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Nice model, but what is the evidence?
EHMA Annual Meeting, Porto, June 15th, 2016
Evidence Based Practice, basic principles and practical examples
Postgraduate Course
Our Fellows
CEBMa: what we do
Promote (seminars, papers, blogs, tweets)
Educate (universities & business schools)
Train & coach (companies > projects)
Support / REAs (companies)
Support / 2nd opinion (BS detector)
15 min Management models
25 min EBP: What is it and why do you need it?
20 min A practical example
… min Discussion
Our mission for today
To disturb
To reassure
Dangers of believing things that aren’t true
It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so. (Mark Twain)
The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge. (Stephen Hawking)
Some examples
What’s happened to average job tenure in the UK and US over the past 10 years?
Up?
Down?
Stayed the same?
Some examples: Job satisfaction
What’s happened to job satisfaction in the US over the past 10 years?
Up?
Down?
Stayed same?
Some examples: VUCA
Is the world moving ever faster – more VUCA (volatility, uncertainty, complexity and ambiguity)?
Faster?
Slower?
Same?
The idea that time is speeding up is clearly popular. It is also plausible. There is just one problem. It is very hard to prove that it is actually happening.
Hard evidence of a great acceleration is hard to come by. The Economist has considered a variety of measures by which the speed of business in America can be quantified. A few do show some acceleration. But a lot do not.
UK Patents
Some examples: Generational differences
Are there generational differences in work attitudes?
Big differences?
Small differences?
No differences?
So what?
There are many taken-for-granted assumptions and ‘truths’ in management that turn out to be wrong or at least overstated
It’s important to examine these assumptions because if they are wrong will lead to poor decisions
Possibly also in the case of Management Models
Nice pictures
Model
Taken-for-granted assumptions?
Fad? Evidence?
The question is …
Model
Most of these models are developed within the domain of management
The problem with managers
They love fads!
38
Scientific Management/Taylorism
Business Process Reengineering
Total Quality Management
Learning Organizations
Knowledge Management
The nearly forgotten fads
39
40
Talent management
Emotional intelligence
Employee engagement
Lean / six sigma / theory of constraints
Autonomous teams (it’s back!)
Agile
The fads that haven’t been forgotten (yet)
41
Fads seem to be attractive, compelling and irresistible
Promise to deliver a lot and fast
Appear simple
Will make everything alright and help contain
anxieties around intractable problems
Help user feel effective and cutting edge
Bits of some fads may work in some context
43
44
1. What tells you a model is a fad?
2. Can you give an example in healthcare management?
Discuss with your neighbour (2 min)
Discussion
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1. Simple, straightforward: Easy to communicate, comprehend, and reduce to a small number of factors or dimensions.
2. Promising results: Fad auteurs are confidently didactic. There is no false humility or hedging.
3. Universal: Solutions for everyone everywhere.
4. Step-down capability: Can be implemented in ritualistic and superficial ways.
How to spot a management fad
5. In tune with zeitgeist: Resonate with trends or perceived business problems of the day.
6. Novel, not radical: Novelty is not so much new discovery as a rediscovery and repackaging of older ideas.
7. Lively, entertaining: Articulate, bold, memorable and upbeat. Filled with labels, buzzwords, lists, acronyms and fun anecdotes > your system 1 loves it!
8. Legitimacy via gurus and star examples: Supported by stories of excellent companies and the status of gurus, not by solid evidence.
How to spot a management fad
Model
So, we need a meta-model to check
whether the model is evidence based
Evidence based practice:What is it?
Evidence based medicine?
Never heard off
Heard off
Heard off and can explain
Evidence based management?
Never heard off
Heard off
Heard off and can explain
Evidence-based practiceCentral Premise:
Decisions should be based on the ‘best available evidence‘.
Evidence?
information, facts or data supporting (or contradicting) a claim, assumption or hypothesis
Evidence?
outcome of scientific research, organizational facts & figures, benchmarking, best practices,
personal experience
All managers and leaders base their decisions on ‘evidence’
But…many managers pay little or no attention to
the quality of the evidence they base their decisions on
and use too few sources of evidence
Trust me, 20 years of management experience
Sources of evidence
problem solution
Practitionersprofessional expertise
Organization internal data
Stakeholdersvalues and concerns
Scientific literature empirical studies
AskAcquire
AppraiseAggregate
ApplyAssess
Professional experience and
judgment
Multiple sources?
Multiple sources?
Organizational data, facts and figures
Multiple sources?
Organizational data, facts and figures
Multiple sources?
Scientific research
outcomes
Evidence based practice:Where does it come from?
McMaster University Medical School, Canada
Medicine: Founding fathers
David Sackett Gordon Guyatt
How it all started
1. Ask: translate a practical issue into an answerable question
2. Acquire: systematically search for and retrieve the evidence
3. Appraise: critically judge the trustworthiness of the evidence
4. Apply: incorporate the evidence into the decision-making process
5. Assess: evaluate the outcome of the decision taken
5 steps of EBmed
Evidence-Based Practice
1991Medicine
1998Education
2000Social care, public policy
Nursing, Criminal justice,
Policing, Architecture, Conservation
2010Management
Evidence-Based Practice
Evidence-Based Practice
Evidence-based … whatever =
the use of evidence from multiple sources to increase the likelihood of a
favourable outcome
Focus on the decision making processThink in terms of probability
Evidence-Based Decision-Making Why do we need it?
It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so. (Mark Twain)
The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge. (Stephen Hawking)
Advice: lie babies down to sleep on their belly(unanimous support through to the 1990s)
Example: medicine
Nr of cot deaths (Holland)
Example: economy / finance
Nov 15, 2005"With respect to their safety, derivatives, for the most part, are traded among very sophisticated financial institutions and individuals who have considerable incentive to understand them and to use them properly.”
Jan 10, 2008”The Federal Reserve is not currently forecasting a recession”
Collateralized Debt Obligations > AAA
0.12% (about 1 chance in 850) default in 5 years
Example: economy / finance
Forecasted Actual
Forecasted and actual 5-year default rates for AAA-rated CDO tranches
0.12%
28%
5 Trillion dollars in pension money, real estate value, savings and bonds disappeared
8 million people lost their job
6 million people lost their houses
Example: economy / finance
(and that was only in the USA)
Scared straight
Example: policy / prevention
Example: HR management
1. Incompetent people benefit more from feedback than highly competent people.
2. Task conflict improves work group performance while relational conflict harms it.
3. Encouraging employees to participate in decision making is more effective for improving organizational performance than setting performance goals.
Likely or unlikely?
ALL NOT LIKELY !
How evidence-based are HR managers?
959 (US) + 626 (Dutch) HR professionals 35 statements, based on an extensive body of
evidence true / false / uncertain
HR Professionals' beliefs about effective human resource practices: correspondence between research and practice, (Rynes et al, 2002, Sanders et al 2008)
Outcome: not better than random chance
Example: management models
George BuckleyJames McNerney
So where does the evidence-based stuff come in?
Relying on only 1 source: bad idea!
problem solution
Practitionersprofessional expertise
Organization internal data
Stakeholdersvalues and concerns
Scientific literature empirical studies
Discuss with your neighbor (1 min)
Over a 5 year period,
why is an orthopedic surgeon's experience, as a rule, more trustworthy than a change manager’s experience?
60595857565453525150494847464544434241403938373635343332313029282726252423222120191817161514131211109876543210
Developing expertise
1. A sufficiently regular, predictable environment
2. Numerous opportunities to practice
3. Receive accurate (objective) feedback
The management domain is not highly favorable to expertise!
Bounded rationality
How your brain works
System 1 Fast Intuitive, associative heuristics & biases emotional
System 2
Lazy Slow Deliberate Rational
dominant
System 1: short cuts
System 1 or system 2?
10 seconds
System 1 or system 2?
A bat and a ball cost $1.10 in total.
The bat costs $1 more than the ball
How much does the ball cost?
109876543210
System 1: necessary to survive
95%
Pattern recognition Overconfidence bias Halo effect False consensus effect Group think Self serving attribution bias Sunk cost fallacy Cognitive dissonance reduction
System 1: prone to cognitive errors
Confirmation bias Authority bias Small numbers fallacy In-group bias Recall bias Anchoring bias Availability bias
When it is your job to make decisions,
you need to know how your brain works
when making decisions!
We are predisposed to see order, pattern and causal relations in the world.
Patternicity: The tendency to find meaningful patterns in both meaningful and meaningless noise.
pattern recognition
We are pattern seeking primates: association learning
pattern recognition
Points of impact of V-1 bombs in London
Points of impact of V-1 bombs in London
Pattern recognition
Pattern recognition
A Type I error or a false positive, is believing a pattern is real when it is not (finding a non existent pattern)
A Type II error or a false negative, is not believing a pattern is real when it is (not recognizing a real pattern)
Dr. Michael Shermer (Director of the Skeptics Society)
Pattern recognition
A Type I error or a false positive: believe that the rustle in the grass is a dangerous predator when it is just the wind (low cost)
Pattern recognition
A Type II error or a false negative: believe that the rustle in the grass is just the wind when it is a dangerous predator (high cost)
Pattern recognition
A Type I error or a false positive: believe that the rustle in the grass is a dangerous predator when it is just the wind (low cost)
A Type II error or a false negative: believe that the rustle in the grass is just the wind when it is a dangerous predator (high cost)
DEFAULT
Pattern recognition
Doctors and managers hold many erroneous beliefs,
not because they are ignorant or stupid, but because
they seem to be the most sensible conclusion
consistent with their own professional experience!
“I’ve been studying judgment for 45 years, and I’m no better than when I started. I make extreme predictions. I’m over-
confident. I fall for every one of the biases.”
Practitionersprofessional expertise
Organization internal data
Stakeholdersvalues and concerns
Scientific literature empirical studies
Four sources of evidence (not only 1)
The performance of knowledge workers
A Practical Example
550 beds
3300 employees
210 medical specialists
225,000 admissions
Top Clinical & Teaching hospital
Organization
The model
2015: 7.2 2016: 6.3
A happy & engaged employee is a productive employee
Fundamental assumption
Let’s have a look at the evidence
Professional experience and
judgment
Organizational data, facts and figures
Stakeholders’ values and concerns
Scientific research
outcomes
AskAcquire
AppraiseApply
Assess
problem solution
Productivity: mean observed r = .15 (𝞀 = .25)
Correlation with job satisfaction r = .91
… The effect of job attitudes (e.g. satisfaction, commitment)
on performance was weak (β = .06) ….
… The relationship was almost eliminated after controlling for
personality traits …. and self esteem.
GREAT! NOW WHAT?
Evidence-based approach, step 1: ASK
problem solution
Practitionersprofessional expertise
Organization internal data
Stakeholdersvalues and concerns
Scientific literature empirical studies
AskAcquire
AppraiseAggregate
ApplyAssess
Population? Knowledge workers
Whether nurses, lawyers, engineers, managers, or staff members, nowadays most workers in organizations are highly dependent on information and communication technology and are involved in
work that involves a high level of cognitive activity.
Question
“Which of the factors that are related to the
performance of knowledge workers are most
widely studied and what is known of their
effect?”What do you think?
I Don’t Know(but I know how to find out)
The 3 hardest words in management
Step 2: ACQUIRE
Search for the best available scientific evidence
ABI, BSP, PsycINFO
Scholarly journals, peer reviewed
1980 – 2013
English
performance, productivity, knowledge work*
ACQUIRE
step 3: APPRAISE & AGGREGATE
Effect size?
Most studied & largest effect size
1. Social cohesion .5 / .7
2. Perceived supervisory support .5
3. Information sharing / TM.5
4. Vision / goal clarity.5
5. Trust.3 / .6
step 3b: CROSS VALIDATE – multiple sources
Step 4: APPLY
Three examples
social cohesion supervisory support
information sharing
Social cohesion
Social cohesion
… a shared liking or team attraction that includes bonds of friendship, caring,
closeness, and enjoyment of each other’s company.
Social cohesion
Measuring social cohesion
Perceived supervisory support
…how employees feel the supervisor helps them in times of need, praises
them for a job well done or recognizes them for extra effort.
Perceived supervisory support
Perceived supervisory support
Measuring perc. sup. support
Information sharing
Information sharing?
…refers to how teams pool and access their knowledge and expertise – which positively
affects decision making and team processes. This has led to the idea of a team ‘Transactive
Memory System’ (TMS), which can be thought of as a collective memory in a collective mind - enabling a team to think and act together
Information sharing
Measuring information sharing
Step 5: ASSESS the outcome
The departments with the lowest performance scored under average on most factors
Reactions
Who knew?
So, when a new model crops up