The slides from the workshop run by Helen Bevan, Christian von Plessen and Goran henriks at the Jonkoping Microsystem Festival on 28th February 2018 #qmicro

1. Connectivism:
Building mastery in
connecting

2. “If you are curious in the concept of connectivism, please join
us in an exploration of the secrets behind the need of
connectors and understanding of connectivism.
Connectivism can be described as the integration of principles
explored by chaos, network, and complexity and self-
organization theories. Connectivism starts when we see that:
Learning and knowledge rests in diversity of opinions and
that learning is a process of connecting nodes or competence
sources. The starting point of connectivism is the individual
and the relationships within networking. This opportunity
of knowledge development (personal to network to
organization) allows learners to remain current in their field
through the connections they have formed”.

3. Who is in the room?
The foundations of connectivism
Tell everyone:
• who you are
• where you are
from
• Something you
want others to
know about you
In one breath!

4. 1. understand concept of connectivism
and the benefits is can bring
2. practice connectivism in real life
situations
3. explore potential and power of
connectivism for your own work
LEARNING

5. • Who’s in the room?
• Agenda for the workshop
• Introduction to connectivism I
• Practicing connectivism
• Fika: randomised coffee trial
• Why connectivism is crucial for the future of quality improvement
• Practicing connectivism II: Danish case study
• Fika
• Practicing connectivism III: Apply connectivism in your own setting
• Learning review: snow storm
13.15-16.45

6. What is connectivism?
Amplifying our learning, knowledge and
understanding by extending our personal
connections and networks
• We need to maintain and nurture our connections
so we can keep learning continuously
• the connections that enable us to learn more are
more important than our current state of
knowledge

7. What is the best way to spread new
knowledge?
Source of data: Nick Milton
http://www.nickmilton.com/2014/10
/why-knowledge-transfer-
through.html
Social connection/discussion is
14 times more effective
than
written word/best practice
databases/toolkits etc.
Source of image: www.happiness-one-quote-time.blogspot.com

8. http://www.nancydixonblog.com/2017/07/the-
hidden-knowledge-problem-in-organizations.html

9. “We learn when
we talk”
Nancy Dixon
https://t.co/t47VYkSSak
Source of image: @GraphicChange

10. Connectivism focuses on tacit knowledge, not
just explicit knowledge
Explicit
knowledge
Tacit
knowledge
Codified
knowledge
Found in documents,
databases, toolkits, quality
standards
Essential for transfer and
storage
Intuitive
knowledge and
know-how
Rooted in context, experience,
Practice and values
Hard to communicate
Most valuable kind of
knowledge for innovation and
improvement
Most likely to lead to
breakthroughs

11. Task: practicing connectivism 1
On your own, identify a problem or challenge
you are currently addressing. Write or draw the
problem on a sheet of paper
Time available: 5 minutes

12. Task: practicing connectivism 1
Find a partner at your table and discuss each
other’s problem or challenge.
What insight can your partner add? Add their
wisdom to your writing or drawing
Time available: 6 minutes

13. Task: practicing connectivism 1
Introduce your partner to the rest of the table and
share their challenge or problem
As a table identify a problem/challenge that you
would all like to work on
What knowledge or wisdom do the rest of the table
have that can help?
Time available: 15 minutes

14. Task: practicing connectivism
Review the outputs of your
discussion.
What tacit knowledge could others
on your table share?
What was the impact of
connectivism?
Be prepared to share with the
whole group
Time available: 15 minutes

15. Task: practicing connectivism
Whole group discussion
• What difference does
connectivism make?
• What are the principles of
connectivism we used?
Time available: 15 minutes

16. For our break, we will
have a RCT

17. • Randomised Coffee Trial!
• Randomised Coffee Trial!
Randomised Coffee Trial!

18. Outcomes of Randomised Coffee Trials

19. ”Yet, there is frustration across the healthcare
system that this process [diffusing…innovations]
is often too slow and laborious, that too many
innovations fail to spread beyond their site of
origin, and that even when they do, many
struggle to reproduce the original outcomes and
impact.”
Health Foundation and Innovation Unit:
Against the Odds, Successfully Scaling
Innovation in the NHS, p 5.

20. The “pilot and roll-out” model is increasingly being
questioned as a method for spreading change
Pilot project Rolling out
“If we opened our eyes we would see the wonderful irony. Trying to
manage human change through pilot and roll-out has actually grown
something. A proliferation of project managers”.
John Atkinson

21. See also:
Health Foundation and Innovation Unit:
Against the Odds, Successfully Scaling Innovation in the NHS
Greenhalgh et al 2004. Diffusion of Innovations in Service Organisations:
Systematic Review and Recommendations. Milbank Quaterly
Should considerOften done
• ‘Prove it works’
• ‘Find a
champion’
• ‘Focus on
exemplars’
• ‘Make them do
it’
• Building demand through existing
networks and narratives
• Scaling vehicles rather than lone
champions
• Using evidence to build demand
• Capitalising on national and local
system priorities
• Using policy and financial levers to
kick start momentum
• External funding to support spread

22. “Many researchers have already cast much
darkness upon this subject, and it is probable
that if they continue, that we shall soon know
nothing at all about it”
Mark Twain

23. Some traditional theories on learning

26. Some aspects of connectivism
• ”Knowledge is distributed across a network of connections, and
therefore learning consists of the ability to construct and
traverse these networks”
• Qualitative and quantitative knowledge AND distributed
knowledge (Stephen Downes)
• ”In connectivism there is no real concept of transferring
knowledge, managing knowledge, or building knowledge, rather
the activities we conduct” (Stephen Downes)
• Knowledge is ‘IN’ the network and ‘OF’ the network (or of the field, see
Bagger Vance: https://youtu.be/GGthroXgjs8 for a nice example of ”knowledge of the field”)

27. Key features of connectivism

28. Choose one question and discuss at table!
• How can connectivism promote improvement
and patient safety?
• How will patients and professionals notice
changes of connectivism?
• How does connecitvism impact professionals
at different organisation/system levelse?
• What could be limits of and problems with
connectivism?

29. How could a connectivist approach make a difference
for learning from adverse events in primary care in the
Region of Southern Denmark?
A case clinic

30. Adverse events primary care, Region of Southern Denmark
Setting:
• 1,2 mil inhabitants
• 850 General practitioners
• Clusters of 12
• 22 municipalities
• 5 hospitals
• GPs report 1600 AEs annually
• < 50% read regional practice newsletter

31. Adverse events primary care, Region of Southern Denmark
Aims for project:
• Raise awareness and motivation
• Improve safety in the entire patient pathway
• Improve learning from AE’s among GPs
• Spread improvements among GP’s

32. Adverse events primary care, Region of Southern Denmark
Perspectives:

33. Adverse events primary care, Region of Southern
Denmark: some facilitators and barriers
• Collegial bonds • Sectors
• Liaison GPs • ‘Tense climate’
• Contracts between GPs and
Region
• Different work realities,
cultures, languages
• Clusters of 12 • Financial incentives not
aligned
• Annual practice day • Money talks
• Social media platforms • Older GPs not ”into social
media”
• Patients
Impeding connectivenessSupporting connectiveness

34. Talk about the case at the tables
• What are the challenges?
• How would you approach the task?

35. The era of connectivism
Source of image: @voinonen

36. End of
Moore’s Law

37. The era of connectivism
We are witnessing the collapse of expertise
and rise of collaborative sensemaking
David Holzmer
Source of image: ACCA

38. Collaborative innovation methods are
outpacing traditional R&D
Source: PWC Innovation benchmarking survey 2017

40. “Many times experts fail because
they are experts in the past version
of the world”
Vikram Khosia

41. We still organise health and care like the
Tabulating Machine Co. of 1917
Source of image: @corp_rebels

44. Source: Innovisor

45. Three time points of collaboration among
cancer clinicians and researchers
from Braithwaite and colleagues 2017

46. Source: World Economic Forum goo.gl/VDSnhA

47. Connect with the 3%
Just 3% of people in the organisation or
system influence 85% of the other people
Source: research by Innovisor

48. The 3% rule also appears true for
social media
Source: research by Graham MacKenzie using NodeXL
In health and
healthcare globally,
tweets by 3.3% of
tweeters accounted
for 85% of retweets

49. Most social media operates within an
echo chamber
Source of image: Scriberia

50. The powerful medical “superconnectors”
Source: NodeXL analysis:

51. Let´s connect
• Click call and walk

52. • https://ungcancer.se/
• https://www.diabetes.se/ungdiabetes/

53. Collaborate in partnerships

57. Talk at your tables!
• Where do I start when I come home?
• Do I have to change any of my workprocesses
at home?
• How can my teammates recognize my
improvements?

58. Our finale: “Snowstorm”
• Write down one key thing you have
learnt from this workshop on a sheet of
white paper

59. Our finale: “Snowstorm”
• Write down one key thing you have
learnt from this workshop on a sheet of
white paper
• Screw the paper up

60. Our finale: “Snowstorm”
• Write down one key thing you have
learnt from this workshop on a sheet of
white paper
• Screw the paper up
• On the signal, throw your paper
snowball in the air

61. Our finale: “Snowstorm”
• Write down one key thing you have learnt
from this workshop on a sheet of white
paper
• Screw the paper up
• On the signal, throw your paper snowball in
the air
• Pick up a snowball that lands near you and
read it aloud to the rest of your table