I have to say Richard, this is the most comprehensive response I have ever received and I think it is fantastic! I definitely agree with all of what you have said if not most. I'm not sure what prompted it, but I greatly appreciate it. This post was in a short thought after a 10 minute tangential discussion in class, but something I found interesting. Thank you for sharing your thoughts!

I definitely agree with your point that individuals are not static beings and we range on how we feel, think, and act on different issues. I for one my be an 'early adopter' when it comes to a technology and a 'laggard' (or an innovator) when it comes to grammar and spelling. However, in all seriousness I do believe, and hope, there is logic and reason behind individuals' decisions to change.

Richard, what are your thoughts now that have moved away from Rogers' work? Any particular theorists you would suggest or perspective you are currently using?

Another point that you are spot on about is that innovators rarely know what is best. Or at least I hope they (read we or I) can admit that there is potential behind an idea or change that is being suggested. I'm also greatly realizing there are both merits and dangers of innovation. Hopefully this course will help me develop a stronger understanding on how to turn ideas into reality and make those changes sustainable.

Robert,

You’ll have to forgive me for the rant. I was neck deep in writing my proposal yesterday on this very topic. I ‘had’ originally planned to use a Rogerian perspective for my PhD work (Rogers’ latest book is sitting on my bookshelf beside me). Thankfully, I’ve had about 5 years of combined grad school to think about the perspective and over that time, I’ve become rather critical of his approach. That said, I should reiterate that I don’t think that Rogerian perspectives should be abandoned – it serves a purpose in many respects – people using his approach just need to be tactful and cognizant of its limitations.

In terms of ‘other’ theories – this is where things get sticky. Once you go down this rabbit hole of straying away from diffusion based methodologies of innovation/adoption/use and this post-positivist way of conceptualizing the world, you can never go back. Practically the entire literature on adoption/use of innovation is underpinned by Rogerian and diffusion based principles (e.g., from what Infoway uses for their benefits analysis, to, system eval in the health literature) – attempting to break from this dominate perspective is difficult, as it involves reconceptualizing how we view innovation, use, adoption, and many other aspects in this process that from a Rogerian perspective, were ‘non-issues’. So, with fair warning, here comes the Coles notes version of how I’m looking at things… we’ll do coffee in the near future and I’ll give you the longer version if you’re interested.

Lately, I’ve been using an approach called Actor-Network Theory (ANT). Unlike many of the other deterministic approaches (whether they be socially deterministic, or technological deterministic – I would say that Rogers can do both equally well), ANT examines the network of actors (both human and non-human) on a level playing field. Humans do not get priority in the analysis – nor does the material (i.e., technology). They are all just ‘actors’ in the relationship – the actors are viewed in symmetry. As actors come together, they align due to common interests and goals – the more alignment they have between these various actors, the stronger they are able to speak as one or produce a common goal. For instance, if you think of an automobile as an actor-network – there are a ton of various parts that make up a car. You as a human, who drives the car is just one part of the puzzle. All the various parts of the car work together in a subscribed manner for things to happen (e.g., when you turn the ignition, the car starts; when you depress the gas pedal, the car moves). If one of these actors (e.g, the spark plug) fails to work, the actor-network becomes weakened or compromised. A small part like the spark plug (worth only a few dollars) can halt the collective action of many other actors, including a human, from completing a task they set out to do (e.g., drive somewhere). Therefore, like complexity theory, a small actor, regardless if they are human or non-human, plays a significant role in determining the outcome of ‘something’. Since things like cars generally ‘work’, all the hidden processes of the actors working together gets blackboxed – that is, we don’t see the actions of the individual actors in relation to other actors – we forget the individual function of actors and just view them as a collective (e.g., a car that has the ability to move when a driver, drives it, or more aptly, a car). Only when the network stops functioning (e.g., the car doesn’t turn on when you fire the ignition) do the individual actors start to emerge from the blackboxed process and start to examine why the network is no longer functioning like it had been (eg., recall the dead spark plug actor).

From an innovation point of view, unless we look at the context, and examine the ‘actors’ involved in innovation diffusion, then, we’ll never actually understand how diffusion/adoption/use occurs. That spark plug ‘halted’ innovation in the example I provided above. This type of example could be translated even further into other domains – like adoption of social media technologies. What are the actors that align for someone to use social media? Is it the other actors around them that bring them into their network (e.g., sends someone an email saying they should join a new social networking website), or, is it some automated system out there that data-mined their facebook profile and alerted them to a new resource website because it read/collated/processed/translated their personal info and directed them to resources they thought would be useful for them? Humans and non-humans working together, in an entangled mess of sociomateriality (go pull some of the later articles 2007-2010 from Orlikowski on this – she’s from the IS business lit and one of my favourite authors). Attempting to tease apart where the human starts/ends, or the technology in the same regard, is fruitless. It’s more important to understand the actors and the network(s) they form to accomplish some common goal.

Now, with that, I respect that there are many people out there who disagree with ANT. They table that it does not respect human agency, that it is actually deterministic in the sense that subscribes actualized roles to things, etc. The list goes on – I generally find people from a constructivist perspective have issue with ANT as it reduces the human to ‘just an actor’ in the network. Regardless, it’s the only approach I’ve found in the last 5 years that resonates with me in terms of explaining innovation. All other (generally positivist and post-positivist) approaches have never totally agreed with me. It’s actually very refreshing to have found ANT – it gives me a language to describe something I always knew existed, but lacked the lexicon to describe or outline.

That’s where I’ve been immersed for the last 6 months. There are other approaches like ANT out there that focus on other aspects – but I’ve found ANT to be the most fruitful for my work as it (historically it’s from sociology looking at Information Systems) aligns with technology in an extremely usable fashion.

Also, “the first academic comment” posted on twitter – appreciated, but I only consider myself a budding academic at best. I’ve got a long way to go!

Ok – back to the proposal now!

You ask some tough questions Rob! I have to say that where particular nurses fall depends on much, their experience, their comfort, their particular personality. Although I would like to say that all of us educators are innovators and early adopters it is not always true. Often, education lags behind practice. I wonder why that is?
I know many nurses that are great innovators, @NerdNurse is one of them. Innovators tend also to be energizers and leaders. Social media is full of such nurses and their innovation is not job dependent, but personality dependent. Often though, innovators make many mistakes and often must go back and apologize or call a 'do over'. That does not bode well in practice or in education very well, keeping many cautious. (However, I also have to agree with torontoemerg…. some of it is institutional and has to to with leadership, modeling, mentoring, and the culture set up by the institution)
Keep up the excellent and thought provoking posts!!!

Hi Rob

Didn't mean to be a disappointment to you, There are innovators out there on the front line — I have seen a few myself, but their position is sometimes incredibly difficult.

I honestly think it needs a culture shift in institutions where nurses practice. Part of it needs to come from the front line itself to start to seriously using their critical thinking skills, seek out real innovation — and then take ownership of it, which means, yes, doing research and engaging managers and administration. But equally, not only do managers and administrators need to stop misusing the word “innovation” to spin whatever unpleasantness they're about to inflict on the front line, but they also must actively support innovation from nurses, not just give lip service to it. This might include an expectation (i.e in job descriptions) that innovation is part of nursing duties, but also giving permission and support for innovators to do their thing, but supporting innovators in implementation — which includes navigating a very Byzantine hospital bureaucracy, but also budget.

Google ought to be the model for nurses in innovation, but how many hospitals are organized like Google?

Fascinating discussion… so fascinating I am writing my own post!