The problem to be addressed is very broad, covers a wide range of organisations, and needs to synthesise proposals from a diverse and sometimes conflicting set of opinions. It therefore does not fit into a straightforward hypothesis and test method of exploring the issue. It is also not single focus, as the issues vary from context to context, which means that a qualitative approach based purely on interviews is likely to not cover the ground thoroughly. The scope is wide, and there is a need to contain activity to achieve useful results within the timeframe of a masters project.

The Soft Systems Methodology

The Soft Systems Methodology (SSM) (Checkland, 2000) is a method that explores a problem situation using an action-research approach (Brydon-Miller, Greenwood & Maguire, 2003). Action-research is problem-directed, and allows engagement with different parties to propose and implement solutions. SSM will be used to bring together the various strands involved in this research. This is not an IT methodology, but it has been used widely in the area of information systems development. The NHS information strategy in 1998 (Department of Health, 1998) was developed using this method (Checkland & Poulter, 2006), and it has been used elsewhere in healthcare (Gillies & Galloway, 2008).

The method begins with defining a clear “problem situation”. Reframing the research question for this project, we can define the problem as follows: the MBA teaching profession does not have an adequate and complete picture of national implementation of mindfulness-based programmes, arising from a number of factors:


    Consequently, there are problems in justifying the development and implementation of MBPs and related aspects of the MBA teaching profession, and problems conducting research with large cohorts and with groups who have long-established mindfulness practices.

    Working with the problem definition, a focussed examination of the overall system is considered. This begins with a “rich picture” of the overall system; Figure 2.1 provides a rich picture which has been used to elaborate the initial modelling. In this view:


      This model is abstract in the sense that components can cover a range of different instances in different context, and it will need to be adapted and refined as the review of the system as a whole progresses. For example, the NHS is the commissioner of MBCT courses under IAPT, but an individual may commission an MBCT or other MBP course for themselves, and an employer may commission an MBP course for their staff. Using a model like this helps to constrain the investigation to the areas of relevance to the problem situation.

      Slide1


      Figure 2.1: Rich picture of the overall system relevant to the problem situation

      Relevant subsystems have been elaborated, and root definitions relevant to the problem situation are produced. These are not exhaustive definitions, rather they are intended to guide the investigation. The guidance on root definitions is to structure them around purposeful activity, expressed in a form: “do P by Q in order to achieve R”. A root definition for MBPs might be: help an individual develop their mindfulness skills by following a mindfulness-based training programme in order to improve their general wellbeing and in some cases alleviate a chronic condition.

      Elements of the system were analysed using CATWOE analysis under the following categories:

      Customers – those people or organisations using or relying on the system;
      Actors – those people or organisations who are involved in operating or controlling the system in some way;
      Transformations what transformations the system is intended to provide;
      Weltanschauung – the view of the system in relation to the problem situation;
      Owner – who owns the system;
      Environment – what aspects of the environment are relevant.

      The modelling is constrained to the problem situation, and therefore should not be viewed as a comprehensive view of the system as a whole.

      To illustrate the use of the above categories:


        The problem-directed analysis focuses the development of the model, and provides a particular perspective on the system and subsystems. Considering the overall system in this way in the light of a problem situation, a number of questions can arise. For example, the question arises on whether it is of value to record details of an MBP course delivery, such as who are the participants. That may lead to questions about what detail to record about a participant, such as any health circumstances that brought an individual to an MBP course, whether the MBP course was perceived to have any impact on it, and who determines that outcome (e.g. participant or teacher). Then there may arise questions about what information might be shared, for what purposes, and whether there may be legal and ethical issues around these.

        A comprehensive model has been constructed and it is available on the website
        www.informingmindfulness.co.uk. This model has been refined and developed throughout the project. Experience of this model has shown that it is effective in covering the broad sweep of the relevant areas, and that the directed nature of the modelling quickly focusses attention on areas of interest. The model itself is potentially a useful resource for other researchers, but for participants providing data it is likely to be overly complex and so summary papers were produced, with focused questions arising from the modelling. A challenge to the research has been the large size of the model, and so it has been necessary to constrain the scope of the modelling and qualify recommendations accordingly.

        Soft Systems models are are exploratory, not prescriptive. The overall intention is to clarify thinking about the problem situation and share that explicitly. They may change the thinking of individuals through the process. The conclusions, in this case expressed as an information plan, should be traceable back through the system model. The overall model gives a holistic overview that can be explored and examined at a detailed level. An overview of the sub-models, which gives a picture of the wider landscape is provided in Figure 2.2. The broad system is wide, and there are a large number of subsystems analysed as in Figures 3.2, 4.1, 4.2, 4.3 and 4.4.

        Pasted Graphic



        Figure 2.2: The top level structure of the areas modelled.




        Agile Project Management

        Given the wide scope of the problem, the model was developed iteratively. The phases of construction were time-boxed according to the DSDM (2016) agile methodology; a time-box is a fixed period within which an agreed set of prioritised activities are tackled in order, some of which are essential but many of which are of less importance. Non-essential items can be deferred to later stages of a project, or even changed or removed if insight from the phase suggests that. A full project plan is included in Appendix E.

        The first model was devised through literature-based research, including public documents on national infrastructure. The modelling process then raised questions about parts of the wider system. The model is available through a web site (www.informingmindfulness.co.uk). As the model is large, components of it were summarised in working papers focussed on parts of the system. Aspects of the model were explored through interviews, and interview questions derived from preliminary modelling are included in the ethics application (Appendix A). A model covering health in detail was considered essential. This modelling commenced in January 2016 and completed in May 2016, including evaluation of the model and interviewing using questions developed using the model.

        Based on responses to the model and questions arising from it, a second model was devised. This raised further questions, and relevant parties will be invited to respond to focussed questions through interviews and questionnaires; a questionnaire derived from preliminary modelling are included in the ethics application (Appendix A), and a questionnaire based on further modelling and the interview results was included in an update to the ethics application (Appendix A). This led to a third model on which the final conclusions are based. This phase lasted from May through to August 2016; overlap of phases is permitted in the DSDM methodology.

        The final model, and the formation of the information plan ran from August to September 2016. If the project is successful in engaging the community, then there are likely to be subsequent phases. How such phases are undertaken are part of the information plan and the recommendations arising from the research.

        As the model developed, questions arose about the wider system. The preliminary model suggested a small number of questions included in the ethics application (Appendix A). Data gathering was from public documents and occasionally from enquiries to public body help desks. All data used from these sources is public domain.

        An ethics application was submitted and approved with two amendments regarding changes to the original questionnaire and modes of advertising the questionnaire. The research did not involve any form of intervention that may affect an individual, no personal confidential data has been collected, and sources of data are kept confidential. The full ethics application is included in Appendix A.