brand Values B

OrganisationalValues Support

FunctionsValues

ShareholderValues

ExecTeam

Values

Board ofDirectors

Values

Cultural/Societal Values

TeamFull Alignment

Partial alignment of individualswith team values

The Outsider:total conflict with team values

Agile Leaders focus on building and sharing a common understanding and purpose. There is a vision of change that is meaningful and applicable to the organisation. The work of the Agile Leader is to be aware of what is in the hearts and minds of their colleagues then to unify and align those values into inspired action.


Organisational/Group ValuesValues are an extremely important part of organisational life, but are often downplayed or underused. Organisations should approach the exercise of eliciting values as more than a tick box activity, otherwise they miss a great opportunity to engage and inspire the wider organisational community. It’s not just about choosing values that sound good, it’s an opportunity to get all the people working together towards a common goal.

It is important, therefore, for Agile Leaders at all levels of the organisation to be mindful of the fact that values operate at all levels – and will vary by person and the role they perform. More importantly they need to be aware of where potential conflicts exist and work towards their resolution.

The Agile Leader will make sure that a team’s values are understood, agreed and continually aligned

This is the underlying secret in helping a team to work with purpose and meaning.

Recruiting the Right ValuesWorkplace values drive the attitudes and behaviors that the Agile Leader wants to see within their team. These values should include respecting others, keeping promises, showing personal accountability, and providing excellent customer service.

It is important to identify and understand the workplace values of successful team members, so that the Agile Leader can select new recruits who share these values. When interviewing new recruits, the Agile Leader will ask focused interview questions, use role-playing scenarios and tools, look at past history, and use psychometric tests to find new recruits with the best cultural fit.3

The Usefulness of Values Tensions As the diagram above shows, team values consist of the various individual values; at times compromises are made on personal values in order to remain “part of the team”. Too much compromise will result in high levels of individual dissatisfaction and will eventually result in factions and cliques forming. The ultimate result will be people leaving the team or organisation. Evidence shows that performance will dip where this type of conflict exists; this is what Tuckman refers to as “Group Storming”4. However, once the conflict is resolved, rather than avoided or denied, the team will be stronger. This is achieved either by re-embedding the current values or by taking on new values that allow the group to evolve, living the new value through different behaviours.

The Agile Leader is skilled at helping resolve conflicts by facilitating, coaching and inspiring the team to resolve them for themselves, so creating an environment of shared values

Sources1. Survey into Worklife Fulfillment: - YouGov 2015 d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/g0h77ytkkm/Opi_InternalResults_150811_Work_W.pdf

2. The surprising truth about what motivates us - Pink, D. 2009 Drive. Canongate Books (paperback 2011 edition) p133

3. Understanding Workplace Values - mindtools.com/pages/article/understanding-workplace-values.htm pressure, employee satisfaction, ability to prioritise.

4. Developmental sequence in small groups - Tuckman, Bruce W. Psychological Bulletin, Vol 63(6), Jun 1965, 384-399


“Innovation happens best when we reduce our fears and ego defensiveness, thereby freeing our minds to imagine, create, connect, and explore the new and unknown with others in a non-competitive way. That happens best when people feel psychologically safe and trust each other. It is all about emotions.”1

However, there is a myth that says emotions should be left at home. Would that be helpful to organisational life? Would the Agile Leader choose to ask people to come to work without excitement, joy or enthusiasm?

Creativity at workCreativity is increasingly seen as vital to competitive advantage. Leaders are under growing pressure to generate creative output. People’s moods and emotions influence several critical elements in organisations, from creativity to performance, to collaboration and decision making.

A recent study has shown that positive moods help with creative tasks and are likely to lead to more receptive, big picture thinking.2

“Empathetic, emotionally intelligent work environments have a good track record of increasing creativity, improving problem solving and raising productivity.”3

However a balance needs to be struck. Positive emotions encourage open-mindedness and flexibility and so help generate more creative solutions, connections with others and help focus on achieving goals. Neutral or slightly negative emotions do have their place - they narrow the attention and help detect mistakes, assess risks and evaluate plans, resulting in more careful and better quality arguments.

Agile Leadership: Principle 5 Principle 5: Emotion is a foundation to enhanced creativity and innovation - emotion; emotional intelligence; motivation; creativity

Agile Leaders inspire others to bring their best selves to their work. They understand that emotion is an important part of the human experience and when individuals work with their emotions, they achieve more of their potential. Innovation and creativity rely heavily on respect that the Agile Leader encourages by being accessible, open, honest and transparent whilst expecting the same from others.


Just leave the negative emotions at homeOn the other hand, highly negative emotions such as anger, frustration, sadness or fear are considered unhelpful in a working environment. It’s easy to confuse “emotion” with “emotional”. Emotional is usually a term reserved for those people who easily express a range of emotions in public or those who are considered enthusiastic-overreactors 4; in these terms, emotional behaviour is not helpful in workplace situations.

When faced with someone else’s negative emotions, some people will tend to change their own emotional state, quite often to a state that mirrors the other: frustration rewarded with more frustration, anger with anger, sadness with sadness and so on. Others may find these uncomfortable emotions too difficult to deal with and will move away from their source, either by literally walking away or by withdrawing emotionally in order to protect themselves. It is easy to see why people are asked to leave their emotions at home, emotions appear to be the cause of the “bad stuff” that happens in the workplace.

Removing barriers to creativityResearch has shown a number of environmental factors that block creativity; these include criticising new ideas, political problems within the organisation, an emphasis on the status quo, a conservative low risk attitude among top management and excessive time pressure4.

“People are most creative when they feel motivated primarily by the interest, enjoyment, satisfaction, and challenge of the work itself”

The Agile Leader has a responsibility to remove those blockages to creativity, to encourage motivation and to ensure an environment that is safe for teams to thrive.

The Role of the Agile LeaderPositive emotions will spread organically throughout organisations, amongst team members and to customers; encouraging positive emotions will help individuals contribute more creatively to the effectiveness of their organisation.

The role of the Agile Leader is to balance support for new and creative ideas whilst managing risk in a way that doesn’t affect the stability of the organisation – critically though they have to remain open continuously to the possibilities that enhanced creativity and innovation can bring.

Sources1. Research report impact of emotions on creativity - langleygroup.com.au/work/research-report-impact-of-emotions-on-creativity

2. Here’s Why Emotions are the Secret Sauce of Innovation - Ed Hess , Forbes, January 2017

3. Emotional Intelligence: Why It Can Matter More Than IQ - Daniel Goleman

4. Personality Adaptations - Joines, V. and Stewart, I. (2002), Lifespace Publishing, Kegworth


Agile Leadership needs to live and breathe at all levels of an organisation, rather than being something that is found only at the pinnacle. This is especially important during times of change. Leadership should apply at all levels in the organisation. It is not just something done by the leaders, i.e. a person who leads a team, a group or an organisation. This principle is about seeing leadership differently. Agile Leadership always starts first by looking at Self (individual level). Individuals are part of teams or groups which in turn sit within an organisation. An organisation itself is part of the wider society, community and the country in which it operates. This whole ecosystem can be seen as a complex adaptive system, dynamic and continuously evolving.

Self-Leadership is about having a developed sense of who you are, what you can do and where you are going. This is coupled with the ability to influence communication, emotions and behaviours on the way to getting there. Agile Leaders are those who take personal responsibility for their actions and hold themselves accountable for their decisions. They lead by example and encourage colleagues to behave in the same way.

Team and Group Leadership is about exploring what principles need to be in place for teams or groups to be self-organising and manage change. The work of the Agile Leader is to create an environment where people can realise their potential. Agile Leaders develop leaders; they encourage their colleagues to take responsibility and hold themselves accountable for actions and decisions.

Organisational Leadership is about creating and sustaining a culture where individuals, teams and groups can evolve from doing Agile to being Agile. It is also about recognising and understanding that leadership development is an ongoing practice. This requires commitment to investment in a continuous process of leadership development. By having leadership development pipelines in place, organisations can help individuals realise their potential through developing their Agile Leadership knowledge, skills and capabilities.

Agile Leadership: Principle 6Principle 6: Leadership lives everywhere in the organisation - self-awareness; responsibility; commitment; servant leadership; mentoring

Agile Leadership should permeate all aspects of an organisation or change initiative. Realising the leadership potential of all its people helps accelerate the organisation’s ability to learn and adapt. The work of an Agile Leader is to develop depth in the organisation’s leadership capability by providing opportunities for their people to lead. Mentoring tomorrow’s leaders in the principles and practices of servant leadership sows the seeds for the agile culture to thrive.

Self

Team/Group

Organisation

Society

Leadership livesat all levels

Leadershipdevelopment


To deal with complexity, the journey has to start with ourselves as individuals; only then can one lead the teams, groups and organisations effectively in an agile way.

Servant Leadership Servant Leadership fits the Agile Leadership model well as it is both a leadership philosophy and set of leadership practices. Traditional leadership generally involves the accumulation and exercise of power by one at the “top of the pyramid.” By comparison, the servant-leader shares power, puts the needs of others first and helps people to develop and perform as highly as possible.1

“The only way to lead when you don’t have control is you lead through the power of your relationships. You can deal with the unknown only if you have enormous levels of trust, and if you’re working together and bringing out the best in people. I don’t know of any other model that can truly work in the world right now except servant-leadership.”2

The Agile Leader as MentorThe Agile Leader will take responsibility for bringing on all members of the team, helping them develop to their full potential. In this role of mentor the Agile Leader needs to demonstrate active listening skills and the ability to ask challenging questions. A good mentor also needs to be comfortable being challenged themselves and must be able to give and receive valuable feedback, as discussed in Principle 3.

To be an effective mentor the leader must demonstrate emotional intelligence, self-awareness, empathy, motivation and mindfulness… all characteristics highlighted in the 9 Principles of Agile Leadership.

“….being a mentor is no longer an unnecessary, expendable task. Instead it will be a rewarding one for you that has a profound impact on others.”3

Agile Leadership integrates Servant Leadership, mentoring and personal development; it is an ongoing commitment to developing yourself and your people at all levels in all aspects of leadership.

Sources1. Definition from Wikipedia

2. The Servant -Leader: From Hero to Host - Margaret Wheatley, 2002

3. Seven Ways To Be An Effective Mentor - E. Wayne Hart, Forbes, June 2010


EmpowermentEmployee empowerment is a philosophy and a set of leadership practices that deliver real benefits for an organisation. The underlying principle gives employees the freedom, flexibility and power to make decisions and solve problems. It also holds them responsible and accountable for the outcomes of their actions, leaving colleagues feeling energised, capable, and determined to make the organisation successful.

The Benefits of EmpowermentResearch has shown that empowerment has a positive impact on an organisation’s quality of work, employee satisfaction, collaboration, productivity, and costs.

Employees with the freedom and flexibility to make a difference deliver higher quality work

Higher job satisfaction levels are found in empowered organisations

Empowered employees have increased self-confidence and ability to collaborate with others

Empowerment gives a sense of increased responsibility, accountability, and ownership, resulting in increased productivity

Empowering employees reduces organisational costs, for example employee turnover and retention costs

All of these benefits help organisations achieve an extra edge, to outperform their competitors and to gain market share.1

As employee satisfaction increases for empowered employees, their sense of loyalty and dedication to their job and the organisation also increases. Empowerment results in more engagement, longer-term employees and improved retention rates; this keeps experience and reduces employee turnover costs.2

HCL Technologies’ empowerment philosophy has enabled the company to provide innovative, high-quality service to their customers, resulting in revenues tripling and customer satisfaction increasing by 73% in the last 5 years. HCL’s empowered employees take personal pride in their work and responsibility for doing a good job.

Empowering Colleagues EffectivelyEmpowerment is not an “all or nothing” concept. The diagram shows the Continuum of Empowerment3 which is a good place for Agile Leaders to start when considering the degree to which they can empower their colleagues (though the term “Empowers” is preferable to “Abdicates” at the top tier!).

The diagram shows a pragmatic way of empowering individuals and teams that requires an understanding of the context, to allow the appropriate level of empowerment to be applied.

Agile Leadership: Principle 7Principle 7: Leaders devolve appropriate power and authority - enablement; empowerment; engagement; humility

Agile Leaders recognise that people work best when they are enabled, engaged and energised. Empowering individuals is a necessary skill of the Agile Leader as they balance the emerging needs and tensions of the organisation. Agile Leaders recognise that empowerment is not an “all or nothing” concept. Instead, it is a continuum of leadership behaviour that responds to the current context for change.


Comparisons of Delegation and Empowerment

Delegation Defined area of freedom An aspect of management Tighter job description Off loading of management

duties Training and development

if personnel Acceptance of dependency

relationship Depends on management

staff relationship &leadership

Empowerment

Greater freedom Autonomy Greater self control An aspect of leadership Manager act as facilitator A staff development tool Loose job description

Tannenbaum and Schmidt Continuum of Empowerment

High use of authorityby manager

High area of freedomfor teams

Tells

Sells

Suggests

Consults

Joins

Delegates

Abdicates

The Agile Leader knows that empowerment has to be applied carefully and not be seen as an opportunity to devolve responsibilities to people who do not have the authority, capability or knowledge to deliver. Unless individuals have a clear idea of their responsibilities and accountabilities empowerment causes more confusion and ends up demotivating individuals rather than motivating or inspiring them. Empowerment has to be a negotiable dialogue where the Agile Leader gives enough power to colleagues, not only to achieve their goals in a more timely fashion but also to consider their development needs. This is where Principle 2 (Improved quality of thinking leads to improved outcomes) applies; taking time to think through how much empowerment is necessary and appropriate for each team as it delivers its goals. The intended outcomes might not always be achieved, and it may not be possible to foresee the pitfalls that these new behaviours may bring about; however, this will provide the team members – and the Agile Leader - with new opportunities to learn and grow.

Empowerment versus DelegationIt is important to distinguish between the concepts of “Empowerment” and “Delegation” as they are two very different things. Delegation entails passing along relatively simple tasks that follow a prescribed process for completion. Empowerment means trusting the employees’ ability to determine the optimal way to solve a problem.As the diagram below shows, delegated responsibility is still controlled and may not provide the necessary authority to decide and to act. Empowerment, on the other hand, assigns degrees of freedom and autonomy to make and act upon decisions.

Embracing ChangeEmpowered employees feel free to challenge the status quo, which is critical for organisations in today’s fast-changing environment. Employees and the organisations they work for can become too complacent, doing things the way they have always done them. Unless employees feel comfortable in questioning the status quo they, and their organisation, are likely to stagnate as competitors move swiftly past them. The Agile Leader will establish an environment where employees feel free to question, to challenge, to offer new ideas – and, crucially, to make their own decisions. This keeps the organisation competitive and benefits the employees’ own development as a result of the empowerment continuum.

A call for Humble LeadershipEmpowerment is a key tool in achieving higher degrees of agility in organisations and in their change initiatives. However, effective empowerment relies on the robust psychology of the Agile Leader. Traditional leaders believe power, status and authority are a natural part of their role; for these types of leaders it is difficult to delegate authority. In some highly political organisations it may be to the individual’s advantage to gain more power. In the Manifesto for Agile Business one of the core values asks leaders to put the needs of the customer above those of their own self-interest. This requires humility and a higher degree of ethics and morals than has been evident in some traditional management approaches.

In summary, organisations with empowered employees reap real economic benefits by delivering high quality products and services that translate to lower costs and higher revenues. The Agile Leader will devolve power and authority to those best placed to make decisions and, in turn, will see the benefits at both the organisation and individual levels.

Sources1. TheBenefitsofEmpoweringEmployees- saylor.org/site/wp-content/uploads/2013/02/BUS208-5.2-The-Benefits-of-Empowering-Employees-FINAL.pdf

2. J.K.:TheElementsofGreatManaging- Wagner, R. & Harter, New York, 2006

3. Howtochoosealeadershippattern- Tannenbaum, R. & Schmidt, W., Harvard Business Review May-June 1973

FigurE 1: “Tannenbaum and Schmidt continuum of empowerment” FigurE 2: “Comparisons of delegation and empowerment”


Why Collaborate?Collaboration is an important aspect of organisational life and is an essential ingredient for enhanced performance, creativity and innovation. However, achieving a more collaborative organisational culture can often be difficult especially when the prevailing culture is one with a silo mentality.

“the most important principle of collaboration isthat it can make the world a better place”1

Collaboration skills help people to work productively with others on any task. Successful collaboration requires a cooperative spirit and mutual respect. Employers typically seek employees who function effectively as part of a team and are willing to balance personal achievement with group goals. In some cases, teams that collaborate may be members of the same department, working on ongoing activities that require coordination or improvement. In other cases, interdepartmental teams are assembled to carry out a special project; or it may be collaboration across organisations or business partners is needed to achieve a mutual goal; and those product/service providers that collaborate closely with their customers will be much more successful than their competitors who do not.

Elements of Successful CollaborationTo promote successful collaboration, the Agile Leader should:

Clearly define and agree the roles of the partners

Communicate openly within teams to share information

Seek consensus on goals and methods for completing the task

Recognise and respect the contribution of everyone

Identify obstacles and address problems cooperatively as they occur

Place group goals above personal ones or recognition

Be prepared to apologise for any mistakes and forgive others for theirs2

Agile Leaders build communities based on high trust, respect and meaningful working relationships. Their role is to provide those communities with all that they need to operate efficiently but then let them function autonomously within their boundaries. The Agile Leader understands that forgiveness, positivity, generosity and gratitude are important parts of a healthy working environment. The healthy functioning of the group together with the preservation of psychological safety allow the Agile Leader to encourage learning and development whilst also balancing sustained output and performance for the benefit of the organisation.

Agile Leadership: Principle 8Principle 8: Collaborative Communities achieve more than individuals - collaboration; trust; teamwork; relationships


Inattention toResults

Avoidance ofAccountability

Lack ofCommitment

Fear ofConflict

Absence ofTrust

An insight into teamdysfunction usingLencioni’s model

Taken from The Five Dysfunctions of a team Patrick Lencioni (2002)

What gets in the way of good collaboration?The defensiveness of people often makes collaboration difficult. Defensiveness is a perfectly natural human response. However, it is dysfunctional when it starts to impede performance and alter our perceptions to the extent that we are no longer in touch with reality. A key role of the Agile Leader is to begin to bring people together and help them to become aware of how their defensive behaviour gets in the way of being more collaborative.

Lencioni’s model3, shown here, helps us to understand that effective teamwork - another word for good collaboration - starts with trust. “Build trust in teams” is the advice given by many experts; whilst this is good advice, it is easier to say than to achieve.

Sources1. The Future Organisation - Jacob Morgan, thefutureorganization.com

2. Collaboration Definition, Skills, and Examples - Alison Doyle, The Balance, March 2017

3. The Five Dysfunctions of a Team - Lencioni, P. (2002)

4. Collaboration: How leaders avoid the traps, create unity, and reap big results - Hansen, M. T., (2009)

Collaboration has to be appropriate Agile Leaders need to understand that collaboration does not provide a silver bullet and in some circumstances it may be wrongly applied’ as Hansen puts it “Bad collaboration is worse than no collaboration.”4

Being an Agile Leader means flexing our behaviour to suit the circumstances. Hansen offers the leader advice on understanding when to collaborate. “When people spend more time networking than getting work done, collaboration destroys results.”(4) To that end, he recommends an approach that he calls disciplined collaboration which consists of three steps:

1. Evaluate opportunities for collaboration

2. Spot barriers for collaboration

3. Tailor collaboration solutions

This is another good example of applying Principle 2 where improving our quality of thinking pays big dividends that result in meaningful action.

Build stronger trust to build collaborative teamsCollaboration must be underpinned by trust. There is no simple or easy way to achieve trust except for the Agile Leader to be trustworthy. The Agile Leader needs not only to drive and promote change by being the change (Principle 1) but also to start to be more trusting of others. That trust will, in turn, be reciprocated.

The process of becoming more trustful is a continuing one that is founded in the roots of a person’s psychology. Lack of trust results in dysfunctional relationships both in our working and private lives. This is why the Agile Leader has to attend to their own issues around trust in order to build more effective relationships. To this end, using experienced coaches that operate from a relational perspective can pay dividends as these types of coaches put relationships at the centre of their coaching practice.

The trust that an Agile Leader creates is the “glue” of strong collaboration

Collaborate for SuccessCollaboration within and between teams, departments, organisations and industry sectors has been shown to drive success – and perhaps the most important collaboration is between an organisation and its customers.

In summary, in a complex and competitive world, product and service providers that collaborate closely with their customers will be much more successful than their competitors who do not.


A Call for IdeasPrinciple 8 (Collaborative communities achieve more than individuals) shows why Agile Leaders should create collaborative communities and highlights trust as the essential ingredient. Principle 9 takes this one stage further and asks leaders to trust their people to come up with creative solutions to the problems they are facing.

Yet one of the most pervasive myths found in organisations is that the people at the top are the only ones that can come up with the best ideas. However, many of the C-suite executives are often too far removed from the reality of day-to-day life in the organisation to know what their people have to contend with.

This principle is a call for Agile Leaders to engage all their colleagues when seeking creative solutions to organisational challenges.

Unwillingness to adopt ideas because they originate from othersThe reality of organisational life is such that many ideas from the brightest people go to waste because they are not heard or their ideas are ignored. Individuals can become frustrated when they believe their leaders ignore or dismiss their ideas. This situation is exacerbated when external consultants are brought in to help the organisation and recommend these same ideas that are then taken on board.

This attitude and behaviour does little to build confidence and morale in colleagues and often creates the opposite effect. People are unlikely to continue to give their best thinking if ideas are not taken seriously or are rejected because they came from a source other than a director or senior manager. Communication is a common theme in Agile Leadership, often taken to be the spoken word or written message. However, communication by example or by behaviour can be the most damaging because colleagues inevitably take meaning from the actions and attitudes of their leaders.

42% of employees have no idea where to submit an idea when it comes to them. And 80% have never been rewarded for a good idea they put forward.1

People who are close to a problem usually have the best ideas about how to solve it. Agile Leaders allow themselves to be open to the influence and ideas of others, regardless of their status or position. To this end, the Agile Leader stops, listens and gives time to really hear the thoughts and ideas for improvement from their colleagues. Even if some ideas are not used, the Agile Leader encourages a continuous flow of creativity by helping people to understand which ideas were useful and which were not.

Agile Leadership: Principle 9Principle 9: Great ideas can come from anywhere in the organisation - trust; flow of creativity; openness; feedback; recognition


The importance of feedback and rewardTo encourage feedback and the generation of ideas, the Agile Leader needs to create an environment of trust and collaboration (Principle 8) as a foundation. The ability of all members of a team to input their ideas and to contribute to improved performance will be enhanced if the leader is seen to promote open and honest feedback (in both directions, per Principle 3); this can be further enhanced through recognition and reward schemes that praise publicly the contributions made by any member of the organisation

As well as formal recognition programmes, the Agile Leader has the ultimate (and free!) tool at their disposal – the ability to say ‘thank you’, to say it in public…. and to do so with genuine gratitude.

The Agile Leader encourages feedback and ideas from all parts of the organisation and does so through both formal systems (such as employee recognition schemes) and through their behaviour (openness, approachability and willingness to praise)

Sources1. P&MM Motivation website -

2. The fifth discipline fieldbook: Strategies and tools for building a learning organisation - Senge, P. et al (1994)

3. Action Learning - Revans, R. (1980), Frederick Muller Ltd

Engage colleagues and build more value in the organisationSo how does the Agile Leader create an environment where ideas are generated and acknowledged from all parts of the organisation? The diagram here shows the Team Learning Cycle.2 This model builds on an approach called Action Learning3 which is easy to apply to any organisation and follows some simple rules.

A Team Learning Cycle

CoordinatedAction

PublicReflection

JointPlanning

SharedMeaning

This need not be “joint action” but can be carried out by the individuals of the team. Coordination may be achieved through a stand-up with the frequency agreed by team

Taken from Senge et al 1994 and adapted by Mark Buchan

Public because each individual in the group shares their mental models, beliefs and assumptions. Challenge is relentless but gentle

The team designs and plans the experiments to bring about the change. Team will also agree their “working agreement”

As common ground is established the team comes to a mutual understanding around the problem or issue. May also be referred to as shared insight

Agile Leaders can encourage several of these types of learning groups across the organisation in order to facilitate and promote learning. When well facilitated, these groups become a fun and inspiring way to help individuals develop and to start to shift the culture of an organisation.

The final word goes to Professor Edgar Schein of MIT Sloan School of Management:

“…..if you go through a big torturous process of giving them (employees) more recreation, nicer place, more privileges, all sorts of stuff and the boss still treats them as a non-entity, then you are not going to get anywhere.”

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3 Ways AI Could Totally Change Healthcare AI could help companies develop drugs faster, assist with diagnosing patients, and reduce ballooning healthcare costs.

Chris Neiger (TMFNewsie)

May 13, 2018 at 11:12AM Most of the time, artificial intelligence (AI) is discussed with respect to how it will make our technology devices better, how it'll usher in driverless cars, or even how dangerous it could be for warfare. But AI capabilities could also drastically improve the efficiency and quality of healthcare.

Algorithms, image recognition technology, natural-language processing, and other AI technologies could end up making our healthcare cheaper, speed up the time it takes to develop new drugs, and even help diagnose diseases in collaboration with doctors. Here's how.

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Faster drug discovery It takes pharmaceutical companies an average of 10 to 15 years to discover and develop a new drug. Some companies, including International Business Machines (NYSE:IBM), believe that AI can drastically reduce the time to find new drugs by sifting through vast amounts of genetic and clinical data.

IBM says that its Watson for Drug Discovery uses natural-language processing to "read millions of pages" and comprehend contextual meaning in the research.

In one recent instance, the Barrow Neurological Institute used Watson for Drug Discovery to find unidentified genes and proteins that may be linked to amyotrophic lateral sclerosis (ALS). Within a few months, Watson discovered five RNA-binding proteins (RBPs) that had never before been associated with ALS.

"Overall, we successfully used IBM Watson to help identify additional RBPs altered in ALS, highlighting the use of artificial intelligence tools to accelerate scientific discovery in ALS and possibly other complex neurological disorders," researchers at Barrow noted in a paper recently published in the journal Acta Neuropathologica.

Some drugmakers are already betting on this type of AI. Last year, GlaxoSmithKline said the time it takes to target a disease and then find a molecule to fight it could be reduced from five and a half years to just one year. The company told Reuters that not only will AI help reduce the time it takes to develop drugs, but it could also reduce their costs.

Assisting with diagnoses

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A team of pathologists at Harvard recently created an AI system to help them more precisely diagnose breast cancer. The AI technique helped the doctors increase their accuracy from 96% to 99.5%. That slight percentage increase is notable, because it means an additional 68,000 to 130,000 women will receive more accurate diagnoses each year.

Similarly, IBM's Watson for Genomics has been tested by oncologists at the University of North Carolina's Lineberger Comprehensive Cancer Center. Watson for Genomics looked at 1,018 patient cases and agreed with the physicians' conclusions more than 99% of the time, but in more than 300 instances Watson found additional genomic events of potential significance.

"Molecular tumor boards empowered by cognitive computing could potentially improve patient care by providing a rapid, comprehensive approach for data analysis and consideration of up-to-date availability of clinical trials," the researchers said last year in a published paper in The Oncologist.

Reducing healthcare costs The Kaiser Family Foundation estimates that the U.S. spends about 18% of its GDP on healthcare expenses, a disproportionate amount relative to its wealth. In fact, other wealthy countries spend about half as much per person on healthcare, on average, as the U.S. does.

But AI could help with these costs. Artificial intelligence can be used for administrative tasks like voice-to-text transcription, which could help healthcare companies and hospitals eliminate or reduce the need to write chart notes, prescriptions, and order tests, according to Accenture.

For example, DeepMind, an AI company owned by Alphabet's (NASDAQ:GOOG) (NASDAQ:GOOGL) Google, partnered last year with the U.K.'s National Health Service to use AI algorithms to read medical scans. DeepMind isn't making decisions on patient care from the scans just yet, but as the AI continues to learn from the scans, it could be used in the future to make recommendations for doctors, which would free up countless hours for healthcare professionals.

New workflow-assistant capabilities like this could reduce work time by 17% for doctors and 51% for registered nurses, according to Accenture's research. By making the overall healthcare industry more efficient, artificial intelligence applications could create $150 billion in annual healthcare savings in the U.S. by 2026.

Play the long game on this one I don't know of any tech stocks at this point that are pure plays in the AI healthcare space. Instead, investors should keep an eye on how IBM, Alphabet, and other major tech players are using artificial intelligence to change the healthcare industry.

The size and scope of the healthcare market, both in the U.S. and abroad, means there are lots of opportunities for companies to benefit. But investors should remember that this market is only beginning to grow, and IBM, Google, and others likely won't break out their healthcare sales for quite some time. Instead of investing in these companies solely based

https://hbr.org/2018/03/ai-will-change-health-care-jobs-for-the-better

http://theoncologist.alphamedpress.org/content/early/2017/11/20/theoncologist.2017-0170.full.pdf+html

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on what they're doing in the healthcare industry, make a note of how well they're expanding into new AI markets.

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ARTICLE INFO

• May 13, 2018 at 11:12AM • Technology and Telecom

5/11/2018 Artificial Intelligence In Healthcare: Separating Reality From Hype

https://www.forbes.com/sites/robertpearl/2018/03/13/artificial-intelligence-in-healthcare/#26bf76231d75 1/6

Pharma & Healthcare #NewTechMAR 13, 2018 @ 08:30 AM 13,094

/ /

Artificial Intelligence In Healthcare: SeparatingReality From Hype

Robert Pearl, M.D. , CONTRIBUTORFULL BIO

Opinions expressed by Forbes Contributors are their own.

It’s impossible to read about the future of healthcare without encountering twopixilated vowels that, together, represent the hopes and fears of an industry seekingmore intelligent solutions.

Though the field of artificial intelligence (AI) has been around since 1956, it hasmade precious few contributions to medical practice. Only recently has the hype ofmachine-based learning begun to merge with reality.

What Is Artificial Intelligence, Really?

Confusion surrounding AI – its applications in healthcare and even its definition –remains widespread in popular media. Today, AI is shorthand for any task a

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computer can perform just as well as, if not better than, humans.

But there are different forms of computer intelligence to consider when thinkingabout its role in medicine.

Most of the computer-generated solutions now emerging in healthcare do not relyon independent computer intelligence. Rather, they use human-created algorithmsas the basis for analyzing data and recommending treatments.

By contrast, “machine learning” relies on neural networks (a computer systemmodeled on the human brain). Such applications involve multilevel probabilisticanalysis, allowing computers to simulate and even expand on the way the humanmind processes data. As a result, not even the programmers can be sure how theircomputer programs will derive solutions.

There’s yet another AI variant, known as “deep learning,” wherein software learns torecognize patterns in distinct layers. In healthcare, this mechanism is becomingincreasingly useful. Because each neural-network layer operates both independentlyand in concert – separating aspects such as color, size and shape before integratingthe outcomes – these newer visual tools hold the promise of transforming diagnosticmedicine and can even search for cancer at the individual cell level.

AI can be sliced and diced many different ways, but the best way to understand itspotential use in healthcare is to break down its applications into three separatecategories: algorithmic solutions, visual tools and medical practice.

Algorithmic Solutions

In healthcare today, the most commonly used “AI” applications are algorithmic:evidence-based approaches programmed by researchers and clinicians.

When humans embed known data into algorithms, computers can extractinformation and apply it to a problem. Take cancer treatment, for example. Usingconsensus algorithms from experts in the field, along with the data that oncologistsenter into a medical record (i.e., a patient’s age, genetics, cancer staging andassociated medical problems), a computer can review dozens, sometimes hundreds,of established treatment alternatives and recommend the most appropriatecombination of chemotherapy drugs for a patient.

Perhaps my favorite algorithmic solution comes by way of Dr. Gabriel Escobar andhis colleagues in The Permanente Medical Group’s division of research.

https://divisionofresearch.kaiserpermanente.org/home



The team’s research centered on one of the most important populations in anyhospital: patients in a medical or surgical unit who will experience a deterioration inclinical status and be transferred to the ICU.

Though these patients receive intensive care for an acute event, and seeminglyreturn to their prior health status, they are three to four times more likely to die thanif a physician had intervened and prevented the deterioration in the first place.

Dr. Escobar, along with division chief Dr. Tracy Lieu and associate executivedirector Dr. Philip Madvig, compiled data from 650,000 hospitalized patients,20,000 of whom required this type of ICU transfer.

The team then created a predictive analytic model to identify which hospitalizedpatients today are most likely to end up in the ICU tomorrow. They then embeddedthe algorithm into a computer system, which continuously monitors the healthstatus of all hospitalized patients. Finally, they designed alerts to notify physicianswhenever a patient is deemed “at risk.” With this information, the doctors canintervene in advance of a major complication and save hundreds more lives eachyear.

Visual Tools

To appreciate the potential of visual pattern recognition in medical care, one mustunderstand how often the human eye fails even the best clinicians.

A pair of independent studies found that 50% to 63% of U.S. women who get regularmammograms over 10 years will receive at least one “false-positive” (a test resultthat wrongly indicates the possibility of cancer, thus requiring additional testingand, sometimes, unnecessary procedures). As much as one-third of the time, two ormore radiologists looking at the same mammography will disagree on theirinterpretation of the results.

Visual pattern recognition software, which can store and compare tens of thousandsof images while using the same heuristic techniques as humans, is estimated to be5% to 10% more accurate than the average physician.

The accuracy gap between the human and digital eye is expected to widen further,and soon. As machines become more powerful and deep-learning approaches gaintraction, they will continue to advance such diagnostic fields as radiology (CT, MRIand mammography interpretation), pathology (microscopic and cytologicaldiagnoses), dermatology (rash identification and pigmented lesion evaluation for

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835966/



potential melanoma), and ophthalmology (retinal vessel examination to predict therisk for diabetic retinopathy and cardiovascular disease).

Uses In Everyday Medical Practice

On the TV show House, one doctor’s genius trumps the expertise of his colleagues,implying that if all physicians were as smart as Dr. Gregory House, diagnosticenigmas would all but disappear along with unnecessary deaths in hospitals.

In reality, the biggest difference between physicians is not their level of intelligence,but (a) how they approach patient problems and (b) the health systems that supportthem. And because "a" and "b" combine to create wide variations in clinicaloutcomes nationwide, machine learning offers great hope for the future.

Two AI approaches, both currently available, could radically improve physicianperformance.

The first is natural-language processing, a branch of AI that that helps computersunderstand and interpret human speech and writing. This software can reviewthousands of comprehensive electronic medical records and elucidate the best stepsfor evaluating and managing patients with multiple illnesses. The second approachinvolves using computers to watch (and learn from) doctors at work.

In San Francisco, Adrian Aoun is using his background in artificial intelligence (AI)to explore how machines can learn from skilled clinicians in real-time.

Rather than extracting and analyzing data retrospectively (after doctors populatetheir medical records), Aoun’s primary care startup Forward is using AI to followwhat doctors do, step-by-step. With touch-screen data entry and voice recognition,Forward’s computers record and analyze how the best physicians achieve superioroutcomes. The results benefit their colleagues and their patients.

If all physicians matched the performance of the top 20% nationwide, patient deathsfrom cancer, infection and cardiovascular disease would decrease by the hundreds ofthousands each year.

Unfortunately, the biggest barrier to artificial intelligence in medicine isn’tmathematics. Rather, it’s a medical culture that values doctor intuition overevidence-based solutions. Physicians cling to their independence and hate being toldwhat to do. Getting them comfortable with the idea of a machine looking over theirshoulder as they practice will prove very difficult in years to come.

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Understanding The Hype And Fear Of AI

Startups and tech firms have hopped all aboard the AI hype wagon, promising a hostof sophisticated new solutions from nurse-bots to “AInsurance” (insurance poweredby AI) to AI wearables for the elderly, to name a few. Most are interesting but nottransformative. In general, they are algorithmic and not true machine-learningapproaches. Nearly all have failed to move the needle on quality outcomes or lifeexpectancy.

For every entrepreneur hyping AI as the next big thing in medicine, there are manywho fear machines will replace (or even turn on) humans. I believe these fears aregrounded more in science-fiction than reality. It’s true that computer intelligence isadvancing faster than human intelligence. But this development offers far moreopportunities than dangers.

If we see computer speeds double another five times over the next 10 years,machine-learning tools and inexpensive diagnostic software could soon become asessential to physicians as the stethoscope was in the past.

At the same time, we need to accept a difficult truth: If technology is goingto improve quality and lower costs in healthcare, some healthcare jobs willdisappear. According to one study, Artificial Intelligence is set to take over 47% ofthe U.S. employment market within 20 years. Though blue-collar jobs have longbeen in technology’s cross hairs, doctors and other health professionals are startingto feel the pressure, too. Unfortunately, that’s the nature of progress. What improveslives and lowers prices for many will negatively affect those who benefited from theold model of success. Uber and Lyft’s impact on the taxi industry is one obviousexample. Robotics in manufacturing is another.

Without question, the role of the physician will change in the future. Fortunately fordoctors, however, computers have yet to demonstrate the kind of empathy andcompassion that millions of patients rely on in their medical care.

The Promise And Potential Of AI In Medicine

I expect entrepreneurs and businesses will continue to invest in AI applications, andhype them more and more. Indeed, machine learning has the potential to takemedicine far beyond what it’s capable of today.

Evidence of this fact can be found in an ancient Chinese game invented more than2,500 years ago.

https://www.oxfordmartin.ox.ac.uk/publications/view/1314



“Go,” a two-player board game in which opponents try to claim the most territory, isincredibly complex and abstract, with a seemingly infinite set of possible moves. Itsdegree of difficulty left few observers believing that a computer could ever best acompetent human. That myth was shattered in 2015 when AlphaGo, a programcreated by the Google Deepmind division, bested Lee Se-dol, one of the world’s topplayers.

What’s most interesting, though, is how AlphaGo went about it. Unlike IBM’s DeepBlue, which defeated chess champion Garry Kasparov in 1997, AlphaGo didn’t“learn” by studying humans and replaying prior matches. According to an article inNature, humans may have taught AlphaGo the rules, but the program mastered thegame by playing against itself.

This type of “deep learning,” could be the very thing that catapults Americanhealthcare into the future – helping to clarify the best care approaches, creating newapproaches for diagnosing and treating hundreds of medical problems, andmeasuring doctor adherence without the faulty biases of the human mind.

These kinds of advances will come sooner to medical organizations that areintegrated, capitated and technology enabled. I predict these organizations willembrace algorithmic solutions on smartphones or tablets first, followed by patternrecognition software and, finally, machine-generated best practices for individualpatients.

Over time, patients will be able to use a variety of AI tools to care for themselves,just as they manage so many other aspects of their lives today. It may not happensoon. After all, efforts to produce self-driving vehicles date back to the 1950s. Butsometime in the future – more years than entrepreneurs would like and fewer yearsthan most doctors hope – AI will disrupt healthcare as we know it. Of that we can besure.

Dr. Robert Pearl is the bestselling author of "Mistreated: Why We Think We'reGetting Good Health Care--And Why We're Usually Wrong" and a StanfordUniversity professor. Follow him @RobertPearlMD

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