“The master has failed more times than the beginner has even tried.”
-Stephen McCranie
I’ve written a bit about models before. I think that having an evolving model of complex systems (humans) is imperative. We certainly have one whether we consciously intend to or not, but intention provides a much stronger, resilient, and adaptive model. In turn, the frequency of success will increase.
Scope of practice, experience, mentors, understanding, etc. will determine how you structure and apply your model. Ongoing study, application, and evidence determine how your models will evolve.
Observation and exposures help build the model. One of the better ways to build a model for each new Padawan evolved from an ambitious student seeking the ability to see more at a glance. His question to me was “how do you do that?” His perception was that I had skipped a few steps in coming to my conclusions in determining the appropriate intervention for a particular client.
My response was that I saw it as soon as they walked in the door. (Everything is an assessment!) I proceeded to explain what I saw and how each step in the evaluation was either confirmation or refutation of my suspicions. I don’t express this idea as if I can do something special. It is merely that my model is more developed than the typical student’s. Thankfully, it has nothing to do with intelligence either. It’s about exposures, reps, successes, and failures. It’s about paying attention. Modeling demands constant testing and retesting.
Each failure is an opportunity to eliminate a possibility and then ask the next question. Edison failed 1,000 times trying to invent the light bulb. Each failure was actually an opportunity to recognize the fact that he found another way NOT to invent a light bulb.
Question: How can we accelerate building a model safely without putting a patient/client/athlete at risk or wasting time?
Enter the concept of chessboards.
We assess and document the initial measures on the client’s arrival. The end result produces a grid that becomes a representation of the client. No single test is more important or representative of anything meaningful. It requires an examination of the relationships among the tests as a whole. Otherwise, it’s too easy to fall into the trap of reductionism and structuralism. The grid is your chessboard.
The analogy is from the movie searching for Bobby Fischer. There’s a great scene where Josh Waitzkin’s teacher dramatically clears the chessboard and challenges him to “see” the pieces on the chessboard and make the next move. Just like Josh, the Padawan has to “see” the current chess pieces (the representation of the client) and give it a meaning. But how do you know what is important?
Enter the concept of coffee cups.
In his book On Intelligence, Jeff Hawkins discusses how prediction works in the brain. He explains how the brain is constantly making predictions from memories about everything in your environment. If our prediction is accurate, then we tend to behave as if we don’t notice our surroundings as much. However, when something is novel or doesn’t fit our prediction, it draws our attention. His example was of sitting in his own office recognizing his surroundings with all of his predictions being true. He typically wouldn’t particularly notice anything special. However, if someone places a blue coffee cup in the room, it will draw his attention because it didn’t fit the current prediction model of what should be in the room.
So, I ask the Padawan as he looks at the representation of the client, “Where are the coffee cups?”
What stands out? What is meaningful?
How can you impact the current presentation and where do you start? Can anything on the chessboard address multiple concerns? If so, what do you expect to happen next? How will that potentially affect the client’s complex movements? What is your next decision based on your predicted outcome? What if your prediction is wrong?
[Note: complex movements are comparators not decision-makers]
Not only does this process improve the Padawan’s current model, but it increases his exposures without the anxieties of having to be correct or with the fears that you may put a patient at risk or simply make a wrong decision. Pattern recognition improves. Clinical decision-making is refined. If you want to get technical, we could say that we’ve taken advantage of neuroplasticity and made new connections.
It is these connections after all that created our model in the first place.
Much like an Air Force pilot spending hours in the simulator to get comfortable with exposure to potential failures and learn appropriate actions, the Padawan has an opportunity to perform safe-to-fail experiments without putting the patients at risk. These experiments are essential in working with complex systems (humans) as cause and effect can only be identified in hindsight, thus the importance of a strong, ever-evolving model.
What does your chessboard look like and what are your coffee cups?