Michael Moore's latest movie, Sicko, is a powerful example of how Stories trump Facts when attempting to teach material that is intended to invoke change (mental and/or active).
Although the film won't be in wide release in the US until later this month (June 29th), Moore has been on the promotional circuit non-stop since his latest work debuted at Cannes' annual film festival (where he won top prize of Best Picture three years ago for Fahrenheit 9/11'). This time around, Moore set his sites on the flawed American health care system.
This blog isn't the proper place to comment upon the in/validity of the content within Sicko. Nor is it the right forum for arguing the pros and/or cons of socialized medicine. Besides, a quick search on the 'net will turn up more than enough 'discussion' on these topics.
I'm mentioning this movie here not because of WHAT material is contained in the film, but rather because of HOW that material is presented.
Here, in the US, the shortcomings of the healthcare system aren't something newly uncovered, freshly emerging, or previously unrecognized. The issues associated with this topic have been discussed and analyzed in great depth, for several years, by both political parties and a myriad of independent agencies (see this, that, and the other for a short, random sampling) . And yet, little has occurred in the way of substantive change on this hot topic.
Why?
While it would be wrong to simplistically distill this complex issue's solution into a blog entry, for the purposes of education, learning, and change (arguably the focus of this blog), there may be something interesting and illuminating that we can learn here.
Consider the following statistics:
- "Rates of potentially preventable hospital admissions ranged from more than 10,000 per 100,000 Medicare enrollees in the worst performing states to 5,000 per 100,000 enrollees in the five best... The researchers estimated that if all states could reach low levels of preventable hospital admissions and readmissions for Medicare recipients, hospitalization rates for senior citizens alone could be reduced by 30% to 47% and save Medicare $2 to $5 billion a year." (source)
- "Between 2000 and 2005, 7.2 million Americans lost their health coverage according to the US Census Bureau.... At the end of 2005, the number of Americans without health insurance reached 47 million." (source)
- "...the U.S. is an outlier in terms of financial burdens placed on patients. One-half of adults with health problems in the U.S. said they did not see a doctor when sick, did not get recommended treatment, or did not fill a prescription because of cost... Despite these high rates of forgone care, one-third of U.S. patients spent more than $1,000 out-of-pocket in the past year. In contrast, just 13 percent of U.K. adults reported not getting needed care because of costs, and two-thirds had no out-of-pocket costs." (source)
OK... Now consider these profiles from Sicko (as summarized by Robert Weissman):
- Dawnelle, whose 18-month-old daughter Michelle died because her health plan, Kaiser, insisted Michelle not be treated at the hospital to which an ambulance had taken her, but instead be transferred to a Kaiser hospital. Fifteen minutes after arriving at the next hospital, Michelle died, probably from a bacterial infection that could have been treated with antibiotics.
- Julie, who works at a hospital, explains how her insurance plan refused to authorize a bone marrow transplant recommended for her cancer-riven husband. He died quickly.
Larry and Donna, a late-middle-age couple, find that co-payments and deductibles for treatment after Donna has cancer add up to such a burden that they have to sell their house and move into a small room in their adult daughter's house. The day they move into their daughter's house, her husband leaves to work as a contractor in Iraq.
Which list better captured your attention? Which list made the (claimed) crisis more real/tangible to you? Which list created more outrage... sadness... anger... disappointment... amazement?
From an Instructional Design perspective, which list (or approach: fact vs. stories) is more likely to improve your ability to understand the situation at hand, recall relevant examples of the claims, and invoke behavioral change with your local government representative? (Comprehension, Retention, and Application are three primary legs upon which the fundamental goals of Instructional Design rest).
The questions are effectively rhetorical. In matters of Change Management at nearly any level (personal, corporate, organizational, political), the analytical and quantitative approach of providing stacks of facts and figures in hopes to evoke a shift in behavior is inefficient (at best) and ineffective (at worst). Most change doesn't occur based on evidence - it most often happens based on emotion.
Al Gore's award-winning documentary on global warming, An Inconvenient Truth,
was chucked full of statistics and report findings that had been around
for years, but those numbers weren't what made the film a catalyst of
attention and action - it was the stories and photos (in part) that caused audiences worldwide to speak up and take action.
The dangers of Methamphetamine are well documented, but the factual presentation
of definitions and known side effects were largely ineffective against
the powerful lure of the drug. Solution: move away from the dry
figures and highlight the stories of real people (individuals, as well as their families, children, neighbors, and communities).
The next time you are tempted to force a change in your organization (or at home) by overwhelming your audience with facts, figures, charts, graphs, reports, or (gasp) orders from authority figures ("Why should you do this? Because I/your boss/the CEO said so, that's why!"), take a moment and resist the urge. After all, you know in your heart that sort of an approach is rarely effective beyond the short-term.
Instead, come up with a tangible example (story) that illustrates why action is necessary, what sorts of positive (or negative) results may blossom from the change (or lack thereof), or how the success of the change is intimately tied to the actions of individuals. The difference, not only reception, but in deep understanding and internally-motivated behavioral change/action will be amazing.
In the end, it's easy for data to be questioned and argued to the point that your larger message is lost; to bury your call to action beneath an appeal to facts; to mistakenly assume that your audience is logically-driven rather than emotionally-driven.
When we tell (focus on the quantitative), we force our audience to accept a viewpoint that isn't theirs. When we share (focus on the qualitative), we allow our audience to draw a conclusion for themselves - to decide, for their own reasons, that change is necessary.
All long-term, meaningful change is grounded in belief, and belief ultimately comes only from within. Stories provide a uniquely effective path to the threshold of internally-motivated change.
(Jon Revelos is the Director of Story-based Learning at Tata Interactive Systems)
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