In their 2014 article, Jacobson, Kapur, and Reimann propose shifting the paradigm of learning theory towards the conceptual framework of complexity science. They argue that the longstanding dichotomy between cognitive and situative theories of learning fails to capture the intricate dynamics at play. Learning arises across a “bio-psycho-social” system involving interactive feedback loops linking neuronal processes, individual cognition, social context, and cultural milieu. As such, what emerges cannot be reduced to any individual component. To better understand how macro-scale phenomena like learning manifest from micro-scale interactions, the authors invoke the notion of “emergence” prominent in the study of complex adaptive systems. Discrete agents interacting according to simple rules can self-organize into sophisticated structures through across-scale feedback. For instance, the formation of a traffic jam results from the cumulative behavior of individual drivers. The jam then constrains their ensuing decisions. Similarly, in learning contexts, the construction of shared knowledge, norms, values …
How do we reframe health performance management within complex adaptive systems?
We need a conceptual framework that situates health performance management within complex adaptive systems. This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to performance management in a given context. Existing performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies. Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change. In my view, this important paper mends an important broken link in theories of change that try to consider learning beyond training. The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to …
What is a system?
Donella H. Meadows wrote the following simple, eloquent description of a system: “A system isn’t just any old collection of things. A system must consist of three kinds of things: elements, interconnections, and a function or purpose. A system is an interconnected set of elements that is coherently organized in a way that achieves something. The behavior of a system cannot be known just by knowing the elements of which the system is made. A system is more than the sum of its parts. It may exhibit adaptive, dynamic, goal-seeking, self-preserving, and sometimes evolutionary behavior. It is easier to learn about a system’s elements than about its interconnections. If information-based relationships are hard to see, functions or purposes are even harder. A system’s function or purpose is not necessarily spoken, written, or expressed explicitly, except through the operation of the system. Purposes are deduced from behavior, not from rhetoric or …