Understanding the Human BrainIts Generative Capacities, Its limitations and

Sources of Human ErrorEd Chaplin, M.D. FAAN

Medical Director555 Washington St

San Diego, CA

Presenter Contact Information:Email:echaplin@san.rr.com

Figure 1

Hold the figure 1 at eye level, close your left eye, and stare at the circle in the middle of the grid with your right eye. Slowly move the paper along the line of your vision, until the star vanishes (about ten tofifteen inches in front of you). The star disappears when it is in your blind spot. If we have a blind spot,

how is it we do not go around with a hole in our vision? Now open your left eye, close your right eye, and stare at the star. Move the figure until the circle in the middle of the grid Figure 1vanishes. When it does, notice that the lines of the grid remain intact.

Display DataItem Thoughts Images Sensations in

BodyPredisposition toward action

Neckers cube

Visual CortexOccipital Lobe

Lateral GeniculateBody

Field of vision

Optic Nerve

Optic Tract

Ganglion CellLayer

Rods & Cones

Retina

Bottom UpBottom Up

Top DownTop Down

A Schematic Process For AwarenessA Schematic Process For Awareness

150 msec.(0.15 seconds)

500 msec.(0.5 seconds)

> 0.5 secs.2-3 secs

ExternalStimulus

1. A Change in “as is” State

Associated Memory(Historical selection)

Triggers action sequences

Primary Emotional Response

2. Perceptual Awareness

A 3 Dimensional Spatial MapObject Recognizable patterns

(faces, goblets, disks off center)Internal feeling - sense of self

Movie in the brainTranslation of images &

schemas into symbolsSpeculations - JudgementSecondary Emotions

3. Conceptual Awareness/ Linguistic coding

0. Resting or “as is” State

Figure 4.9The figure is drawn in linear fashion for simplicity and the timeframes are approximations. It is the relative order and not the actual time that is important.

3 Brained AnimalHuman

Mammalian

Reptilian

AWARENESSAWARENESSText

Stimulus

AmebaLizard

AmebaLizard

SensoryApparatus

EventAway

AnticipationPlanning/SpeculationEventReflection

Inquiry

EventJudgement Fantasy

Grandiose

Catastrophic

Blame

Guilt.

.

PleasantEventNotPleasant

Sensations

NarrativeSpin

Awareness

ImagesEventImages

Toward

.M

ore

dire

ct e

xper

ienc

e

AN

ALY

SIS

SY

NT

HE

SIS

Mor

e C

once

ptua

l

Nature of Now

• Shows up • In context • Shaped by history

• Sometimes by design– always and experiment that will show up with some of

83 problems– Lever for design is context

SELF ORGANIZING & SELF LEARNING SYSTEM

7. Output- Outcome Double Loop Learning

8. External Feedback

3. Target (with Measurable Dimensions)

1. Stimulus (Perception)

2. Interpretation (Priority & Selection)

6. Internal Feedback

4. Sequences of Action ( Process)

5. Individual Actions (Skills)

Single Loop Learning

Doing what do better

Accept/ Reject/ModifyAccept/ Reject/Modify

HypothesisHypothesis

ExperimentExperiment

DataData

Doing differently

1

X

Sensor2

3

Awareness

4Presuppositions

REINFORCE5

5ABORT

Recognize?

Feedback Feed Forward

Figure 9.1

REINFORCEKeeps you doing the old

ABORTBlocks doing the new

STIMULUS

DESIGNDESIGN• Starts with the whole• Design like change is a journey not an

event• Few Root problems• Limited generic intervention

Grounded Grounded vsvs Ungrounded Ungrounded AssessmentsAssessments

.

A grounded assessment includes the following:A statement about an action in a particular domain

An assertion (witnessable event) about past action in that domain

A relation to some community standard (shared interpretation)

A recognized speculation about future actionsin that domain

A grounded assessment is an interpretation (hypothesis) that is specific (applies to a particular domain of action) with reference to community standards.

Additionally, it is substantiated by events (data) that can be witnessed in the world by a community of observers.

A grounded assessment embodies the elements of the scientific method. The scientific method is an essential practice of life.

The General- ContextUnderlying Structure of Social Spaces

• Morality – a set of agreed upon distinctions between helpful and harmful actions (shared map)

• Accountability – managing Promises & Requeststhe glue for coordinating actions (shared practices)

• Charity – contributing together creates more good that can be generated individually (Goal)

• Transcendence – a powerful vision and a view that the whole is more than the sum of day-to-day appearances. (Belief that it makes a difference)

Aspiration – VisionDeposition toward life – Attitude

Practice

Customers & Environment*Customers)

Organization(Leaders)

Differentiated Processes (Process managers)

Tasks(Staff)

Socialized(Tacit)

ProceduralAction

Internalization(Tacit)

ProceduralAction

IMFORMATION FLOW

Externalization(Explicit)

ConceptualThought

Combination(Explicit)

ConceptualThought

Combination(Explicit)

ConceptualThought

Repetition(Performers)

T5 Tasks Outcomes

T3 Process Measures

Tasks Measures

T4

C h a r tM D

R NP h a r

TRANSLATION

DemandedQualities

Steps

T1

TRANSLATION

5 Step Translation Process

MeasurableDimensions

Organizational PMs

T2

DivergenceConvergence

From Chaplin, E and Akao, Y. Process Improvement: Translate Know- What into Know- How Quality Progress 10:56-61 December 2003

Go toGemba

Where arethe Customers?

VOCT II

Items

What are theirneeds?

VerbatimCustomer

needs

RAPID CYCLE -BLITZ QFD

High value needs

DQs DQs

What is theirstructure?

What needs werenot stated?

What DQs aremost important?

AffinityDiagram

HierarchyTree

Structured needs

DAY 1

MaximumValue Table

Items

Nee

ds

Task

s TasksTasks

ProjectTask Table

How will wemeet needs?

How will we do it?

Criticaltasks & measures

2nd DAY

High Risk?

FMEA

Need moredetail?

QualityDeployment

Matrix

2-3 Customers

From Chapter 14Chaplin, E and Terninko, J: Customer Driven Healthcare: QFD for Process

Improvement and Cost Reduction Milwaukee, WI ASQ Press 2000 (www.asq.org)

TRANSLATIONTRANSLATIONC h a r t

M DR N

P h a r

Customers & Environment*Customers)

Organization(Leaders)

Differentiated Processes (Process managers)

Tasks(Staff)

Repetition(Performers)

Quality Function Deployment- Visits 10-12 customers capture 85% of wants and needs - Expand 95%

Demanded Quality Performance Function Failure ModeMeasure (Actions)

Structure - subject + verb + object + adverb Structure - witnessable metric Structure - noun + verb + object Structure - effect, defect or cause - subject + verb + adjective + object (units)

TARGETS - Measurable Characteristic and Time Frame PROCESS ITEMS

MISTAKE PROOFING

MAXIMUM VALUE TABLE

THE SPECIFICTHE SPECIFICQuality Function Deployment - Visit 10-12

customers capture 85% of their wants and needs - Expand 95% (WHAT -TARGETS)

TRIZ- 95% of what need to know is already available in another industry or discipline. (HOW)

Barrier to success:- access to the knowledge - to the know how to- inertia -historical habits & biases- contradictions within existing systems- seeing change as an event- longing for technology as the magic potion- failures in capture & translation of knowledge- trapped in 10,000 constructs, not living in the

actual experience

The General- ContextUnderlying Structure of Social Spaces

• Morality – a set of agreed upon distinctions between helpful and harmful actions (shared map)

• Accountability – managing Promises & Requeststhe glue for coordinating actions (shared practices)

• Charity – contributing together creates more good that can be generated individually (Goal)

• Transcendence – a powerful vision and a view that the whole is more than the sum of day-to-day appearances. (Belief that it makes a difference)

Aspiration – VisionDeposition toward life – Attitude

Practice

SCIENCESCIENCE

TheoryTheory

ExperienceExperience

Life is an evolving hypothesisLife is an evolving hypothesis

Our task is to listen to the dataOur task is to listen to the data

Millions of years of Intelligence & Wisdom

THERE IS BEAUTY IN SIMPLICITY

X1=X2 + cX2=X1

2+cX -> Xn

2 + c

Simplicity & 85th Problem

2. Engage in practices to be present

Direct experienceBottom UPBottom UP

Top DownTop DownTop Down1. Inquiry into our natureUnderstanding top down nature

3. A Journey not a DestinationScientific Method

ReferencesChaplin, E and Terninko, J: Customer Driven Healthcare: QFD for Process

Improvement and Cost Reduction Milwaukee, WI ASQ Press 2000 (www.asq.org)

Chaplin, E and Akao, Y. Process Improvement: Translate Know- What into Know-How Quality Progress 10:56-61 December 2003

Blackmore S Consciousness: An Introduction Oxford University press 2004

Gregory RL: Eye and Brain: The Psychology of Seeing. New York, McGraw- Hill, 1966.

Gazzaigna, M 1998 Minds and Brains Press, Cambridge 1999

Nonkaka, I and Takeucho, H, The Knowledge Creating Company Oxford University Pres, NY 1995

Demassio, A The Felling of What Happens: Body and Emotion in the Making of Consciousness Hardcourt Brace & Company New York 1999

Verela, F, Ethical Know-How; Action, Wisdom and Cognition Stanford University Press, Stanford, 1999 (Embodied mind)

Eldemen, G, Trononi, G. A Universe of Consciousness: How Matter Becomes Imagination Basic Books New York 2000

Johnson, M., Moral Imagination, Implications of Cognitive Science for Ethics. The University of Chicago Press, Chicago, 1993.

Libet, B: Neurophysiology of Consciousness Selected Papers and New Essays by Benjamin Libet, Boston MA, Birkhauser, 1993

Varela, F: Ethical Know-How : Action, Wisdom, and Cognition Palo Alto, CA Stanford

Video Gorilla Surprising Studies Visual Awareness Daniel Simons www.viscog.com