Sunday 11 May 2014

Decision Fatigue

They say that ‘the Curate’s egg” is “good in parts”.

That strange expression dates from a cartoon in the satirical magazine Punch at the end of the 19th century. The nervous junior clergyman is too scared of his bishop to admit that breakfast egg he has been served is bad.

 

Bishop: "I'm afraid you've got a bad egg, Mr Jones".

Mr Jones (the Curate): "Oh, no, my Lord, I assure you that parts of it are excellent!"
[Not copyright material – see http://en.wikipedia.org/wiki/File:True_humility.png]

A curate’s egg is what I thought of the research report on decision making by the Behavioural Insights Team for the Department for Education [1]; it was good in parts.


Incidentally there is a useful summary of the report in Children and Young People Now.

The good bits are:

  • The report recognises that time and workload pressures increase the reliance upon social workers’ intuition in making decisions.
  • The authors draw attention to the kinds of biases that affect social workers’ ability to make objective judgements. Such as  ‘availability heuristic’  (making judgments about the probability of events based on how easy it is to think of examples), confirmation bias (only looking for evidence that confirms pre-existing views) and the tendency to judge cases on their relative rather than objective merits.
  • They recognise the complexity of social workers’ decision-making
  • They note that many sequential decisions have to be made everyday, which can result in ‘decision fatigue’
  • And they note that the information provided to social workers is often of relatively low quality. Resulting in the need to spend time and energy making sense of a complex jigsaw.

These findings lead to some sensible recommendations:

  • Introducing feedback loops to help social workers learn from past decisions
  • Developing simpler systems for filtering out irrelevant information
  • Developing checklists to guide decision-making that are much less complex than current ‘actuarial tools’, such as the Framework for the Assessment of Children in Need

The bit of the report where I began to find the smell of hydrogen sulphide a bit overpowering surrounded what was said about evidence and what works. It wasn’t that I disagreed with the view that the evidence base for child protection social work is weak, but I thought that the discussion of this tended to be mechanical and naïve.



The authors of the report talk as if “… an almost total lack of robust evidence available or given to social workers on what works…” is just some sort of unfortunate oversight which can be quickly corrected by introducing “… quantitative, predictive modelling to identify effective practices” which they say will result in social workers making “… faster, more evidence-based decisions in the future”.



However, I believe that it is not simply a matter of some group of clever people building a database – the report speaks of unlocking and connecting the data. It is much more a cultural issue of creating the conditions in which practitioners can become learners from their own practice.



Child protection in Britain – and I expect elsewhere – has suffered for far too long from quick fixes being imposed from the outside. Yes, we do want to make better use of data and yes we do want to learn what works and what does not. But just as professions such as medicine have had to climb their own learning curves, so too must child protection social work embark on a long, hard journey towards building a more robust evidence base. That will not come from data mining existing corporate systems; it will come from creating in the people who do the work a scientific spirit of discovery and a commitment to never-ending improvement. It needs the creation of organizations that value and encourage learning, not which insist on toeing the corporate line and keeping your mouth shut. 



 [1] Elspeth Kirkman and Karen Melrose. Clinical Judgement and Decision-Making in Children’s Social Work: An analysis of the ‘front door’ system. Research report. April 2014 - https://www.gov.uk/government/publications/clinical-judgement-and-decision-making-in-childrens-social-work