Tags // Decision-making
Atul Gawande’s ‘Checklist’ For Surgery Success
Brilliant article by NPR on Atul Gawande’s new book, The Checklist Manifesto. Gawande has written an entire book on how checklist and other reminders help in complex situations. Here is a good quote:
There was about 80 percent who thought that this was something they wanted to continue to use. But 20 percent remained strongly against it. They said, ‘This is a waste of my time, I don’t think it makes any difference.’ And then we asked them, ‘If you were to have an operation, would you want the checklist?’ Ninety-four percent wanted the checklist.”
I’m waiting to read Gawande’s new book but right now I’m in the middle of another book that talks about the same checklist culture from a very different angle. This book titled Streetlights and Shadows and is written by the brilliant Gary Klein. Both Klein and Gawande are my favourite authors. I’ve read all their previous books. So, this is interesting for me to see how their worlds collide. In his book, Klein spends an entire chapter debunking the use of checklists in complex scenarios. His idea is that checklists are wonderful in well-structured and predictive environments and do not work that well in ill-structured and unpredictable environments.
Here’s the question I want answered when I start reading Gawande’s book: are the checklists just for mechanical tasks or are they for complex procedures? The surgical safety checklist mentioned in the article looks quite general. Maybe that is the point: even the ‘general’ stuff in surgery can lead to a life or death situation.
Multitasking Muddles the Mind?
A Stanford University study seems to suggest that multitasking reduces intellectual efficiency.
“Nass [the author] says the study has a disturbing implication in an age when more and more people are simultaneously working on a computer, listening to music, surfing the Web, texting, or talking on the phone: Access to more information tools is not necessarily making people more efficient in their intellectual chores.”
Elliott Masie points to this article in the Armed Forces Journal by T.X. Hammes (retired Marine Corps). In this article, Hammes systematically describes how Power Point is a horrible tool for doing decision-making briefings.
“PowerPoint is not a neutral tool —it is actively hostile to thoughtful decision-making. It has fundamentally changed our culture by altering the expectations of who makes decisions, what decisions they make and how they make them… PowerPoint has clearly decreased the quality of the information provided to the decision-maker, but the damage doesn’t end there. It has also changed the culture of decision-making.”
Hammes’ argument is that Power Point runs against the grain when it comes to the decision-making process. It just does not allow for deep understanding and does not provide the big picture—big barriers to effective decision making.
Hammes however thinks that Power Point is good for information briefs and not decision briefs. But Hammes is not convincing in this position. He hardly spends a couple of paragraphs on the positive aspects of Power Point before going negative again!
I really enjoyed Dan Ariely's book -- Predictably Irrational -- on everyday decision-making. He goes on to show how bad we're really at when making decisions and that we are predictable in making these decisions -- that is we make them time and time again, sometimes even when we have the knowledge of making such deviations. There book website has many demonstrations that we can take to test out some of our decision making flaws.
e-learning: some still don’t get it
Yesterday I had to give a presentation - a pitch actually - to the director of training of a very large organization for developing an e-learning course. Here's what happened:
PLAN: this guy, being a director, would be strategic in thinking. He would want to know about the benefits of the course and the design and how to make it all work. Right?
THE PITCH: collaboration and decision-making are key. E-learning needs to be made meaningful, and by that we mean social and interesting. Learners want to see different perspectives from the ground-level not subject-matter level... and so on. Basically trying to paint the e-learning 2.0 picture without using any of the jargon.
OUTCOME: After half an hour, he says, "Can you show me animations with smooth transitions? The last vendor showed some nifty ones."
It's situations like these that make me want to pull my hair out. Screw all this e-learning bit; better to sell peanuts on the roadside. At least I'll retain the dignity of having decent conversations.
Ok. that was a vent. I must admit, not all clients are the same. I have met with many who, simply put, get it. And from my experience, these people are those who treat us not as VENDORS but as partners with whom some knowledge and experience can be exchanged. Put it simply, it all boils down to world-view: the ones that see the world as a complex, organic, bottom up, emergent phenomena and the ones that see the world as a mechanistic device, some part of which is under their control. Sadly, when it comes to e-learning, I've met more clients with the latter world-view.
RESOLUTION: next time, I'll ask more questions about the person involved. I'll Google the company involved. If I find that the world-view of the person or the company is as small as a pimple-on-the-ass-of-an-ant, then I'm walking away. I'll also walk away if its any bigger!
Include Extreme Points of View In Group Decisions
This report from the Stanford Graduate School of Business tells us that:
When designing a group decision-making process for potentially biased managers, intuition tells us that throwing out extreme opinions neutralizes the most severe biases among the group’s members and leads to better decisions. Surprisingly, research suggests our intuition may be wrong.
So this says that if we have a bunch of people who are potentially biased (who is not these days) then do not throw away extreme comments or suggestions. And do not take a vote count. You are better off listening to each comment or suggestion and making a decision on the quality of the information provided.
No more categories
I’ve done away with categories. I was constantly struggling with categories for a long time. I had 3 iterations in the past and always thought that I would finally get to a more representative set, but never did. The main reason I guess is that I find myself not talking about a single topic or domain. If I were to do that, say on instructional design, then I think I would have found that representative set. But the topics I find myself getting into are so diverse—design, decision-making, branding, neuroscience, intranets, etc.—that it would be absurd to have a listing of categories for these entries. Blog posts, I’ve come to realise, want to be free.
Boards Get Brains, Chalk Vanishes
I've used this type of board and find it quite useful for explaining concepts. But I find it more useful in participatory decision-making workshops where different viewpoints are put on the same 'map' and participants see how their perspectives relate with that of their colleagues. I find the ensuing discussions during these workshops to be more focused and productive.
"All across the country, chalkboards are being ditched in favor of interactive, computer-driven whiteboards that allow students and teachers to share assignments, surf the web and edit video using their fingers as pens."
Reflections on Making Decisions
This is an interesting article on the changing nature of decision-making in the healthcare industry. Not surprisingly, the changes are in the area of interpersonal communications: "Increasingly, a growing body of studies supports the fact that poor physician-nurse communication leads to negative patient outcomes."
Here's Jay's account of a project that I'm associated with: decision games. This term was coined by Gary Klein, in his book, Power of Intuition. Decision games are high impact learning events that are aimed at getting learners to practice decision-making skills that are to be exercised in ambiguous, uncertain events such as project management, risk management, competition analysis, emergency management, disaster management, etc.
Together with KM experts, Straits Knowledge, I'm involved in developing decision games that combine Gary Klein's work with intuitive decision making and Dave Snowden's work with narrative analysis to elicit knowledge from expert practitioners (as opposed to subject matter experts). What results from these techniques is a far cry from what is possible by just analyzing subject matter. (Malcolm Gladwell's Blink gives a good account of the kind of knowledge that can be elicited through these techniques.)
I will post more on this method at a later date. By the way, if you are wondering where I feature in Jay's article, it's with Pebble Road, my company. Yes, I've finally started out on my own. The website is a little bare right now, but will post more when I get the time.
Amy Gahran on narratives and decision-makingAmy Gahran has followed up with two detailed articles here and here on my previous post using e-learning as a narrative technique. Wonderful stuff. "If you want to treat e-learners as human beings, give them narrative. Save the exposition for backgrounders in your library." "Effective e-learning can
It’s all about rich e-learning experiences
Here are my thoughts on the current discussion between focusing on tasks and focusing on information in an e-learning course. Amy Gahran points out that a task-oriented approach is more effective in most e-learning than an information oriented approach. My point is that a decision-making or an execution-based approach is even better. Decisions are what business organizations are about. The need to perform a task or to acquire information really depends on the decision you are trying to make. Thus, know-how is equally important as know-why or know-what, it really depends on the decision.
For example, if you are a research analyst looking into mergers and acquisitions, knowing what to look for is as important as knowing how to perform an analysis. The decision you as an analyst have to make is to figure out if there is compatibility in the two companies seeking to merge, for example.
This brings me to learning objectives. Amy mentions that a learning objective can clarify what kind of approach is needed. For example, if you have to use “know” or “understand” then an information-oriented approach is suggested, but if you use “list” or “order” or “assemble” then a task-oriented approach is suggested. This is true only for micro-level instructions. In business organizations, people demand the micro only when the macro is justified.
Too much e-learning is focused on the conditioning mindset – provide the cheese crumbs to the caged mouse and he will ‘learn’ to find his way to the exit. This is where the behaviourists have ruled for so long. The sanitizing and listing down of bullet-objectives with carefully selected words that make complete sense only to the instructional designer is the most visible indication of a behaviourist or a Fredrick Taylor-ian slant. So, what’s a better approach? Write a simple 1-2 paragraph blurb of how learning the content or the steps to a task will help you execute a decision in your practice. See how HotWired does it. Treat learners as humans and they will love you for it; treat them as cogs in a wheel and, well, they’ll just click the Close button!
Here's a simple story from Learning To Fly which describes British Petroleum’s knowledge management journey. Professor John Henderson of Boston University tells this story to senior BP managers.
I interviewed a colonel. Now this colonel was a colonel in the 82nd airborne, one of the more elite groups in the US Army. He got a call on Saturday morning at 8 o’clock reminding him that a hurricane had just hit. He was told that the current administration had very strong ties to that particular part of the country that they did not believe that this should be left to the reserve group because they wanted no “screw-ups”.
So the orders to the colonel were very clear: go down there, provide any support necessary to the people after this hurricane and don’t screw up. Clear orders. The Army calls it intent – strategic intent. The strategic intent was clear.
This particular colonel was a very highly decorated combat soldier – he had never done this in his life. He had never actually commanded any type of civilian-related activity. He’d always been right on the front lines in hot action. It turns out as part of the executive education in the army he had been exposed to the ‘Centre for Army Lessons Learned’ as part of their executive education process.
So he got on his laptop computer he dialled into Army net, hooked into the Centre of Army Lessons Learned’ and asked the following question – ‘what does the Army know about hurricane cleanup?’
Within four hours he had:
- A profile of the deployment of troops in the last three hurricanes that occurred in North America that the army was sent to provide support and clean-up including types of staff, skills, numbers of skills.
- A pro-forma budget – both what budget was required and what the actual budget was and where the cost overruns were.
- The ten questions that you will be asked by CNN in the first 30 minutes on your arrival.
- A list of every state agency and federal agency that had to be contacted and coordinated with and the name of the contact person that he had to contact, and the army liaison person who was currently working with that group some place in North America.
- Established a Lotus Notes advisory team of three commanders, who agreed to be his advisory group in the command structure.
Now, if we were to design an e-learning episode, or a knowledge asset as BP calls it, on hurricane clean-ups, how would we design it? Would we design based on tasks or information? Would we begin with a list of bullet-objectives? Here’s where I differentiate between designing an e-learning course and designing a rich e-learning experience, with all its real-life ambiguities. This is where the prospect of using e-learning as a narrative technique rocks. I'd love to hear your comments. E-mail me at maish-at-elearningpost.com.
Corporate E-Learning: Focus on TasksAmy Gahran is quickly learning the reality of corporate e-learning: "In my opinion, too much corporate training is basically an information dump rather than skill development." Her solution is to create e-learning that focuses on the task and on new information that an employee would be interested in. I would simplify it even further and focus on the decision-making. For example, providing learners the answers to "The 10 most important things you need to know about this task" or "The 5 most important decisions related to this task" will help the them to focus on the execution of the task. These checksheets can also be linked to detailed documents for the learner to dig into if he/she wishes.
GUUUI: Personas and the customer decision-making processGUUUI: Personas and the customer decision-making process
"With this case study I want to show how our team used the concept of personas - fictional, representative user archetypes - and the customer decision-making process model in a project, in order to capture the nature of customers and their needs and concerns as they progress through the customer decision-making process."
Edge: Why Do Some Societies Make Disastrous Decisions?Edge: Why Do Some Societies Make Disastrous Decisions?
Jared Diamond: "First of all, a group may fail to anticipate a problem before the problem actually arrives. Secondly, when the problem arrives, the group may fail to perceive the problem. Then, after they perceive the problem, they may fail even to try to solve the problem. Finally, they may try to solve it but may fail in their attempts to do so. While all this talking about reasons for failure and collapses of society may seem pessimistic, the flip side is optimistic: namely, successful decision-making. Perhaps if we understand the reasons why groups make bad decisions, we can use that knowledge as a check list to help groups make good decisions."
Computer Times: Once upon aComputer Times: Once upon a time...
KM is about improving decision-making and encouraging innovation, and not simply about databases and codification. It is also about the need for companies to recognise that people will make decisions based on past experience.
- elearningpost: The Art and Science of Story (Report from "Ba" - KM Asia 2001)
Page 1 of 2 pages