Accompanying a paper

1. HaCIRIC 2010 The simulation model as an object between boundaries M.Kapsali, T. Bolt, S. Bayer, S. Brailsford

2. Outline - Stakeholder interaction - The boundary roles of technology - What do models do - Simulation as a social object - Ideal Types - 2 case studies - Results - Questions

3. Stakeholder interaction Different diverse communities, Healthcare complexity, cognitive distance – various backgrounds, professions, roles, levels etc. + Different interests, viewpoints and background - communication patterns = Different forms of collaboration

4. The boundary roles of technology Communication and translation artefacts between several intersecting social worlds - multi-dimensional nature - satisfy their information requirements - explore perceptions and attitudes - convey meaning and create understanding used to manipulate meaning or assert status ambiguous role since they are used subjectively

5. What do models do? (Zagonel, 2002) (Zagonel, 2002)

6. Simulation as a social object 1. facilitate interdisciplinarity2. used to make predictions 3. shape the conversation 4. conceptual modelling as representing reality 5. negotiating a social order

7. Simulation as a social object (Ewenstein & Whyte, 2009)

8. Ideal Types

9. Ideal Types

10. Ideal Types Easily changeable, (visually) making systemic mechanisms easily accessible Fixed, (visually) making systems outcomes attractive

12. Work carried out by consultants in collaboration with expert group for health care client

13. Similar group model building approach

14. Different composition of expert group

15. Local project aims to inform commissioning

17. case studies cont.... National The goal was clear and shared Codifying the already shared knowledge The common understanding combined with the tool building focus resulted in limited use of the model as a boundary object. Local The model used to provide to stakeholders a shared imagery of the system through its RO function workshops spent time at creating the shared understanding of the problem

18. National: producing a generic tool for all PCTs Goal: "influence policy" and "make a difference“, "reflect the work we had done in this“, "Provide a tool for local authorities to make a robust business case." Group composition: "it is a reasonably small field" and so "we all knew each other" Some said model building made them "look at everything“ while others don’t see difference to other policy discussions Welcome broad participation in group (different disciplines) Model is ("looking at full spectrum of interventions") – model can communicate this to others Model can also distract because some find it difficult to understand

19. Local: producing a specific tool for one PCT Data clashed with perception of participants – learning about wider system, finding about the performance of the solutions, attention directed by modeller towards solutions Iterative process where the boundaries of the model are negotiated with participants depending on changing perceptions of the system “Three key points to help the participants use the model constructively: a well defined issue, people who have the power to make changes to take part in the process and the simplest model to address the issue.” “ ..... it is a group learning process – if you present it cold through a model without the learning process it is very difficult to own the results ......” “the model works best with those (participants) who have a whole systems view and can articulate what they see ....”

20. Results The ability of the model to serve as a boundary/epistemic object was limited by the perceived complexity of its visual representation. The role taken by the model at various points seemed to be linked to the project process- the process had an effect. Tied to the project process are the issues of consistency in participation and learning elements. Therefore it is a matter of project management handling the project group.

21. Results The less diverse and distant the group the more the representative role was successful- because the group had a common understanding of the reality of the system and common goal, did not need to negotiate it and created successfully fixed representational and technical elements in the model

22. Dominant role in case studies Local National

23. Questions Thank you