Developing Systems Thinkers: Strategies for Effective Instructional Design

Welcome everyone well thank you so much for being here we really appreciate your attendance um today's session Health Professions educator health system science um session is going to have some of our Virginia Tech Partners presenting our main presenter Dr Hannah sure is an associate professor and extension specialist in the department of agricultural leadership and Community Education at Virginia Tech she's joined today by the following session facilitators Matt Norris who is a PhD student in the department of agricultural leadership and Community Education Dixon otin-o PhD student in the department of agricultural leadership and Community Education and Casey Owen who is a master's student also in the department of agricultural leadership and Community Education Dr Shearer I'll now turn things over to you so Matt Norris is actually in engineering education so just a clarification on that and we came together as a facilitation team because I teach a course called systems thinking pedagogy and Praxis and so it's really thinking at a more of a process level of how do we understand systems thinking and how do we help people become systems thinkers in lots of different um contexts and so the students that are helping facilitate today were all in that class in um fall 2021 um so it's really great to be able to continue to collaborate with them so today we're going to be really scratching the surface on this idea of how do we develop systems thinkers and I'm couch this in the idea of effective instructional design I know that's something that you all are really interested in and um we're really going to just start to think about some strategies and so um my goal with this today is really for you to leave with more questions than you have now um and lots of ideas for thinking about moving this work forward some of the objectives as I said these are really we're going to get started on these um being able to describe some approaches to instructional design for systems thinking um and then strategies for supporting systems thinking in your own instructional context and we're going to do that through some breakout room discussions after some brief framing um in the way that I like to think about some of these things throughout the presentation I've put some put references on the slides as well as several kind of starting point references resources at the end so and I've tried to choose those citations to be good entry points for um the topics that we're discussing so if there's pieces that are new to you I would encourage you to seek out those resources to get going on that to start with I'm going to talk a little bit about the way I like to think about instructional design it's an entire field of study and and some of you focus on this some of you may not really think about it at all I like this idea of grounded design which is really that um we have learning environments and there's a lot of different things that are at play there um we have kind of psychological learning theory what's going on within the in our understanding of how learning occurs um we have pedagogical foundations how do we understand that teaching and learning process to operate and what are some of the kind of philosophical um pieces that guide those decisions we have technological considerations there's pragmatic considerations which I know in medical education is a huge part um and then cultural and so grounded design really says that like for good instructional design all of these things need to be simultaneously aligned they need to make sense we need to consider the tensions between those and um really seek to have all of those things be congruent so that we get powerful um learning environments for our Learners so that's you know where we're when we're contextualizing this within systems thinking I really like to kind of think about all of those pieces and today we're going to be focusing more on the the psychological and pedagogical pieces another way to think about instructional design that I find really powerful is this idea of backward design which is really fundamentally we're starting with the end in mind so what is it that we want Learners to be able to do who do we want them to be what are our like five to ten years from now where where do we want them to be what are those desired results um at both the big and small scale from there we think about what's the evidence that's going to tell us that they've achieved those results and then we think about planning those learning experiences to um get them there and this is really I have the arrows in both directions here because it really is iterative and in the end we want all of these things to be supporting each other and make sense um for today we're going to focus on the desired results and the way I think about learning outcomes and again this is Guided by Wiggins and mcteags backward design framework thinking about different types of learning outcomes so transfer what kinds of complex tasks we want them to be able to do um and I think of systems thinking is really a transfer goal it's a complex task that they should be able to apply systems thinking in lots of different complex systems environments um what is the meaning that we want them to make what are those overarching conceptual understandings what's the factual knowledge so this is getting into the smaller scale that will help that make meaning and then what are those discrete skills that they're going to need to build together to um accomplish those tasks so again if you're if you don't think about learning outcomes a lot this is a great starting point and just this is the way as you're in your breakout rooms and thinking about different types of outcomes um these different ways to think about those again they all support each other so getting into um systems thinking itself and I've been looking at some of the the resources in terms of health system science and I think that danella Meadows framing of of what a system is is consistent with what I've seen in some of the work you all are doing this idea that a system is an interconnected set of elements so there's things there right and they're interconnected in some way and a lot of the conceptual understanding um is about how are those things connected what are the processes um but then what makes it a system is really that those elements are organized in a way to achieve something there are there's a goal there when and we're talking about um Design Systems it's a well-defined goal that somebody set out to do and we're talking about something more like biological systems you know that that goal is to keep that thing alive um and so that's the way we can frame kind of at a high level what we mean by a system and then if if that's how we're thinking about a system then systems thinking really is a set of habits of mind that can lead to mental models of complex systems that are closer to the real world and I put real in quotation marks because often when we're dealing with social systems there's even different perceptions of so yeah oh okay um and so this this framing of systems thinking is really how do we approach the world how do we approach complex systems so that we can better uncover the complexity there um and within the U.S educational context system this is typically framed as a kind of a deficit in um Learners or challenged in systems thinking um but that's you know socially and culturally mediated there's a lot of different um cultural groups where that system's thinking is part of their worldview and part of how people are raised and so um it's important to kind of think about that as as we're thinking about what what's challenging about systems thinking and what's um what supports do people need um but often when prompted the research shows that people can and will draw those connections and they can develop as systems thinkers but it may not be their default way of thinking about a problem and it needs to be explicit so if we're to try if the goal is for people to develop these habits of mind um often in and I I would assume this is the same in health system science when I work with folks that are trained in science we have this idea of systems thinking versus system science and often people will default to a system science View and equate those two things so I just wanted to tease those apart a little bit that you know being able to describe a system in its complexity isn't necessarily the same thing as systems thinking as a transferable skill you need systems thinking to be able to develop a complex map of something but it may not but actually being able to describe a particular system is not a transferable skill so this is just an example I pulled that's a a system map of obesity and so we're not gonna unpack this but you can see how there's a lot going on here and you might zoom in on one of these things like individual psychology if that's your discipline and your learners might be really focused on understanding those Pathways within that particular part of that um but what we want them to be able to do is say okay if I'm seeing these different elements and these are connecting and and these feedbacks are happening where do I see that pattern reproducing in food production are there similar patterns of how these things are interacting in a totally different system and that's where we can start to think about systems thinking as something that is a way of approaching a problem versus understanding all of the new nuanced systems complex systems connections within a particular problem space and so I really encourage you to zoom out and think about what are those transferable pieces that we hope that Learners would then when they enter a new environment a new problem space that they are um looking for those types of of systems based patterns and then to complicate things even within system science there are lots of different approaches to how um scientists look at systems and this review paper that I've I've cited here in the reference references at the end of the presentation because I wanted to put it in kind of the suggested resources that comes from um designers but it's a really nice overview and kind of literature review of different approaches to systems thinking that I find very accessible for folks that are new to this space um so we have within system science approaches to trying to understand those complex systems and kind of again within a U.S scientific context we really started with hard systems thinking which comes from a positive perspective and this idea that the complexity of a system is knowable right either we can design it the way we want if we're thinking about computer science or um some of those technological spaces but also if we are aiming to predict how a system is functioning um so systems biology it's another example right we we know we can kind of assume that the body functions in a way that if we try hard enough we can know all of those connections all of those elements to be able to try to to problem solve so that that is that's really hard systems thinking is trying to understand that um all of those connections all of those things and it um from that perspective when we start to move out of science and engineering spaces more into the social sciences soft systems thinking is really extending that idea to acknowledge the social complexity of a system and we can't really ever actually fully understand the system we can't fully solve the problems but we can use systems ideas and perspectives to really understand the different perspectives on a problem and try to manage it better um and so that's where um I think the health system Sciences really is probably aligning with some of those ideas and then extending from that critical systems thinking again is focused more on social system and really addresses the idea of power in Social systems so really explicitly considering the perspectives of who's designing this system or who is um the decision maker in that system and who's affected by that system and is there equity in voice in that and so I see that in some of the the way within Health System Sciences it's that seems to be very important when we're thinking about um that broader social context that um people might be bringing and so these are just some ways to kind of unpack what we mean by systems thinking within these spaces there's different skill sets in terms of um how we might want Learners to be thinking about these things if we take all of that framing as I said it's a lot to start with um some things to think about as you're thinking about translating those ideas into your instructional context and by that think about it whatever makes sense for you as you're discussing this in your breakout rooms the activities assessments projects um whatever other clinical environments I don't know a lot about medical school so you all use your expertise there to to broaden that frame in terms of the spaces that our Learners are in but some things to think about going back to that idea of keeping the end in mind we really want to Define learning goals to both the content that you're needing to teach but also the process and really thinking about what are those systems thinking skills that will really um be addressed in this learning environment and Define those have a separate goal or have it explicitly part of your learning goals because that's how we get to them thinking about it as that transferable skill um and then as I mentioned right there are many different ways that we Define systems thinking and what skills are important in different spaces so really consider how it's used in your disciplinary or interdisciplinary context so get specific about it it's not just like vaguely interconnections right when we get down into the way that we're thinking about it um so so spend some time thinking through that especially with colleagues um identifying points of confusion um and how you're gonna plan to break them down when we have these very complex systems with you know spaghetti maps of um ways that things are interacting that's that's tricky for Learners right um and so thinking ahead for how how you're going to break those down scaffold systems thinking Concepts along with other Concepts so again related you know if you have your learning goals and both of those are there then really thinking about that in your learning environments how are we going to build those systems thinking Concepts along with other content and then finally research shows that we really need to use systems language explicitly so if feedbacks are an important concept for example um those operate the same no matter whether we're talking about a thermostat or homeostasis or flow of information in um like an information management system right this idea of positive or reinforcing and um positive and negative feedback loops right that if we use that language explicitly and break that down while we're learning about homeostasis then students or Learners might be able to recognize oh I see this as like a runaway feedback in this other space and so using that language explicitly can really help with um that those transfer abilities so before we send you out to chat about these things I just wanted to um bring up some things that were a little bit more specific to the health system science piece that you all are working with and as I look at this um some systems Concepts that stand out to me which I encourage you to keep building on this um but that may be important and or challenging the idea of scale right you're dealing with patients or even like a particular system in a patient right all the way up to like healthcare policy right so that idea of how do these things interact at different scales is it a really important concept to consider and where um especially cross-curricularly as you're teaching in different pieces of this like how do we help Learners understand how these things operate at different scales you also have multiple interacting subsystems right just looking at this wheel and all of the different pieces that are on here um there's lots to understand at the subsystem scale but then how do these things interact and inform each other even if somebody is working in a particular subsystem um the idea that in complex systems we can have multiple causal factors influencing one income in one outcome whether it's a breakdown of information or um you know a disease presenting in a patient that they're unpacking those um multiple factors that could be influencing one thing that we're observing is a really important complex systems concept and then this idea of dynamic systems right that systems are always changing um the a new policy right can completely change how we're um operating at the health system scale all the way down to you know people over the lifespan so this idea that systems are constantly changing so those are just some pieces that I pulled out of kind of the standard complex systems thinking abilities um that may be relevant here and then just to um have everyone on the same page that the World Health Organization has defined systems thinking in a way that's fairly consistent with what um danella Meadows has said and the way we've been talking about it that it's really an approach to problem solving that views problems as part of a wider dynamic system so we're we're contextualizing this particular thing in a bigger system so we it demands a deeper understanding of linkages relationships interactions and behaviors among the elements that characterize the entire system so again we're looking at um what are these things how are they related um and using that approach to solve problems so I think that if we're bringing all of these pieces together in that way it's helping to um kind of develop practitioners and Learners that are really in that kind of health system science mindset so with all of that there's lots to think about lots to chat about um we're gonna have some facilitated breakout room discussions um and so if you have like burning questions that you can bring them to the rooms we all have been thinking about systems thinking for a while um but the goal is really to work with your colleagues to identify strategies for how you might support systems thinking in your own instructional context so using some of the ideas that I've given you or anything else that you have from your expertise or experience um we have some questions that will start things off but feel free to take that in a Direction that's generative for the folks in the room um making sure that everyone has a chance to share and get input as they're able on Zoom I know some folks may be multitasking so that's okay um if the conversation is going down a path and you feel like oh I want to see what other groups are thinking about um you're welcome to go back to the main room and get assigned to a new room um but also well yeah the facilitators will make sure that everyone has a chance to share so we'll be out in our rooms for um 20 minutes we'll end at 12 45 the facilitators will have a Google doc that will take notes in so that um the Education team can kind of have a sense of what all happened there um and if anyone in the room wants to take notes in there um you're welcome to do that as well and then what we'll do is come back at 12 45 each of the facilitators will share um one or two big ideas that came from the discussion and then um we'll have some time for a bigger discussion as a whole group welcome back um so what we'll do is um have the facilitators just share out a few kind of big ideas from where the discussion went um and then we can open it up for any other comments that folks want to make depending on what time we have left um I just have two more slides to share as kind of some closing thoughts so I'll keep an eye on the time and um so we can have that discussion and let's see Dixon do you want to go first oh yes sure so uh so we had a great deliberations in in our group and uh the issues that I saw uh come up very clearly were uh this is around like having the end in mind uh that that is very helpful in systems thinking just uh having the end in mind and then working working backwards uh to to to address all the issues that are there then those issues around interdisciplinarity of of systems thinking you might not be in a position to address everything at that point at any given point in time that's why we borrow from each other and then learn from one another in a systems approach uh to to address these issues interdisciplinarity also brings issues around diversity diversity or perspectives so uh those are some of the of the key issues that uh that uh arose out of the meeting that we had just have an interdisciplinary approach have the end in sight and then work backwards uh that that would help build the system thank you awesome Casey how about your room our group also had a very interesting discussion um question four I think was where we got some really unique ideas especially around uh from Jed on just employing the tools and approaches to systems thinking and how those can be difficult challenges but that if you come in with um certain uh skill sets or characteristics like humility and being humble enough to know that you may not know something um or you may be making assumptions that can really assist with this leaving those assumptions at the door and how important this prerequisite is to becoming a physician or working in this field having a growth mindset and actually practicing that um and then just kind of thinking about like the wheel the image that there's so much involved and included and how do we incorporate all of these various elements into thinking about curriculum and instructional design and at what level and thinking about is this for a student is it for a resident is it for a faculty perspective and kind of tailoring it to that as well um so those were some of the the high level overviews that I thought were interesting to highlight from our group discussion awesome thank you how about you Matt uh we we had uh as everyone said good discussions a number of the points that Casey brought up um really trying to get at that holistic view um our discussion went a slightly different direction though and and people talked a little uh quite a bit about opportunities and some changes that have been happening um changes I believe the next gen RN examination and um covet is a case study essentially for really diving into how these systems works and talked a lot about opportunities um that are kind of already present in um someone mentioned that they are already teaching interns the economics of how where you order a prescription or tests at different locations can impact how that will impact the patient um and the perspective taking as well showed up the idea of trying to approach a problem or issue with that sense of humility and inquiry and looking at the issue from multiple perspectives of those involved to really kind of have the best you know teamwork in terms of quality and safety um all popped out from our discussion great and our group we we spent a lot of time talking about kind of the different systems approaches and kind of how systems thinking is is already used in in a lot of the contexts and we had a really interesting discussion about what whether hard systems or soft systems or critical systems applied and it it seems that um you know they all apply in different spaces right when we're talking about um like the actual like physical systems and how how things are operating and understanding like the physics of light if you're trying to understand the eye right so there's like definitely hard systems things there um and then moving into you know well people or you know this idea of soft systems and and there's um but we need to think about critical systems as well and so we had people from lots of different um disciplinary perspectives and I think it was really important to have that discussion around um these different types of systems approaches and and what I was hearing was that you know we need we should have Learners be able to understand all three of those and the differences and where they're showing up and how those are intersecting um it as we move through different parts of of the health system um the health system so I thought that was really interesting and that's something I love to think about and just from my work um and then really some really great examples of kind of how are we already doing this in terms of like case examples and and ways that people are thinking about this like differential diagnosis within nursing and you know the that there are a lot of these processes already really being reinforced in the in the teaching um and then this idea of interdisciplinary teams coming together to solve problems like diabetes right that there's really um a lot going on there so really generative discussion around kind of what do we mean by systems and what types of systems um are Learners um likely to encounter so um it's it's always interesting these discussions go in lots of different directions which is great um so one of the things that um I know is important as we're thinking about systems trying to develop systems thinkers across all of these different um spaces that you all are trying to help people learn um Matt had shared this this paper from um some authors in in your field this idea that um being a systems-minded practitioner or educator requires the development of a new professional identity as much as knowledge acquisition um it also involves an expanded mindset that necessitates caring for and addressing insufficiencies in the system as obligatory aspects of the professional role and so I heard a lot of that in in all the breakout rooms sharing that this is this is important this is where we're headed and it's you know what we are thinking about in terms of who people are as a professional it is being able to see that system and diagnose that system but also operate um within that system and so when I read this paper about like this challenge of professional identity um I and the some of the barriers to implementing health system science it made me think of um an author who's in a totally different space Adrian Marie Brown is a brilliant thinker that um Works more in um committee organizing and and social change and she's up her book emergent strategy really takes ideas of of complex systems um from nature and applies those to thinking about organizing and so one of her factors or one of her strategies within emergent strategy is this idea of fractals so I thought this might be helpful to you all as you're thinking about um staying motivated to work through the challenges that you're all going to have to face in terms of how do we help people see this whole giant thing um she says how we are at the small scale is how we are at the large scale the patterns of the universe repeat at scale there's a structural Echo that suggests what we practice at a small scale can reverberate to the largest scale and I was thinking about this as like what we do to manipulate cells all the way to the health system right and but who we are and what we are how we operate really can build towards system change and so as you think about the learning environments you're in the upcoming practitioners that um you're working with this is this is something that just kind of resonated with me as I was thinking about today's session um so I mentioned there's some starting point references for you um and I'll stop sharing this and happy to take any questions or any further comments from anyone in the um breakout rooms that you wanted to elaborate on so folks welcome to type in the chat or raise your hand or if you're quick start talking before anybody else does uh Hannah I just want to comment about that because this is the first time coming for the system thinking kind of an inter-professional kind of a discussion I love the initiation I appreciate that but uh how we Implement each department to I love to hear the and there's some successful his uh story you know some uh that would be helpful maybe this is a first session but maybe you kind of consider maybe second or third and then maybe some faculty from the different departments they can kind of assure there's some example that would be very helpful for me to how to implement it yeah like I said at the beginning this is a just a starting point for sure absolutely you know if we also have uh lots of folks who would love to engage in this conversation with you um if you want to get a hold of us separately we can have uh independent discussions on those types of things and you can listen to very discussions um about uh separate examples for folks who are doing this really well that was a great comment thank you if anyone has any other questions feel free to put those in the chat or feel free to take yourself off mute and ask those questions now I believe we've put an evaluation Link in the chat for you feel free to engage with that we want to thank everyone for their time um and being here and joining us today some of you probably have things that you need to jump off but if not feel free to stay and be part of the conversation before we close enjoy your day everybody thanks for the opportunity this is fun absolutely thank you all for uh your time and and the effort that you put into this uh presentation and facilitation it means a lot for you to be a part of this conversation.