The Business Sensei

Hidden Assumptions

We’ve been hearing a lot about how it now appears that two nurses working with Ebola patients in Dallas have contracted the disease. The big question is, of course, how did it happen? What was the mistake or violation of medical protocol that led to them getting infected?

When I ran a pandemic flu simulation exercise (essentially, an experiential assessment) in Washington DC, part of the exercise involved doctors coming down with the deadly flu strain. I received some very interesting feedback from one of the doctors. He told me about all the different simulations that they do: natural disasters, terrorist attacks, accidents, radiation poisoning, etc. Then he said, “But we’ve never done one where we get sick.”

Hidden assumptions: the things we so take for granted that we don’t even consider them. Doctors and nurses are used to working with sick people, and they are used to working through a lot of minor discomforts. They just don’t think about getting sick. Apparently, though, no one ever told that to the Ebola virus.

And that’s the key point: our hidden assumptions are great until they’re not. It’s like the old slapstick routine where the comic steps on a rake: it seems to pop up out of nowhere and smack him in the face.

The problem, though, is that hidden assumptions are just that: hidden. We don’t even realize they’re there until we trip over them. At that point, the damage is done.

It’s far better to find them ahead of time. Unfortunately, we can’t just ask about them: what are we not considering? Hidden assumptions are hidden; they are, by definition, the things we are not thinking about or even considering. They are the box we don’t even know we’re in. Experiential assessment can change that by forcing us into experiences that reveal the box.

Real opportunity comes when we realize what we’re taking for granted.

Going Viral: What Ebola Can Teach Us About Organizational Learning

It’s been interesting listening to the news about the Ebola patient in Dallas. At times, it almost sounds like an ongoing soap opera, except that it won’t turn out to be a bad dream.

What was particularly noteworthy, though, was the news report that the hospital that incorrectly sent the Ebola patient home had just completed an Ebola simulation exercise. Assuming that the story is correct, this really makes me wonder about the simulation the hospital staff engaged in and its effectiveness at promoting organizational learning.

The problem, to be fair, with a great many simulations is that they are too scripted: the problems are presented with big flashing neon signs saying, “DANGER! DANGER!” and there is always a clear and correct solution. While this type of drill can be useful in basic skill development, it does not train people to handle real situations unless those real situations mimic the drill reasonably precisely. Effective simulations need to be more open-ended and ambiguous; people need to practice the much more difficult scenario of making decisions where the answers are not clear and the problems are indicated by flashing neon signs.

When I ran a pandemic bird flu simulation in Washington DC, I applied exactly those principles: the flu epidemic began quietly, the initial clues were subtle. Participants in the exercise, including doctors, military officials, businessmen, and politicians, initially missed the danger signs. No one wanted to be seen as Chicken Little, no one wanted to appear to panic or to be publicly wrong. As a result, they failed to stop the flu while it was still limited to only a few exposed people. Of the over 100 participants in the exercise, every one was exposed and over 60% “caught” the flu. Real changes took place after that.

Organizational learning is not just showing people what to do. Organizational learning is giving people the chance to practice skills in settings where they can experience success and failure, and where failure becomes an opportunity to learn and improve. That’s really what effective simulations are all about, at least if you actually want your organization to actually learn.

Going Viral: What Ebola Can Teach Us About Organizational Learning

It’s been interesting listening to the news about the Ebola patient in Dallas. At times, it almost sounds like an ongoing soap opera, except that it won’t turn out to be a bad dream.

What was particularly noteworthy, though, was the news report that the hospital that incorrectly sent the Ebola patient home had just completed an Ebola simulation exercise. Assuming that the story is correct, this really makes me wonder about the simulation the hospital staff engaged in and its effectiveness at promoting organizational learning.

The problem, to be fair, with a great many simulations is that they are too scripted: the problems are presented with big flashing neon signs saying, “DANGER! DANGER!” and there is always a clear and correct solution. While this type of drill can be useful in basic skill development, it does not train people to handle real situations unless those real situations mimic the drill reasonably precisely. Effective simulations need to be more open-ended and ambiguous; people need to practice the much more difficult scenario of making decisions where the answers are not clear and the problems are indicated by flashing neon signs.

When I ran a pandemic bird flu simulation in Washington DC, I applied exactly those principles: the flu epidemic began quietly, the initial clues were subtle. Participants in the exercise, including doctors, military officials, businessmen, and politicians, initially missed the danger signs. No one wanted to be seen as Chicken Little, no one wanted to appear to panic or to be publicly wrong. As a result, they failed to stop the flu while it was still limited to only a few exposed people. Of the over 100 participants in the exercise, every one was exposed and over 60% “caught” the flu. Real changes took place after that.

Organizational learning is not just showing people what to do. Organizational learning is giving people the chance to practice skills in settings where they can experience success and failure, and where failure becomes an opportunity to learn and improve. That’s really what effective simulations are all about, at least if you actually want your organization to actually learn.