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Well the best way is to realize we do PD essays all the time so we may not put you know think about going through the entire cycle we may not think about the rigor that we try to apply when we're doing it in an improvement context but we're always trying things we have theories about something we try it we do it you know if there's about our diet or our exercise or about our sleep or any number of these things and we're always testing things now it when we're trying to get people to do it within our work environments and the systems that we work in the challenge is that the best way to learn is to do it and you we can explain it from a theoretical standpoint and then have people try to apply it but often that's hard so some a way we do it in the middle is to try to create exercises that enable people to go through the experience in sort of a simulation and then from there hopefully get enough of an experience that will enable them to go and try it in their own environment so as we were doing our learning lab we were focusing in on different exercises that help people to try testing small changes and trying theories and predictions and learning from what what they experienced so for example one exercise we used was the mr. Potato Head exercise that I created a few years ago and the aim of that was to help people appreciate that here's this toy that you know most of us probably had as a kid we have a lot of experience with and we think we know and then all of a sudden we're put in this situation where we actually have to test trying to put it together a certain way in in this efficient way is possible when we realize there's a bunch of things we didn't know or there's the things that we things that we assume and it's not until we actually start to do tests of change related to trying to put them together that you realize I'll gosh there's a lot I can learn there's things that I can transform in terms of the process and there's much that my colleagues can share with me to that'll enable me to do it better and faster and so we use tools like that or exercises let that to help people kind of appreciate the value of the iterative tests and that there's things that we assume we know but as we test we actually learn and gain deeper knowledge and our hope is then we can take that knowledge and apply it to doing real tests in our own work environment so that we can apply the same kinds of principles to testing changes that will influence patient safety and care
