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Learning Activities Using This Resource Kit:

Applying the Nine Emerging Complexity Principles


Group discussion about the practical consequences of the application of the principles of complexity in healthcare organizations.

When To Use: Early in your explorations of CAS.

Group Considerations:

Appropriate for any group. Break up large groups into smaller groups of 4-8 people to encourage more active conversation.

Learning Styles:

The various elements of the discussion should appeal to all learning styles. Extroverts and Activists can jump right into the discussion. Introverts and Theorists can read the principles beforehand and collect their thoughts. Opportunities for connections abound for those who like seeing these, and discussion of real situations will appeal to the concrete Pragmatists. Beware that Activists may get bored repeating this exercise for each of the principles. Provide variety for them by re-shuffling small groups so they get to interact with different people, re-phrasing the questions, and so on.

The Leader:

Needs to be comfortable with facilitating dialogue that does not have to go in any particular direction nor come to any conclusion. Remember, be a co-learner.

Supplies Needed:

Copies of the Principles section of this Resource Kit. Share these beforehand so that those who like to prepare can do so. You may want to have easel pads for groups to record their thoughts, but avoid the impression that there is a "right answer" or that the output will be critiqued.


Select a principle, provide about 3-5 minutes of explanation about it so that everyone is clear what it means, and give the discussion group these three activities to do:

  • Make a list of 3 or 4 traditions in healthcare that seem to you to be counter to this principle.

  • Tell stories from your past experience that seem to you to illustrate this principle (either positively or negatively).

  • Pick a current issue and discuss how you might approach it with this principle in mind.

Have a large group discussion of key insights from each group.

Let the pace and intensity of the discussion be your guide regarding how long to spend on this. Fruitful discussion can be had in as few as 10 minutes and as much as an hour. The first time you use it, set a time limit of 15 minutes, announce time checks every five minutes and ask the groups to move on to the next item to be sure they cover them all. See how it goes and adjust the time accordingly for the next principle you discuss.

You might cover several principles in a 1-2 hour session and save the rest for another time. Trying to cover all 11 principles in one session is probably too much.

A Peek Behind the Activity

The structure of the questions is intended to contain anxiety. Participants can first engage the principle at arms length by looking at general traditions that "others" in healthcare typically follow. They next tell stories from the perspective of hind-sight, where it is always easier to be wise. But, in the end, they are drawn into a discussion of some issue that is close to home for them.

The structure of the questions also creates some healthy tension for change, social support, and skills for more effective action.

Finally, the questions move from abstract, conceptual analysis to concrete action in the here and now; something for all learning styles.

Extensions of the Activity

The three questions are a nice fractal for discussion of any new concept, not just the formally stated principles of complexity. For example, you could explain the Aide of Minimum Specifications and then go
on to group discussion using basically these same three items.

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Copyright 2001, Paul E. Plsek & Associates,
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