Stories of the Futures You Didn’t See Coming: Scenario Planning, Healthcare, and the Humanities

Blog by Matt Finch

By Jay Huang from Pleasanton, USA – Low Fog Sunrise @Golden Gate Bridge, CC BY 2.0.

Though it’s just a trick of the calendar, as the new year begins our thoughts inevitably turn to the future. Yet we cannot gather data from events that haven’t happened yet, and forecasts drawing on precedent can flounder when situations are unstable.

Under so-called “TUNA” conditions of turbulence, uncertainty, novelty, and ambiguity, it becomes impossible to say what tomorrow will bring based on experiences and models drawn from the past.1 In these circumstances, the humanities have a special gift to offer decision-makers at all levels.

Narrative descriptions of contrasting, plausible futures, or “scenarios” in foresight research, can provide the basis for wise decision-making under conditions of uncertainty.2 Building scenarios requires skills closely aligned with history, storytelling, and even poetry.

Ramírez and Wilkinson draw on the words of novelist Carlos Fuentes to compare scenarios to literary texts: “What then is a novel, other than telling that which cannot be told otherwise? A novel is a verbal search for that which awaits being written.”3

The criterion for good scenario planning is not whether it predicts events correctly or outlines a desired, normative state of affairs. Rather, scenarios strive to be plausible by offering credible challenges to current assumptions about what is going on around us and how situations might unfold.4

Scenarios have been used by a range of healthcare institutions, for a variety of purposes. United European Gastroenterology used scenarios to examine education priorities.5 Students entering medical school in 2014 would be halfway through their careers by 2040, so how well would their education serve them in a range of possible futures? Understanding gastroenterology’s future required exploring changing lifestyles and agrifood systems, as well as medicine and healthcare.

At the Global Outbreak Alert and Response Network (GOARN), scenarios produced during the Covid-19 pandemic enabled a diverse group of organizations involved in the fight against infectious disease to come together on the common ground of an unwritten future.[6] Looking ahead to 2030, they explored challenging contexts in which the nature of international collaboration and the scope of public health emergencies varied widely.

GOARN Chair Gail Carson also contributed to the European Commission-funded IMAJINE project, whose four scenarios told of worlds in which Europeans experienced new kinds of inequality shaped by climate change, digital technology, and shifting geopolitical dynamics.[7 In her view, “The hit of the [Covid-19] pandemic showed up all the weaknesses of the system […] Looking at these scenarios can identify systemic weaknesses before we have to endure the next hit; doing that work of identification and early intervention would be an honourable thing to do.”8

Scenarios are strategic tools grounded in the needs of a specific user and purpose9; they aim to challenge mental models and to help users to re-perceive their context.10 This includes unlearning as much as learning, that is, “letting go or relaxing the rigidities of previously held assumptions and beliefs, rather than forgetting them.”11

Aesthetics plays as much of a role as reasoning does in achieving this goal: “What one feels about something […] is the beginning of what one knows.”12 Different projects may require different resources to help users re-perceive their context, whether visual materials, extensive reports, or simply a succinct and evocative expression, as the poet and scenario planner Betty Sue Flowers notes: “If you can find the right image for a story you need to tell, knowing that leaders are very busy and don’t have time to read academic prose, then those leaders can recreate their own story from that particular image.”13

Scenarios, then, are aesthetic objects with a special purchase on the mindset of decision-makers. They must be constructed with care and rigor, but can be tailored to different users and settings.14 During the Covid-19 pandemic, new forms of scenario planning evolved to suit the needs of users experiencing exceptionally fast-moving uncertainty.15

Most excitingly, scenarios differ from many other forms of narrative in their collaborative nature as well as in their practical application. They embody, in Van der Heijden’s phrase, “the art of strategic conversation” and serve as spaces for diverse actors to explore uncertainty together.16

As Ramírez and Wilkinson put it, citing Fuentes again: “The novel, like the scenario, enables conversational relations between readers and the writer in reading and rereading: ‘never again should we have only one voice or reading. Imagination is real and its languages multiple.’”17

What better attitude for us to take forward together into the coming year, with all that’s unknown about what awaits?

 

Matt Finch is a strategy and foresight researcher and practitioner, an Associate Fellow at the Saïd Business School at the University of Oxford, and a consultant at mechanicaldolphin.com.

 

References

[1] Rafael Ramírez and Angela Wilkinson, Strategic Reframing: The Oxford Scenario Planning Approach (Oxford: Oxford University Press, 2016). https://doi.org/10.1093/acprof:oso/9780198745693.001.0001

[2] Matthew J. Spaniol and Nicholas J. Rowland, “Defining Scenario,” Futures & Foresight Science 1, no. 1 (March 2019) e3. https://doi.org/10.1002/ffo2.3; Rafael Ramírez et al., “We Need to Talk (More Wisely) about Wisdom: A Set of Conversations about Wisdom, Science, and Futures,” Futures 108 (April 2019): 72-80. https://doi.org/10.1016/j.futures.2019.02.002.

[3] Strategic Reframing 44-45.

[4] Ricarda Schmidt-Scheele, The Plausibility of Future Scenarios: Conceptualizing an Unexplored Criterion in Scenario Planning (New Rockford: Transcript Publishing, 2021).

[5] United European Gastroenterology, Healthcare in Europe: Scenarios and Implications for Digestive and Liver Diseases, 2014. https://ueg.eu/files/776/8c6744c9d42ec2cb9e8885b54ff744d0.pdf.

[6] Rafael Ramírez et al., “Strategizing across Organizations,” MIT Sloan Management Review 64, no. 3 (Spring 2023): 62-65.

[7] IMAJINE, Scenarios for the Future of European Spatial Justice, 2021, https://imajine-project.eu/wp-content/uploads/2021/10/IMAJINE-Scenarios-with-expert-responses.pdf.

[8] “Imajine Scenario Response—Gail Carson, Centre for Tropical Medicine & Global Health, University of Oxford,” IMAJINE (blog interview), June 16, 2022, https://imajine-project.eu/2022/06/16/imajine-scenario-response-gail-carson-centre-for-tropical-medicine-global-health-university-of-oxford/.

[9] Strategic Reframing

[10] Pierre Wack, “Scenarios: Shooting the Rapids.” Harvard Business Review 63, no. 6 (November 1985): 139-50.

[11] George Burt and Anup K. Nair, “Rigidities of Imagination in Scenario Planning: Strategic Foresight through ‘Unlearning,’” Technological Forecasting and Social Change 153 (April 2020): e119927. https://doi.org/10.1016/j.techfore.2020.119927.

[12] Rafael Ramírez and Jerome Ravetz, “Feral Futures: Zen and Aesthetics,” Futures 43, no. 4 (May 2011): 478-87. https://doi.org/10.1016/j.futures.2010.12.005.

[13] Betty Sue Flowers, interview by Matt Finch, Mechanical Dolphin, October 10, 2020, https://booksadventures.files.wordpress.com/2020/10/betty-sue-flowers-interview-by-matt-finch-final.pdf

[14] Rafael Ramírez, Trudi Lang, and Gayle Peterson, “Seven Sure-fire Ways to Do Scenario Planning Badly: A Guide to Poor Practice.” Announcement, Long Range Planning (April 1, 2021) https://www.journals.elsevier.com/long-range-planning/announcements/seven-sure-fire-ways-to-do-scenario; Thomas J. Chermack, Using Scenarios: Scenario Planning for Improving Organizations (Oakland: Berrett-Koehler, 2022).

[15] Rafael Ramírez and Trudi Lang, 2020. “Developing an Initial Set of Scenarios Frugally in Response to Covid-19,” Oxford Answers (blog), Saïd Business School, Oxford University, April 28, 2020, https://www.sbs.ox.ac.uk/oxford-answers/developing-initial-set-scenarios-frugally-response-covid-19

[16] Kees van der Heijden, Scenarios: The Art of Strategic Conversation (New York: Wiley, 1996).

[17] Strategic Reframing 45.

(Visited 587 times, 2 visits today)