critical thinking for hro - iha insurance solutions · ‘cold thinking’ is akin to higher order...
TRANSCRIPT
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Presented by:
Michael R. Rip, PhD MSc(Med)
September 27, 2018
Critical Thinking for HRO
Mark A. Vroman, MBA EFO
34th Annual Risk Managers’ MeetingIllinois Provider Trust/Illinois Risk Management Services
Laying a Cognitive Foundation for Improving Patient Safety
L e a d i n g M i n d sA d v a n c i n g R e a s o n
R e v e a l i n g T r u t hB r e a k i n g P a t t e r n s t o I n n o v a t e
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Authors
!2 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Michael R. Rip, PhD MSc(Med)
Founding Director, MindLeap LLC Founding Director, Program in Healthcare Management (Eli Broad College of Business) Formerly: Founding Director, Program in Public Health (College of Human Medicine) Assistant Professor, Intelligence Program, School of Criminal Justice (College of Social Sciences) Michigan State University, East Lansing, MI 48824
Mark A. Vroman, MBA EFO
Co-Director: MindLeap LLC Battalion Chief, Meridian Township Fire Department Okemos, Michigan 48864
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Introduction
© 2017 Michael R. Rip PhD MindLeap LLC
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!4© 2017 Michael R. Rip PhD
MindLeap LLC!4
Introduction
Question
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WhydoesHROnotariseorganically,buthastobeimposedonhumanorganizationalsystems?
Thatis,whyisHROnotthedefaultpositionforhuman-createdprocessesandsystems?
CommonSense!(akaInstinctiveThinking)Answer
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!5 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
‘Thegreatestdeceptionpeoplesufferfromistheirownopinions.’
WithapologiestodaVinci!—afterLeonardodaVinci(1500s)
Leonardo da Vinci (1452–1519)
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!6 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
“Anofficer’sfirstweaponistheirmind.”—ColonelStephenLiszewski,USMC
CommandantofMidshipmen,U.S.NavalAcademy(19August2015)
https://www.usni.org/magazines/proceedings/2018-08/dynamic-thinking-no-threat?utm_source=U.S.+Naval+Institute&utm_campaign=728b8d64b2-EMAIL_CAMPAIGN_2018_08_23_Pro_Today&utm_medium=email&utm_term=0_adee2c2162-728b8d64b2-222821625&mc_cid=728b8d64b2&mc_eid=18fdd08abd
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!7© 2017 Michael R. Rip PhD
MindLeap LLC!7
Elite Cognitive Performance
Goal: Achieve Elite Cognitive Performance in the workplace
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It’allaMindGame!
InstinctiveThinking(default)akaCommonSense
Mediocre
Elite CriticalThinking
Performance Type of Thinking
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!8 © 2017 Michael R. Rip PhD MindLeap LLC
Business 4.0
Top 10 skills
in 2020in 2015
Complex problem solving
Source: WEF, The Future of Jobs: Employment, Skills and Workforce Strategy for the Fourth Industrial Revolution (January 2016)http://www3.weforum.org/docs/WEF_Future_of_Jobs.pdf
12 Coordinating with others (Teams)3456789
10
People ManagementCritical ThinkingNegotiationQuality ControlService OrientationJudgment & Decision-MakingActive ListeningCreativity
Critical Thinking
People ManagementCoordinating with others (Teams)
Service OrientationNegotiation
Complex problem solving
Creativity
Emotional IntelligenceJudgment & Decision-Making
Cognitive Flexibility
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!9 © 2017 Michael R. Rip PhD MindLeap LLC
Industry 4.0
•Changeandthepace(rate)ofchange
Some features … that CRITICAL THINKING will be vital for …
•Fastdecision-makingcycle
•Acceptingandworkingwithcomplexity
•Askingthe“right”questions—ratherthanthe“right”solution(answers)
•Thefocusisonthefuture
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—Tactical:employ‘EliteOODALoop’
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!10 © 2017 Michael R. Rip PhD MindLeap LLC
Common mantra …
But, actually there is an ‘I’ in Team …
We want … •Independentminds•Maximizecollaborationandcooperation
There it is!
•Toavoid/minimizethecognitivebiasofGroup-Think!
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Operational Environment
© 2017 Michael R. Rip PhD MindLeap LLC
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!12 © 2017 Michael R. Rip PhD MindLeap LLC
The Era of VUCA
This acronym emerged in the U.S. Army War College in the 1990s to describe the capability to engage situations marked by change and challenges
Thenatureanddynamicsofchange,andthenatureandspeedofchangeforcesandchangecatalysts
Thelackofpredictability,theprospectsforsurprise,andthesenseofawarenessandunderstandingofissuesandevents
Themultiplexofforces,theconfoundingofissues,andconfusionthatsurroundanorganization
V = Volatility
U = Uncertainty
C = Complexity
A = Ambiguity Thehazinessofreality,thepotentialformisreads,andthemixed
meaningsofconditions;cause-and-effectconfusion
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Page 19 [Emphasis added]
“ Adaptability is responding to new needs or
changes without a loss of functionality.
Adaptive leaders possess many different skills and qualities that allow the Army to retain the
initiative. Army leaders think critically, are comfortable
with ambiguity, accept prudent risk, assess the situation continuously, develop innovative
solutions to problems, and remain mentally and physically agile to capitalize on opportunities. ”
U.S. Army
http://www.tradoc.army.mil/tpubs/pams/tp525-3-1.pdf
!13 © 2017 Michael R. Rip PhD MindLeap LLC
Mental agility
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On Human Thinking …
© 2017 Michael R. Rip PhD MindLeap LLC
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!15 © 2017 Michael R. Rip PhD MindLeap LLC
Arguing …
https://heleo.com/conversation-humans-are-great-at-arguing-but-bad-at-reasoning-julia-galef-explains-why/11304/
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This is known as the Argumentative Theory
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!16 © Michael R. Rip 2014
2 Modes of Thinking: ’Hot’ and ‘Cold’ Thinking
Hot
—Coldcognitionisessentiallythelackofemotionalinfluenceincognitiveprocess
—Decision-makingwithcoldcognitionismorelikelytoinvolvelogicandcriticalanalysis
‘Cold Thinking’ is akin to Higher Order Thinking
—Hotcognitionisahypothesisonmotivatedreasoninginwhichaperson'sthinkingisinfluencedbytheiremotionalstate
—Itissignificantlyinfluencedbycognitivebiasesandfallacies
Cold
Hot equates to Intuitive (Instinctive) Thinking
System 2
System 1
•Trainingoughttominimizeemotionalthinking
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Daniel Kahneman ,Thinking, Fast and Slow (2011) Critical Thinking is the application of Higher Order Thinking to discover ‘truth’
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Characteristics of our ‘Hot’ and ‘Cold’ Thinking Mind
Copyright © 2017 Michael R. Rip PhD MindLeap LLC
Fast
System 1Instinctive Thinking
System 2Higher Order Thinking
Unconscious
Automatic
Pattern-based
Everydaydecisions
Error-prone
Slower
Conscious
Effortful
Notpattern-controlled
Complexdecisions
Reliable
Instinctive Thinking High Order Thinking
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Thehumanbraindoesnotusually‘think,’butadherestosetsofrulesbasedonpatterns.
• Kills creativity ... and eventually innovation suffers
Human ‘Thinking’
•Instinctive-patternedthinking(viapattern-seeking/pattern-finding)•Learned
•Createsasenseofpredictability•Certainty
But • Kills higher order reasoning
• Produces risk-averse thinking and behavior
‘Mindlessness’
‘Conscious awareness drives only about 20% of what we think and do every day.’
•Consistency
© 2016 Michael R. Rip PhDFIRSTRESPONDER
Note:ThisistheoppositeofwhatVUCAcallsfor!
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On Instinctive Thinking …
© 2017 Michael R. Rip PhD MindLeap LLC
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Common sense is controlled by patterns!
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!20 © Dr. Michael R. Rip 2008
Our ‘Hunter-Gatherer’ Minds
Instinctive Thinking
Known as: • Commonsense• Natural Thinking• Intuitive Thinking
We use correlations of patterns to infer explanations
April 2016
The minds key strategy: Pattern-Seeking • Pattern-Finding • Pattern-Extrapolating
Characteristics: • Unconscious• Rapid• Employs heuristics
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Three key insights from neuroscience research
© 2015 Michael R. Rip PhD
The brain seeks …
PATTERNS
PLEASURE
Short-term memory connects new to existing memory through PATTERN MATCHING
Rewards
Reward is exactly how we optimize those choices
Reward influences our happiness, pleasure, and motivation to do something
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PAIN Avoid pain/discomfort
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The brain interprets new information (data) based on existing pattern(s)
© 2015 Michael R. Rip PhD
Patterns …
Got a pattern?
New input (data) is misinterpreted, rejected, or simply disappears!
YES NO
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!23 © 2016 Michael R. Rip PhD
Pattern-Seeking / Pattern-finding
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LOV EWhat do you see here?
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!24 © 2017 Michael R. Rip PhD MindLeap LLC
· Oversimplifies complex situations· Jumps to conclusions· Relies on experience· Uses cognitive heuristics (shortcuts) · Uses cognitive biases (predispositions)
Some additional characteristics of Instinctive Thinking
Various effects include: · Inhibits questioning· Inhibits curiosity· Inhibits asking why
The role of emotion
Anxiety and fear cause us to default to ‘hard-core instinctive thinking’
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Cognitive Biases
!25 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Let’s Explore These …
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!26 © Michael R. Rip 2008
SEEING IS BELIEVING?
Pleasecounttheblackdots...
you are how you think
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Making assumptions
Anexample
Copyright © 2017 Michael R. Rip PhD MindLeap LLC
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!28 © 2016 Michael R. Rip PhD
20 biases that screw up your decision-making
See: Jennifer Wood, ’20 Cognitive Biases That Affect Your Decisions (17 September 2015)http://mentalfloss.com/article/68705/20-cognitive-biases-affect-your-decisions
Cognitive BiasesOur unconscious cognitive predispositions
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!29 © 2016 Michael R. Rip PhD
Welcome to CONFIRMATION BIAS
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!30 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Source:RichardsHeuer,PsychologyofIntelligenceAnalysis.CIA(1999).Availableat<https://www.cia.gov/library/center-for-the-study-of-intelligence/csi-publications/books-and-monographs/psychology-of-intelligence-analysis>.
“Cognitivebiasesaresimilartoopticalillusionsinthattheerrorremainscompellingevenwhenoneisfullyawareofitsnature.Awarenessofthebias,byitself,doesnotproduceamoreaccurateperception.Cognitivebiases,therefore,are,exceedinglydifficulttoovercome.”
[RichardsHeuer,1999,p.112]
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!31 © 2016 Michael R. Rip PhD
Organizing Cognitive Biases to better understand them …
Courtesy of: Buster Benson, ‘Cognitive bias cheat sheet: Because thinking is hard’ (September 1, 2016). Document available at: <https://betterhumans.coach.me/cognitive-bias-cheat-sheet-55a472476b18#.ahp5romx9>.
4 problems that cognitive biases help our minds address
Too much information — so we aggressively filter (cherry-pick) almost all of it out
Problem 1:
Problem 2:
Problem 3:
Problem 4:
Not enough meaning — the world is confusing, so we fill in the gaps via pattern-seeking/-finding to construct meaning
Need to act fast — lest we lose our chance, so we jump to conclusions
What should we remember? — This isn’t getting easier, so we try to remember the important bits
• These 4 problems have 4 consequences (problems) of their own• There are 4 problems that cognitive biases help our minds address
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!32 © 2016 Michael R. Rip PhD
Courtesy of: Buster Benson, ‘Cognitive bias cheat sheet: Because thinking is hard’ (September 1, 2016). Document available at: <https://betterhumans.coach.me/cognitive-bias-cheat-sheet-55a472476b18#.ahp5romx9>.
Those 4 problems have 4 consequences (problems) of their own
We don’t see everything — Some of the information we filter out is actually useful and important
Consequence 1:
Consequence 2:
Consequence 3:
Consequence 4:
Organizing Cognitive Biases (continued) …
Our instincts can be very wrong sometimes — Some of the conclusions we jump to about what it all means are wrong or outdated
Quick decisions can be seriously flawed — Some of the quick reactions are unfair, self-serving, and counter-productive
Our memory reinforces errors — Some of the stuff we remember for later just makes all of the above systems more biased, and more damaging to our thought processes
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Worst cognitive biases …
Claiming that your Instinctive Thinking is perfect for reasoned thought and decision-making
Claiming that you do not have any cognitive biases!
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On Critical Thinking …
© 2017 Michael R. Rip PhD MindLeap LLC
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Getting to CAUSALITY Getting Cause-Effect (Consequence) Correct
A Disciplined, Structured Way of Thinking
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Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
INSTINCTIVE THINKING
Innovation
Causality
HRO
DISCIPLINED INSTINCTIVE THINKING
CRITICAL THINKINGRT: Reflective ThinkingRC: Reality Checking
Crucial for 21st leadership in the era of Business 4.0 and VUCA
CPS: Creative Problem Solving
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MindLeap Definition of Critical Thinking
© 2015 Michael R. Rip
Critical thinking is the deliberate use of high-level cognitive strategies to avoid the traps of Instinctive Thinking and ensure our understanding of reality (especially causality) is as accurate as possible.
Without critical thinking, we have no way of checking if our perceptions and beliefs about the world are correct. It provides us with a vital negative feedback (error correcting) loop.
Definition according to Michael Rip (2013-17)
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MindLeap RT*RC Model for Critical Thinking …
Instinctive Thinking1Mindless / Unconscious / Default
3Critical Thinking
Mindful / Conscious / Deliberate
Reflective Thinking
Reality Checking
key elements
2Disciplined
Instinctive ThinkingMindful / Conscious / Deliberate
MindLeap 6 Step Process
© 2017 Michael R. Rip PhD MindLeap LLC!37FIRST
RESPONDER
Pattern-Seeking / Pattern-Finding
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The Importance of Curiosity
Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Greatmomentsindiscoveryoccurnotwhenasomeoneexclaims“Eureka!”
…butwhentheymurmur“That’sstrange”
…andsoitiswithinvention…“Why?”
alongwiththeWho,What,Where,When,andHow
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MindLeap 6-Step Critical Thinking RT*RC Model
RC: 2 Phases
2 Hypothesis Testing
RT
1 Hypothesis Generation
Who What Where When How
Now get to the WHY question
!39 © 2017 Michael R. Rip PhD MindLeap LLC
Investigate the situation
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!40 © 2017 Michael R. Rip PhD MindLeap LLC
The importance of WHY?
AskingWHY?manytimes…
•Helpstriggerinquiry,curiosity,andQUESTIONING
•HelpswithrevealingunrecognizedASSUMPTIONS
•HelpsrecognizingunconsciousCOGNITIVEBIASES
•HelpssparkCREATIVITY;INVENTION;andINNOVATION
Must create an environment of WHY
•Helpsavoid(EPIC)BLUNDERS/ERRORS
•Helpsprotectagainst(personal/tactical/strategic)DECEPTION
—Valuecollegiality,andTRUST,butdon’tbecontrolledbyit!
—AskingWHYdoesnotmeandisagreement
•HelpsgenerateMULTIPLEHYPOTHESES
FIRSTRESPONDER
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HRO Principles
© 2017 Michael R. Rip PhD MindLeap LLC
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!42 © 2017 Michael R. Rip PhD MindLeap LLC
HRO High-Reliability Organization(s) * Refer to handout
1 PREOCCUPATION WITH FAILURE
2 RELUCTANCE TO (OVER)SIMPLIFY
3 SENSITIVITY TO OPERATIONS
4 DEFERENCE TO EXPERTISE
5 COMMITMENT TO RESILIENCE
HRO Traits / Characteristics
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!43 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
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Surgeon General’s Committee on Smoking and Health 1963
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How not to tackle HRO issues …
Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Stackthecommittee!
“Threeofthememberssmokedcigarettes,andtwosmokedpipesorcigars.Terry,himselfasmoker,servedasthenominalchairmanofthegroup,butitwasagreedhewouldnotparticipateinanyofitsdeliberationsorconclusions.”
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Epic Fail and Why HRO is So Important
!45 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
India's new nuclear ballistic missile submarine INS Arihant
Rear hatch left open
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Recording Space Walks and HRO
!46 Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Failure/Error are not options for astronauts
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HRO Principle #1
© 2017 Michael R. Rip PhD MindLeap LLC
!47FIRSTRESPONDER
Preoccupation with failure
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!48© 2017 Michael R. Rip PhD
MindLeap LLC!48
HRO Principle #1
Feedback Mechanisms
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Avoidthe‘blameandshame’game
Inversion Thinking Tool
Avoidreinforcingfailure
Operationalizebothpositiveandnegativefeedbackloops
Positivefeedback:Self-reinforcing Negativefeedback:Self-correcting
TocounteractInstinctiveThinking(esp.ConfirmationBias)
Prevention and Mitigation Accuratedeterminationofcause-consequence(effect)
Alignrewards/incentives
Every ‘system’ demands both positive and negative feedback loops
Reinforce success Correct errors
Preoccupation with failure
Example IgnazSemmelweisandhand-washing(1840s)
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Putting Negative-Feedback Mechanisms Into Our Systems
Example
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In1999,NASA’s$125millionMarsClimateOrbiterburnedupintheMartianatmospherebecauseengineerstransmittedincorrectunitstothesatellite
“Peoplesometimesmakeerrors.Theproblemherewasnottheerror,itwasthefailureofNASA’ssystemsengineering,andthechecksandbalancesinourprocessestodetecttheerror.That’swhywelostthespacecraft.”
After-Action Review Thrust(navigation)commandswerecalculatedinImperialUnits(aspounds),andnotinMetricUnits(asNewtons)
Systemsmustbeableto‘trap’errors/failures!
Dr.EdwardWeiler(AssociateAdministratorforSpaceScience,NASA)providedavitallyimportantinsight:
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A few items
Copyright © 2011-18 Michael R. Rip, PhD MindLeap LLC
Using GPS in Afghanistan
Checklists
Employing Checklist
NewtechnologyfortargetingGPS-guidedmunitions
1•batteryissue
2•verballysendingco-ordstocirclingB-52bomber
Usedynamicscrambling
USAirFlight1549landedontheHudsonRiver,NYC
Turbinerestartchecklistissue
USSJohnS.McCainwarshipcollisioninSingaporeStrait
Loststeerage&usedchecklisttorecover,but…
al-Qa’aeda So-called“TrainingManual”eventuallygrewtoover8,000pages!
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HRO Principle #2
© 2017 Michael R. Rip PhD MindLeap LLC
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Reluctance to simplify
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!52© 2017 Michael R. Rip PhD
MindLeap LLC!52
HRO Principle #2
Goal
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OvercomeInstinctiveThinking
Limit‘oversimplification’bias
Simplify,butbeawareofVUCA(esp.complexity)
Okaytosimplify,but…
Simplify,butbeawareofdistractions
Maintain‘systems’perspectives
AvoidWYSIATIbias! WYSIATI:‘WhatYouSeeIsAllThereIs’
Appreciatemind’sdesireforcertainty
Reluctance to simplify
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HRO Principle #3
© 2017 Michael R. Rip PhD MindLeap LLC
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Sensitivity to operations
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!54© 2017 Michael R. Rip PhD
MindLeap LLC!54
HRO Principle #3
Importance of Training
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Influenceofemotiononperformance
Training=createtheenvironmentRealism/Realistictraining
Continual(notanevent;continuesintheworkplace)
Embeddedintothefabricoftheorganization
Appropriatelyincentivized/rewarded
Createsconsciousthinking–shiftsdefaultfromunconscioustoconsciousthinking
Sensitivity to operations
Trainingoughttobetested/evaluatedforeffectiveness/outcomes
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HRO Principle #4
© 2017 Michael R. Rip PhD MindLeap LLC
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Commitment to resilience
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HRO Principle #4
Organizational
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Individual
Comfortablewithchange
Creative&innovativeproblemsolving—rewardproblem-prevention!
Commitment to resilience
Resilience(individual&organization)–howwerespondandrecoverfromerror/failure
Ensurethattheoutcomeremainsthesamenomattertheenvironmentalconditions
Criticalthinkingteams=Negativefeedbackmechanism
—Weseeourfaultsinothersfirst
‘TraintheMind’AvoiddistractionsRealistictraining Dryruns Rehearsal Testing
MinimizepoorthinkingAvoidpattern-baseddecisionmaking(i.e.,absolutes,rules,bestpractices,experience)
Cognitive ability Comfortable with change Critical thinking
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HRO Principle #5
© 2017 Michael R. Rip PhD MindLeap LLC
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Deference to expertise
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!58© 2017 Michael R. Rip PhD
MindLeap LLC!58
HRO Principle #5
Expertise
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Deference to expertise
Avoidself-justification“everyoneisanexpert”
Avoidover-confidence
Dunning-KreugerEffect–illusory(deeplysubjective)superiority
Causesofepicfailures—CIA
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Summary
© 2017 Michael R. Rip PhD MindLeap LLC
!59FIRSTRESPONDER
A few parting shots …
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!60 © 2016 Michael R. Rip PhD
There are three distinct types (or varieties) of action that lead to epic blunders:
The confidence-skill disconnectWhenaperson’sconfidenceoutstripstheirskill(overconfidenceisaproblem!)
Impulsive actsWhenourbehaviorseemsoutofcontrol.Usuallydrivenbyemotion!
1
2
3 Lapses of attentionDistraction,assumptions,biases…
THE CAUSES OF EPIC FAILURES
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!61 © 2017 Michael R. Rip PhD MindLeap LLC
Key Cognitive Strategies (not in any order of priority)
Deliberately minimize distraction and create the opportunity for uninterrupted focus
Deliberatelyrecognizeandbreakpatterns,usingyourpattern-finding/seeking/extrapolatingability
Deliberatelyfocusongeneratingquestions—delayseekinganswers
DeliberatelyuseReflectiveThinking(RT)
Also:employ‘Systems(Theory)Thinking’
DeliberatelyuseInversionThinkingtool
Keypriorityistofullyunderstandtheproblem(situation)
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Overall, Critical Thinking represents a negative feedback mechanism for the HRO adventure
1)
2)
3)
4)
5)
6)
7)
8) Avoidmultitasking
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In Closing …
© 2017 Michael R. Rip PhD MindLeap LLC
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To end …
Our presentation began with this question
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“WhydoesHROnotariseorganically,buthastobeimposedonhumanorganizationalsystems?”
“Thatis,whyisHROnotthedefaultpositionforhuman-createdprocessesandsystems?”
Your reply … Atthisstageofthepresentation,younowpossessaninformedawarenessandknowledgeofhowcriticalthinkingformsthefoundationforHRO,asenseofhowtoleveragecriticalthinkingintoyourprocessesandoperations,andwhattoavoidorimprove
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MindLeap Training Programs
© 2017 Michael R. Rip PhD MindLeap LLC!64FIRST
RESPONDER
MindLeap provides 1-, 2-, 3-, and 4-day Critical Thinking and Leadership training programs to support HRO initiatives
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© 2017 Michael R. Rip PhD MindLeap LLC!65FIRST
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Thank You!
Contact
Michael R. Rip PhD MSc(Med)Director, MindLeap LLC
Mark A. Vroman MBA EFOCo-Director, MindLeap LLC