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Learning Activities Using This Resource Kit:

General Learning Activities, Demonstrations, Games, Etc.

Multiple Perspectives

Synopsis:

To explore the mental models and points of view of the agents within a real, local CAS.

When To Use:

When you have a real issue and a CAS that you would like to understand better.

Group Considerations:

Appropriate for any group. As noted below, if the members of the discussion group are also members of the CAS under consideration, make sure that the discussion will be safe for everyone. Participants must be open to learning how others see them and sharing honestly how they see others. The exercise will probably take an hour or more to conduct at an appropriate depth. The nature of the exercise is such that its value is lost if it must end prematurely. Only start it if you have plenty of time and participants will remain present (physically and mentally).

Learning Styles:

Different parts of the exercise will appeal to all learning styles.

The Leader:

Needs to be a true co-participant; comfortable with open, honest discussion and able to tune the information flow, power differential, and diversity of the group as needed.

Supplies Needed:

Index cards on which to write descriptions of the key agents within the CAS, and a enough easel sheets to capture thoughts about each of these agents.

Source:

Based loosely on suggestions by Charlotte Roberts and Jim Boswell, in The Fifth Dimension Fieldbook, pages 273-5

Step 1: Setting the Context and Identifying the Agents in the CAS

Begin with a discussion about the issue that needs analysis. Typically, this would have been agreed upon prior to the group meeting and will be an issue with which everyone is familiar. The discussion is just to make sure that everyone understands the context before delving into the exercise. For example, the issue might be "Sharing financial gains from improvement activities with physicians."

Next, agree on the key agents in the CAS. These might be specific individuals, like the Medical Director, or the CEO; or they might be groups, such as Cardiologists, nurses, and managers. Some of the agents might actually be a part of the learning group. If so, make it clear that the ground rules are that this is a "safe" discussion. Participants must be open to learning how others see them, and committed to sharing honestly how they see others.

There is always some judgment needed about how many agents to identify. We do not want to make a rule here, use you good sense and your understanding of what the phrase "key agents in the CAS" means in your context. Of course, the more agents you identify, the longer the discussion will take and the more confusing it might become. But, if you leave someone out who is truly key, you sacrifice the reality and value of the exercise.

Write the individual or group names on separate cards and put up an easel sheet for each one.

Step 2: Constructing the Mental Models

Shuffle the cards and pass them out. If you have more cards than participants, pass one card to each person and just keep the left overs for the next shuffle. If you have more participants than cards, involve different people in each rounds such that everyone shares equally in the work.

Each person takes the card they have been dealt and goes to the easel sheet for that agent. They have two minutes to complete the sentence "From the perspective of this agent, the critical elements within this situation are..." Participants are to respond as if they were the person or group on the card. In essence, we are capturing our mental models of other's mental models. No one is allowed to pass.

Participants should not be influenced by what is already written. It is OK if your response contains elements already mentioned by others. The redundancy serves to illustrate how widely held the belief is.

If you get a card, you must respond as you think that person would respond. If you are the person or a member of the group, be honest in sharing your understanding of your own mental models. But this response is not the final word. Other should honestly share their models about you, even after seeing your response.

Continue cycling through card shuffles and two minute periods of writing until each easel sheet has at least 3-6 listings under it. If you have more cards than participants, you can remove cards from circulation at some point after the easel sheet gets full.

This period of card shuffling and writing should be very active. Make participants walk around to get to the easel sheets. Talking is OK. But keep the pace lively by holding to the two minute rule.

Step 3: Discussion About the Mental Models

Now spend 3-5 minutes looking at each easel sheet one at a time as a full group. If practical, do this standing up, moving from sheet to sheet. Others who didn't get a chance to write on the sheet can add additional insights to the sheet if they wish.

The purpose of the discussion is to create a complex picture both of that agent's mental models, and others' mental models of that agent's mental models. The point is that in a CAS both are relevant. Each agent's actions are influenced by what they really think, by what they think others think, and by what they think others think about them. Everything on the easel sheet is therefore important. It is not necessary to sort it out nor get to some conception of "truth." It is just all there.

Throughout the discussion, the one facilitating the activity should pay attention to the need to "tune to the edge." Keep the information flowing. Stress that every bit of information is relevant, diversity of viewpoint is good. Don't allow power plays or statements that imply that someone "really knows' what the agent thinks or what they will do. Point out that anxiety is good and there is no need to resolve anything, but don't let the anxiety cause the information flow to shut down.

Step 4: Implications for Systems Behavior

With a loose understanding of the agents and the mental models that are active in the system, turn the group's attention now to a discussion of the potential behavior of the CAS. Point out that while it is impossible to predict the detailed behavior of a CAS, we are often able to make general observations that can give us insight.

Begin the discussion with a "Suppose we did X" scenario statement. For example, "suppose we said we were going to offer physicians who served on improvement teams a 20% share of the documented cost savings from that team?" Ask for comments on what other agents might think, feel, and do. Participants will likely speak up naturally for certain agents, if not pick an agent at random and inquire about their potential actions. Play out the scenario chronologically and explore multiple "what if?" branches. From time to time, return to the base of the scenario and propose an entirely different beginning.

It is impossible to explore all the potential branches. And, of course, no one can know what will really happen. Just keep the conversation moving and go down as many diverse paths as you can in the time you have.

About 15 minutes before you must break up the group, cut off the exploration and turn attention to reflecting on what you have learned. Ask simply, "So what do we think we have learned about the issue and the CAS we have been exploring?" Anything goes here. There may be thoughts about the need to better understand some of the agents. There may be ideas about new options to explore. The group may see the need for more information or more dialogue with key agents before taking any action. Capture the group's thoughts on an easel sheet.

The group and the person who organized the session must, in the end, use some intuition about what to do next. It may be important to note for the group that taking no next steps is doing something from the perspective of the CAS. The CAS will react to no new action. The system will keep on happening, whether we like it or not.

This is a complex learning exercise. It requires a high degree of dialogue skills and tolerance for anxiety. However, it can profoundly deepens participants understanding of the specific CAS under consideration, and CAS in general.

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