Download from The Future of Nursing Meeting at the National Institute of Medicine/Science/Engineering, July 30, 2019 – Washington,D.C.

What happens when a prestigious foundation brings together nursing experts from across the United States, mixes representatives from other related fields, and invites an internationally well-known futurist to guide them through some brave and complex thinking and exploring about the future of the nursing profession? Well…I got to find out last week when I was invited to participate in exactly this opportunity in Washington, DC.

This event was part of a multi-year engagement in exploring, amplifying, strengthening and preparing the profession of nursing for the future – co-sponsored by the Robert Wood Johnson Foundation and numerous other nursing education and practice leader groups. You can read some of the national consensus panel work that preceded this gathering here.

Amy Webb is a quantitative futurist, a Professor of Strategic Foresight at the NYU Stern School of Business, and Executive Director/Founder of the Future Today Institute in NYC, who has written numerous books on complex futures topics – one of which I reviewed here in this blog (The Big Nine). Another of her notable books is called “The Signals are Talking” which was used for this meeting. This book is very much a primer on futures thinking and her method for actively preparing for it. She notes that “forecasting the future requires a certain amount of mental dexterity,” (p.34). Amy describes the futures field as one that is interdisciplinary and “combines mathematics, engineering, art, technology, economics, design, history, geography, biology, theology, physics, and philosophy,” (p. 10). If you are not familiar with her annual “Tech Trends” report – now in it’s 12th year, you will want to explore this broad and dynamic resource. It is truly fascinating how emerging technologies are most likely to impact our shared future (sometimes in unexpected ways) – and positions/challenges all of us to push for ethical and reasonable evolution in these spaces. If you’d like to watch her in action, you can do so here! “The Signals are Talking” is a textbook on her method which includes six steps: 1) Find the fringe (which are the spaces where changes are most likely initially occurring), 2) Use CIPHER to uncover patterns (contradictions, inflections, practices, hacks, extremes and rarities), 3) As the right questions, 4) Calculate the ETA, 5) Create scenarios and strategies, and 6) Pressure-test your actions. These comprise the building blocks of a facilitated group process which mapped to our day.

Of particular interest to me is Amy’s approach to organizing how to look for and begin to map trends and “signals” about change that is in the air and in motion…and how they may impact the issue you care about and/or interact with one another to create additional ripples of change. This is a handout which lays out these “disruptive sectors” – and I thought quite helpful in organizing our thinking about all the intersecting factors that drive change in the world around us.

The purpose of this gathering was to invite a broad array of key informants to widen and deepen the collective imagination and intelligence to advance and elevate the future of nursing. Our day was spent in small and large group dialogue in which we mapped out relevant signals potentially impacting the future of the nursing profession in all of these areas.

Just a few of the questions we considered included:

  • What are the social determinants of health that will help decide future well-being?
  • What are the new challenges to achieving equitable access to quality healthcare within the next 10-20 years?
  • Who will be involved (other professions or sectors)? How will roles and expectations change (specifically nurses, physicians, and community health workers)?

We were encouraged to map out all kinds of strong and/or weak signals about possible connections and impacts to what nursing practice may look like in the future. Once we were done with this, we used these maps to identify those we thought were most compelling and then, using a method Amy shared with us (identifying axes of uncertainty related to economic shifts, technological progress, social changes and/or politics/activism), strategically create scenarios based on these insights to imagine even deeper possibilities and unexpected turns. As she said, we were trying to “see around corners” in our collective effort. Many fascinating possibilities were identified and created in our shared space. Folks were literally “all over the map” (a good thing!!!) in terms of which they thought were more and less likely to occur – and why – but that was part of the beauty of this process. We were navigating lots of uncertainty and disruption in the way we perceived what kinds of things might happen next in the nursing ecosystem – technology, politics, advances in practice – and emergence of new and more complex health challenges to name a few. We were literally building a shared sense of collective intelligence as we debated and navigated these conversations. It felt productive and definitely got to several levels deeper than typical, more superficial “conference chat.”

After spending time considering some of our scenarios, we were invited to prioritize those we most desired collectively – and used a technique called backcasting to think through what kind of strategies would most valuable to achieve this set of aspirations, being mindful of how many disruptions were likely along the way. We were attentive to the risks of the undesirable scenarios as well…and the degree to which we might have to also consider preparing to defend and/or strategize against them too.

The ideas developed from this day will be used by Amy and others involved in this effort – from RWJF and the Institute of Medicine Consensus Panel leadership – to write a follow up report to guide their ongoing work and planning.

It was a most interesting day. It was a valuable experience – and was terrific to get to see/meet/learn from Amy directly after being such a fan of her work from afar. She’s super smart and delightful!!! Grateful to have participated!! Can’t wait to share many of these lessons with my fellow social work folks!! Let’s build a better future!!

Thanks Amy and RWJF!

Bonus new term to me: Exponential Medicine. This is how futurists in medicine talk about what they are doing. They have an annual conference to share the broad range of what is happening – you can explore more about it here.

Highlights/Download from All Tech is Human Gathering in Seattle, WA – May 18, 2019

This event was billed as an “ethical tech summit” in downtown Seattle. I was excited to participate – though was surprised that it was less “hackathon” and more “thinkathon!” Lots of great community and learning in play.

All Tech is Human’s welcome goes like this:

“You are part of something special happening today. We individually understand the promise and peril of technology, yet collectively struggle to better align its development and implementation with our aspirations as a society. The people in this room are actively working to find a better way. YOU are part of the solution! All Tech is Human aims to co-create a a more thoughtful future towards technology. We say co-create for good reason, as the future depends on a more inclusive process that taps into a diversity of knowledge that can better inform the politics of innovation, including the ever-changing ecosystem of technology product design and development. The dirty truth is that there is no magic bullet for ‘fixing tech.’ Instead, perpetual debate is as important as it is inevitable. Everyone who is impacted by technology should be heard loud and clear as we together explore how we might move forward and create a better tomorrow. Let’s turn up the volume.” David Ryan Polgar

The day started with an overview of the “challenge” of finding our way in a complex new world of technology. Speakers opened the day (Rob Girling and David Ryan Polgar) with remarks and observations of how “tech has altered the human condition” in ways that are not likely to roll back any time soon. The challenge, as it was laid out, is about how to insert more thoughtfulness and humanity in the present and future trajectory of how technology occupies space in the world – and how people (not corporations) can best drive it.

There was lots of discussion about the tensions between computer engineers’ roles in tech (Can I?), the ethicists (Should I?) and the legal experts/lawyers (Must I? Can’t I?). There was discussion of the tension between tech “solutionism” (for every tech problem, there is another (better) tech solution, vs. government “solutionism” in which elected and/or govt. officials declare some aspect of technology out of control and bring out new regulations to try to reign in the “problem.” This led to additional conversation about the politics of tech – and a rationale for how solutions require a “broad, inclusive and multidisciplinary” approach. Finally, there was discussion of how citizens can and should have a role in interacting with those designing, improving and regulating tech so that it truly works for and with people.

The rest of my download will be an assortment of interesting/noteworthy things I learned that I just want to keep track of!

Di Dang, a Design Advocate at Google (@dqpdang) gave the best brief overview of “machine learning” I’ve ever heard: “Computers that can evolve to see patterns without being programmed to do so.” She works in a research group within Google that seeks to use human-centered design to make AI work better for people. Trust was discussed. I worked hard at keeping an open mind, and was aware at how hard it can be not be cynical about the idea of social good and big tech…but I was interested in what she had to say. Here’s their research group. I have some more exploring to do. I’m guarded, but willing to be teachable. I remain worried at how this will all impact the most vulnerable, and it will be hard to move me from that position.

Reid Blackman, who is a founder of a group called Virtue, is a tech ethicist. He sits on a committee for “methods to guide ethical research and design” for artificial intelligence-related technologies. It is heartening to hear folks diving deep on the issue of defining ethics for a new world – but concerning what a political struggle it is to see how much of a struggle it is for these frameworks to take root. You can read more about this work here.

He referenced the Institute for the Future’s Ethical OS model as a tool useful for wrapping our brains around this whole area of practice.

Delany Ruston is a physician and filmmaker who made a film called “Screenagers” about raising kids in a screen-filled tech world. I appreciated the degree to which she’s trying to calm/educate/support worried/frantic parents who feel like they are losing their kids to technology and screens. I haven’t seen the film so can’t comment on it at this point – but I’d like to check it out and may report back later. This is a slippery issue isn’t it? There is a lot of chatter that automatically has a kind of “anti-tech” tone for kids across the board – and I don’t know if that is always helpful. I prefer something that is a little more nuanced – as some are saying…appreciative that there are lots of kinds of screen time. From what I heard, she seems to be embracing of this nuance…but I need to investigate a little deeper before recommending.

There was an excellent session on issues of tech and government/opportunities and challenges. Shankar Narayan, the Technology and Liberty Project Director at the ACLU of Washington gave an overview of his work related to efforts to protect civil liberties in a high tech world. Here is an overview of his work, resources on tech/liberty, and here is a brief overview of recent media coverage of the intense activity of tech and civil liberties in the last couple of years.

From him I learned about something called “affective analysis” being proposed/used which is essentially “machine learning that interprets your faceprint.” This phrase made everyone shudder…and which the ACLU is actively working against, along with facial recognition software. (It was noted, and applauded, that San Francisco is the first major US city to ban use of this technology.) This particular speaker was the most focused on clearly identifying and challenging inequity and racism in the tech sector, the differential impacts (lethal at times) of tech in vulnerable communities and how all of this bodes poorly for the future of democratic societies.

My favorite of Mr. Narayan’s quotes: “It’s a false dichotomy to say that tech and social good can’t co-exist. We are just doing a particularly bad job of getting there.”

Steve Schwartz, Director of Public Affairs for Tableau Software and Tableau Foundation spoke about their efforts to help government and business see, understand and use their data more effectively. This is a software that has a free version that seems to be popular among many in the social sector. I haven’t used it yet, but based on the talk – I’ll definitely explore. You can learn more here. I do think we can and must do better when it comes to understanding and using data to tell the stories we are trying to tell in social work. Those of you who are doing more with data analytics, infographics and the like are my heros. In a visually competitive world – stories with images are powerful. This COULD be a tool to help us.

Another speaker was Amie Thao, who is a Civic Designer for the City of Seattle. Her work involves design-based information and data analytics to tackle civic challenges and advance mayoral priorities including racial equity, affordability, and youth economic opportunity. You can see a little more about her work here. I was super intrigued about what this job is like…she’s the only person in city government who brings her unique combination of tech and civics expertise.

Because I was in this series of sessions, I couldn’t attend another set of sessions that were held simultaneously on “designing tech for inclusion and accessibility.” I’ll list the speakers here so you can explore along with me!

Liz Gerber at Delta Lab, Design for America (@elizgerber) – speaking about human centered design work.

Alexandra Lee (@leejayeun) who spoke about her work at a place called the Civic Design Lab in Oakland, CA. She was sharing about her efforts to apply design thinking, racial equity lens, and system thinking to solve civic resiliency challenges in urban environments.

Anna Zivarts, Rooted in Rights (@annabikes) who spoke about disability/accessibility issues in tech.

Later in the day, I attended sessions about ‘Tech for Good: the Rise of Public Interest Technology.’ Heard from Renee Farris (@farrisra) who works at the Silicon Valley Community Foundation (one of the largest philanthropic institutions in the U.S.). Interesting to hear about their work, and the creative approaches they are using.

Also heard from George Aye (@GeorgeAye), co-founder of the Greater Good Studio in Chicago. They use design principles to tackle community challenges of all kinds. His talk was terrific. His philosophy was clearly stated that when considering community and/or organizational change, “people adopt the change they are part of making.” He shard that there are three principles of good design: Good design honors reality, good design creates ownership and good design builds power. He said designers should study anthropology, social work and organizing as much as traditional design. George emphasized the need to engage those most impacted by the problems we are trying to solve – and who generally have the least amount of power in a traditional sense.

Finally, the last particularly powerful presentation I attended that I wanted to include here was from Yana Calou (@YanaCalou) at CoWork.org which is an organizing group specialized in work with the tech sector. Her presentation was really gripping discussing what has been happening with a gradual “awakening” of tech sector workers about their rights and their need to begin to communicate, organize and work together for a more equitable and transparent workplace. I had not been aware of all that has been happening in this sector, but I’ll list a few articles here that outline much of what she spoke about. We all need to be watching this space closely – the workers in tech are revealing some serious concerns that should cause us all to pay attention. Primary issues are sexism in the workplace/sector, loss of worker control over their own work product, and loss of worker autonomy/privacy.

Employee privacy in the US is at stake as corporate surveillance technology monitors workers’ every move

Google employees are launching a social media blitz to pressure tech giants on workplace harassment issues

Workers’ rights? Bosses don’t care – soon they’ll only need robots 

The Year Tech Workers Realized They Were Workers

How tech workers are fueling a new employee activism movement

The long history behind the Google Walkout

This event was held at a design firm that does work at the intersection of equity/sustainability and community – Artefact.

This is truly only a fraction of all that was discussed, but gives you a flavor of the diverse and complex viewpoints presented. I do think there is a lot of room for improvement in how diversity/equity is actually actualized in these kinds of spaces. While there was some diversity present in the crowd – most folks who were there would agree they have a long way to go.

I met a few folks from venture capital firms, as well as a number of other wonderful people who gathered here because they are curious, unsettled and determined to figure out how tech can do a better job of contributing to a positive future for all. I met a fellow who is getting his Ph.D. in nursing who is doing his dissertation on how VR can help with the healing process. I’m glad I went. I think we have some things to learn about bringing this “civic design” sensibility into our social work spaces and activities. We are strong in many elements of community engagement/organizing, but this additional layer of design frameworks can offer a lot of new energy/possibilities.

Here’s a couple of additional sites/resources I include just for perusing value:

The Bridge (http://thebridgework.com) community connecting leaders in tech, innovation, policy, and politics.

Virtual World Society (http://virtualworldsociety.org)

Also heard this book mentioned a couple of times – The Fuzzy and the Techie. I haven’t heard of it but sounds relevant/interesting! https://www.chronicle.com/article/What-Im-Reading-The-Fuzzy/241820