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Director's Remarks

As complexity grows, risk management requires organizations to shift from top down command and control to decentralized management -- to rely on co-evolving, self-adaptive sub-groups and individuals. New approaches are needed to sustain, de-bias, and enhance the performance of these distributed, emergent parts so that the whole improves its risk management capability. They require an understanding of individualsí decision processes and then designing decision aids for improving their choices.This is a broad research area of interest to both the Ackoff Center for the Advancement of the System Approach (ACASA) and the Wharton Risk Management and Decision Processes Center (WRMDC).We have begun to explore some of these issues in the context of the WRMDC project on learning from chemical and other industrial accidents that almost occurred (see the description of the Near-Miss Project in the Newsletter), which ACASA partially supports. We are just in the early stages of learning how to improve risk management for society through better understanding and support of individual and organizational decision processes.

Given space limits, I omit discussing novel ways that organizations can learn from their parts, and restrict my remarks to the transfer of lessons learned to individual decision makers. In particular, I would like to focus on the design of video games as one of a number of types of de-biasing and judgment-enhancing "interventions" for risk mitigation and performance improvement in social settings (e.g., teen violence in schools), in healthcare situations, in industrial operations, etc. Let me explain one of these in some detail -- the "Heart Sense (HS) Game" sponsored by NIH/National Library of Medicine.

Heart disease is the number one killer in America, and one of its most resistant aspects is delay in those experiencing symptoms in seeking treatment. Medicines avail-able today can mitigate the effects of heart attacks if given rapidly, ideally less than 60 minutes after an attack.Yet subjects delay an average of 4 to 12 hours before arriving at an ER. Media campaigns, Red Cross videos, as well as physician counseling, have all been unable to reduce this delay. These materials are top-down/didactic and require passive listening. Even if "ingested" before an episode, they are soon forgotten and ignored when a heart attack occurs. Little knowledge transfer occurs, and behavior is not shifting.

The obstacles arise not just from poor symptom recognition and misdiagnosis, but also due to social issues (e.g., peer pressure, being labeled a hypochondriac), attitudinal problems (e.g., denial, bias), and efficacy concerns (e.g., lengthy ER waits, ability to pay). The HS Game is an attempt to design a judgment de-biasing intervention that can peel away these issues (e.g., denial and misdiagnoses, misperceived peer pressure, fear of being viewed as a hypochondriac, and many more), and shift decisional intent to reduce risk by reducing delay. The game involves having the users gain skills they can transfer to the real world by encountering virtual characters in a village and by trying to convince them to overcome (a Markov chain of) their delay issues.We also hypothesize that an animated, pedagogical agent with full emotive capabilities (facial expression, body language, voice, humor, empathy, etc.) leads users to better short run performance as well as to greater knowledge retention when deployed as an intermittent companion.

The results from prototype testing offer evidence that the fully emotive versions of the game do noticeably better in improving intention shift and lead to greater changes in before- vs. after-game knowledge about symptoms and delay issues.The prototype passed scientific review by the American Heart Association, and focus groups of physicians stated that if widely disseminated it would lead to ERs being filled to capacity with cardiac patients. If these early results are confirmed through rigorous follow-up, there may be significant potential in this type of intervention for improving web-based EH&S training, accident prevention and near-miss programs, and perhaps contributing to decision-making more generally. Research on ways to leverage advances in communication technology to align behaviors and attitudes of stakeholders towards good health and safety practices is one of the several areas of mutual interest between the Ackoff Center for Advancement of the Systems Approach and the Wharton Risk Center. We look forward to working together on these and related issues over the coming months.

--Barry G. Silverman

  Barry G. Silverman is Director of the Ackoff Center for Advancement of the System Approach (ACASA) in the School of Engineering and Applied Sciences (SEAS) at the University of Pennsylvania.