Complexity theory as an approach to explanation in healthcare: A critical discussion

Paley, John; Eva, Gail

doi:10.1016/j.ijnurstu.2010.09.012

Cited by 70 publications

(63 citation statements)

References 56 publications

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“…However, some components, such as attractors, seem to be open to ambiguity. For example, Paley and Eva (2011) commented that the whole concept of attractors is often misinterpreted as an 'intentional' phenomena, when, in fact, it originates in mathematics as an algebraic descriptor of certain endpoints or end states in a system (such as the point where a pendulum comes to rest). In this paper, we have translated this concept into an end state, where the system is still flexible, but within a more or less defined rage.…”

Section: Discussionmentioning

confidence: 99%

“…He described complex adaptive systems as non-linear systems in which diverse agents interact with each other and are capable of undergoing spontaneous self-organisation. Since 2001, when the British Medical Journal launched a series of articles on complexity in health care (Fraser and Greenhalgh, 2001;Plesk and Greenhalgh, 2001;Plsek and Wilson, 2001;Wilson et al, 2001), there has been a growing debate around the use of the theory in the health care context (Reid, 2001;Paley, 2007;Sturmberg, 2007;Dattée and Barlow, 2010;Greenhalgh et al, 2010;Paley and Eva, 2011;Sturmberg et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Taxonomy for complexity theory in the context of maternity care

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Taxonomy for complexity theory in the context of maternity care

et al. 2015

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“…[1] These and other conversations ignited some opposition to the use of what was argued to be the misguided appropriation and psychologising of complexity theory in its application to health care. [24,25] Despite this opposition the concepts and metaphors drawn from this theory clearly continue to help people to make sense of the healthcare environment in which they work and inspire them to think creatively about approaches to managing the complex problems they encounter. [18] This can be seen in a range of areas where 'complexity thinking' continues to inspire change and innovation in curricula across a variety of health disciplines such as, for example, medicine, [26] healthcare management, [27] dentistry, [28] sports science, [29] interprofessional practice [30] and nursing.…”

Section: Developing a Guiding Conceptual Modelmentioning

confidence: 99%

Renewal of an entry to practice baccalaureate nursing curriculum: Adapting to complexity

Fetherston

Browne

Andrus

et al. 2017

JNEP

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Curriculum re-design in entry to practice nursing degrees requires a rigorous and multifaceted approach to align the needs of students, professional and industry stakeholders, community needs, the faculty's vision and university and regulator requirements. This paper relates the initial steps in the process taken to achieve this re-design in one Australian university's Bachelor of Nursing program, and describes our experiences in two parts. The first part outlines the context in which the need for curriculum renewal was triggered and the ensuing processes undertaken in the development of our new course aim, course outcomes and graduate attributes. The second part discusses how undertaking these activities then came to influence the adoption of Complexity Thinking in the design of our conceptual model, which then guided our program structure and overarching learning and teaching approaches. We share these experiences to illustrate the steps we undertook on this journey, to outline and example the program we created, and to continue the scholarly discussions around the design of baccalaureate nursing program structures, especially those that implement pedagogies inspired by the concepts related to Complexity Theory. The choice of complexity thinking as a guiding theory was key in providing the lens through which we were inspired to graduate nurses with the skills to provide care in complex situations and value the learning that comes through uncertainty, reflection, adaptation and emergence.

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“…Complexity science fits well with the unruly day-to-day reality of primary care psychologists (Smit, 2015). There is no formal definition of complexity sciences but this emerging approach to research can be seen as a collection of theories and conceptual tools (Benham-Hutchins & Clancy, 2010; Paley & Gail, 2011). It can be described as the scientific study of complex systems, in which many parts interact.…”

Section: Vignette Studymentioning

confidence: 99%

Vignette research on messy and confusing problems in primary mental healthcare

Smit

Derksen

2017

Eur. J. Psychol.

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The average primary care psychologist feels an ever-widening gap between objective, measurable reality as described and the complex and dynamic reality they experience. To obtain a better understanding of this complex dynamic reality, we conducted an exploratory mixed-method study of primary care psychologists. We asked our participants to write vignettes about messy and confusing problems in the complex context of mental healthcare. We then examined the data in portions, exposed the patterns in the data, and subsequently analysed all in conjunction. The 113 vignettes showed experiences of psychologists dealing not only with the patient, but also with the family of the patient and/or employers, working together with other healthcare professionals, struggling with dilemmas and having mixed feelings. However, using the Cynafin Framework, 36% of the vignettes were still rated as simple. Was it because those vignettes contained fewer words (p = .006)? Or because it is difficult to grasp complexity when cause and effect are intertwined with emotions, norms and values? In the discussion, we suggest examining a complex dynamic system in terms of both the consistency of its various elements and the dynamics of the system. We also discuss how to optimize the system’s adaptive self-organizing ability and how to challenge ourselves to invent negative feedback loops that can keep the complex system in equilibrium.

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Complexity theory as an approach to explanation in healthcare: A critical discussion

Cited by 70 publications

References 56 publications

Taxonomy for complexity theory in the context of maternity care

Taxonomy for complexity theory in the context of maternity care

Renewal of an entry to practice baccalaureate nursing curriculum: Adapting to complexity

Vignette research on messy and confusing problems in primary mental healthcare

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