What is Manualization?
Manualization means recording what we do (in text, through video file plays) in ways that would help others to do the same thing (and get the same results.) It is really another way of addressing the idea of
team learning - and in this way it relates to ideas about
Developing learning organisations by Peter Senge
A bit of video discussion
Manualization is one of the
Core Features of AMBIT - AMBIT workers don't just read their treatment manual, they are expected to
co-author it.
Above all, Manualization is about promoting
LEARNING at work - particularly
learning from mistakes, or
recognising a piece of local expertise. Recording it (especially so in a public facing website) creates a kind of
"ratchet effect" so that learning in a team is less likely to slip backwards and get lost (
because workers forget those team discussions when 'all came clear', or they leave the team to take up other posts, taking all their expertise with them... ):
AMBIT training
Part of the
AMBIT training involves
Learning about Manualization.
Balancing act
What you are reading now is a
TiddlyManual, which is a different kind of manual from books or conventional websites. In keeping with two other
Core Features of AMBIT (
Respect for Evidence and to
Respect local practice and expertise) it is concerned with the difficult (but as we see it, crucial) task of balancing two potentially contradictory principles:
Systematic
Evidence-based
Practice
|
...&...
| Locally-derived
Practitioner-based
Expertise
|
...The approach to "manualizing" practice in a
TiddlyManual allows for a marriage of 'top-down' evidence-based information and instruction, alongside 'bottom up' local expertise in
how we apply these techniques and methods here, with these particular young people... or
what we learned from a recent near miss/mess/serious incident that would minimise the likelihood of this happening again.
How to do it?
We emphasise that this is a
Dynamic, adaptive Manualization - something that teams can (and should) continue to do as part of their day to day practice.
There are tips and suggestions on
How to do team manualization.
The best place to start is:
(a) to
check you are logged in (b) check the manual is switched to
Edit mode(c) open up
+ Manualize our work, select the category for what you are going to manualize (you won't see the buttons if you aren't logged in and switched to Edit mode) and get going...
Benefits of Manualization?
There are a number of key benefits to having teams engage in manualizing their own practice:
(a) Promoting Service Development
- Developing a shared understanding of the nature and value of this Dynamic, adaptive Manualization...
- Fully integrating and interacting with this document in day-to-day clinical practice (increasing fidelity to AMBIT-influenced and evidence-based practices)...
- Engaging in continual, small, iterative and incremental "tweaks" and changes to ensure that there is LEARNING at work (see Manualization Boundaries where we emphasise the fact that manualizing is a team-based activity)...
(b) Fostering a distinct LOCAL team culture
- A local team develops "our own unique manual" that is:
- "Bespoke" to our own local needs - attuned to the local population and geographical constraints (transport, culture, common clinical problems, etc) - see Customising your local TeamTemplate.
- A record of the ongoing Mentalization efforts (the LEARNING at work) of our team, about our team as a whole (why we behave in the ways we do).
- A powerful tool for Inducting new team members.
- We sustain a practice that is both integrative and multimodal, according to our Core Features of AMBIT.
- It is hoped that the implicit sense that this method working constantly tries to Respect local practice and expertise will also support positive team morale.
(c) Comparing and Sharing our work
In AMBIT there are already multiple teams beginning to adapt their own local versions, and via the
Show references and info panel on each page ("
Tiddler") a user can easily see if alternative versions exist, and compare what other teams have come up with. You can see:
(d) Research
There is as yet little research into the use of wikis in learning organisations, but a helpful paper exists for those who are interested:
Cole, M (2009) Using Wiki technology to support student engagement: Lessons from the trenchesResearch into specific treatment modules, or major manual reconfigurations, will obviously need to adhere to tighter protocols so that the rest of the manual is unchanged and "like can be compared to like". It is possible (easy) to "lock" the manual and prevent further editing for the period of a research project.