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