Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems

Sarah Barry

doi:10.12688/hrbopenres.13199.1

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Method Article

Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems

[version 1; peer review: 2 approved with reservations]

Sarah Barry

PUBLISHED 10 Feb 2021

Author details Author details

Centre for Health Policy and Managment, Trinity College Dublin, Dublin 2, Ireland

Sarah Barry
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

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Abstract

Background: This concept paper presents Contextual Analysis for Practical Action or ‘CAPA’ as an action-oriented tool to understand and implement interventions in real-life service delivery contexts. Understanding how contexts work is a critical challenge for Health and Social Care Systems seeking to become more integrated. CAPA is a tool for understanding and empowering agents in local contexts. The local context is understood here as a key factor in implementation success. This concept paper offers rich theorising to underpin the translation of systems reform initiatives into meaningful local engagement and change.
Methods: Analysis of the ‘implementation conundrum’ highlights the problem, while a review of the organisational learning literature identifies ‘sensemaking in organisation’ as a powerful mechanism to address it. Based on earlier phenomenological research the dynamics of organisational sensemaking are presented. Finally, applications for CAPA are explored and next steps outlined.
Results: CAPA makes tangible the implicit and interpretive nature of organisational life as ‘sensemaking in context’. This phenomenon is analysed as a determinant of implementation success. As such, CAPA opens a path to working with contextual complexity by framing it as a dialectic pattern of topical, ecological, dialogical, and pragmatic modes that ‘contextualise’. CAPA is a tool for researchers and practitioners to explore the complexity of local contexts and their implementation challenges, and working-with local agents for learning and change.
Conclusions: Health reform needs new approaches for understanding implementation in context. CAPA is a tool for understanding and working-with contextual factors central to the complexity of policy or knowledge translation for example. This paper outlines its rationale, principles, and functionality. Possible applications are explored for co-designed practical learning experiences. It concludes with a call to policy makers, service managers and researchers to use the approach in specific settings so it can be developed and refined.

Keywords

Contextual analysis, organisational learning, implementation challenge, complex systems

Corresponding author: Sarah Barry

Competing interests: No competing interests were disclosed.

Grant information: Research conducted in the development of the doctoral dissertation that underpins CAPA was part-funded by the Irish Research Council for the Humanities and Social Sciences (IRCHSS) and Leitrim County Council, Ireland. No additional funding supported the production of the current paper.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2021 Barry S. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Barry S. Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems [version 1; peer review: 2 approved with reservations]. HRB Open Res 2021, 4:18 (https://doi.org/10.12688/hrbopenres.13199.1) First published: 10 Feb 2021, 4:18 (https://doi.org/10.12688/hrbopenres.13199.1) Latest published: 10 Feb 2021, 4:18 (https://doi.org/10.12688/hrbopenres.13199.1)

Introduction

This concept paper presents a practical learning approach to implementing change in complex systems and organisations using a new framework for analysing the functional or modal dynamics of contextualisation. Contextual Analysis for Practical Action, or CAPA, is based on earlier phenomenological research into the everyday sensemaking work in a statutory public organisation in Ireland¹. Many of the characteristics of public organisation and its challenges in implementing change are common across service delivery domains (e.g. health, education, and housing). These include phenomena such as institutionalism, bureaucracy, and embedded cultures that can become intransigent and resistant to change. Siloed languages, identities and meanings reinforce bounded rationalities, unexamined values, obscure path dependencies and fixed organising principles as ‘hidden but real’ mechanisms².

Such phenomena constitute much of the complexity that implementation science and health services research in particular must learn to address with ‘rich theorising’ and ‘generative learning’³. Given the pervasive nature of these challenges, this paper explores the interpretive or everyday sensemaking aspects of that complexity and defines how contextualising factors emerge as important drivers and critical determinants of change management and implementation success. As such, the paper is relevant for change and implementation managers, researchers, organisation leaders, health system reformers and policy makers in general.

Methods

The paper analyses how an ‘implementation conundrum’ inhibits progression and presents a review of organisational learning literature that highlights ‘sensemaking’ as an important and complex mechanism of organisational life in this regard. In order to better understand the nature and functionality of sensemaking, its modes and contextualising patterns are explored using earlier phenomenological research and conceptualisation¹. A contextualising pattern of modal dialectics is thus described, and possible applications for CAPA as an implementation tool are explored.

Analysis

Addressing the implementation conundrum

Implementing change at macro, meso or micro levels is challenging due to an ‘implementation conundrum’ in which universal fear of change, government failure to plan, and a lack of method in working with the social context all play a part⁴. Even with policy in place many implementation projects fail because they are top-down in nature, are siloed in their scope, have unintended consequences, are not evidence-informed, are insufficiently evaluated or do not take enough account of the knowledge translation process^5–8.

Implementation models often display a project-management-type or results-based linear rationale that limits consideration of relevant complexities^8,9. Although newer constructions of more complex causality between interventions and outcomes on realist terms have been developed they are early stage in application and, in using causal logic remain somewhat positivist in their guiding assumptions^10–12. Of particular use in the newer models is a focus on process outcomes¹³ and the need for a consolidated framework to inform change-work across multiple and diverse contexts¹⁴. This includes understanding to a better degree how innovation can be linked to performance for scalability¹⁵.

Increasingly the focus is on the diffuse, seemingly chaotic and uncontrollable aspects of organisational life and change implementation in response to health service and system failures^16,17. Traditional change implementation approaches insufficiently focus on organisation politics for example¹⁸, or too easily attribute outcomes and knowledge transfers¹⁹. These types of constraint make measurement, evaluation and controlled progression hard²⁰. In a paradoxical twist, models and methods that frame change on its own terms are required^21,22. Organisational learning offers some relevant resources for this trajectory, and in particular, a conceptualisation of practical learning that models a dialectic pattern of change in the everyday sensemaking (formal and informal) of normal organisational life^1,23. Modelling this pattern is a step towards generating new ways of working-with everyday sensemaking and its contextualising effects, and offers a path towards addressing some of the challenges highlighted above.

Learning for a change

Early organisational learning literature defined the learning process as knowledge creation^24,25 and a construct for ‘improving actions through better knowledge and understanding’²⁶, but also recognised the complexity of the knowledge-to-action-to-knowledge link^27–29. Initial theorising highlighted the processes of knowledge acquisition, information distribution, interpretation and organisational memory³⁰ and sought to address organisational boundaries as part of the challenge³¹ from a systems perspective²⁸. More recently boundary spanning can be linked to overcoming the ‘silo effect’^32,33.

Dynamic interpretations of how knowledge is generated, communicated, integrated and applied were developed^34–36. Social constructionist approaches posited organisations as language-based interpretive systems^37–42, characterised by metaphorical thinking⁴³. From this perspective ‘systems learning’ is knowledge generation, transfer and linkage to action¹⁹ so that knowledge when understood as a possession is ineffective or incomplete^44,45.

The linguistic-turn in organisation science^46–49 highlighted the power of specific groups and discourses for making organisational knowledge for action^38,40,50. In application the shift towards ‘learning organisations’⁵¹ and ‘communities of practice’⁵² maps onto more recent constructions of the organisation as a community of meaning^53,54. For organisations as communities of meaning, readiness for implementation is judged by variables such as absorptive capacity, organisational eloquence, organisational capability for knowledge management, culture, institution and relationships^55–57.

Although technical or professional knowledge may generate status and identity, it is situational knowledge⁵⁸ and understanding of the local (i.e. particular politics, relationships, culture, story, identity, ways of working) that matters for meaning⁵⁹. Situated meaning defines the nature of a particular context as an essential element of the complexity that must be worked-with for implementation success⁶⁰. This focus on situatedness and context is partly in response to system failures with accountability in the health and social care domain (e.g. 61) and generation of the common good. From a systems perspective, there is a pressing need to understand how the successful pilot or pioneer project can spread or scale; and to take this scalability as an indicator of general readiness for change in complex systemic environments (e.g. 62).

Situatedness and the nature of context

Situatedness highlights the importance of local context, a term still under theorised⁶³. Context has been understood as the backdrop to the real action or intervention, but less frequently as the primary determinant of change^21,64,65. Context has also been conceptualised through internal and external influences⁶⁶ and organisational levels⁶⁷. A relational approach is taken here for which context is understood and generated in local social coordinations. These are made on the basis of what is known, by the underpinning principles and values, and characterised by the language-used for communication^46,47,68. In a reflexive process of context-making ‘texts’ are fixed (for a given time/space) as coordinated meanings that become ‘real’, i.e. they are agreed as practical facts or become identifiable phenomena, including artefacts. This happens through multiloging, which is a creative interactive process of making common or shared understandings⁶⁹.

Texts as coordinated meanings are never ultimately fixed; they have no ultimate origin and are always in the process of making, their only limits are the ‘socio-cultural context[s] in which [they are] made since these are the reference points to which people coordinate’³⁹. This relational view of context coheres with a complex adaptive systems approach in realising that meaning is always emergent, changing, up for reinterpretation, self-organising, far from equilibrium, and path-dependent⁷⁰. With the inherent open-endedness implied this approach makes practical learning a useful driver of implementation and change²⁸.

Sensemaking and learning in four interpretive modes

CAPA or Contextual Analysis for Practical Action is a practical learning framework emerging from qualitative phenomenological research that explores the nature of organisational learning practice in a large government organisation¹. It is based on earlier modelling of empirically identified complex management and change processes as everyday organisational sensemaking. It does this using an organisational learning lens¹.

Sensemaking is understood broadly as the embodied and interactive ability to understand an environment and respond appropriately^71,72. For CAPA, organisations are understood as complex, adaptive and specifically social systems characterised by self-organisation, emergence, connectivity, interdependence, feedback and path-dependence⁷⁰. This social context is understood as a critical determinant of change, which means interpretive practice is the focus of enquiry through a social constructionist frame^41,73.

Specifically, CAPA takes a relational perspective to highlight the interactive nature of common organisational functions such as leading, learning, planning, managing, implementing and evaluating⁷⁴. At the heart of enquiry for CAPA (whether practical or explanatory) are the ways in which people make sense of their world and their work by relating or coordinating meanings that drive action; in so doing they generate both agency and context. For example, as agents promote a purpose their positionality is also coordinated intrinsically as an organisational outcome that becomes a contextualising factor¹. Purpose/positionality therefore becomes a relating practice or coordinated phenomenon to focus on. This type of relating (or related) practice can be corporate, group, team-based, or individual as a somewhat fixed text, but at systemic levels given the characteristics noted above, its emergence and/or sustained nature is rarely linear, simple, nor wholly clear; the system has a life of its own.

Purpose/positionality (as an example of related practice) is made through sensemaking in at least four organisational primary-action-types or modes. These have been identified as:

a. Topical, i.e. the language and discourse making, or the topics talked;
b. Ecological, i.e. the institutional and cultural structuring and patterning of relations that organise and distribute power, e.g. hierarchy
c. Dialogical, i.e. the use of practical tools, technologies, methods and disciplines to process (topical) knowledge to new levels of abstraction for generalisation and action; and
d. Pragmatic, i.e. the practical actions and decisions-made that shift empirical parameters.

These interpretive forces generate the character of organisational situations into specific contexts and as such moderate to a significant degree the success or failure of an implementation process¹. The relating practices emerging from context-making, such as purpose/positionality can be understood as mechanisms, somewhat in the line of Pawson and Tilley⁷⁵, but as phenomena they account for their own generative nature as described below.

CAPA and modal dialectics

A figure representing the functionality of CAPA (Figure 1) shows how the modal dialectic works. Learning and change are de-centred or distributed so that no single centre, individual, group or unit has full view or control of what is going on; all participants become players as the command and control paradigm is destabilised⁷⁶. The four modes identified as topical, ecological, dialogical and pragmatic are the forces driving activity and change in a cyclical or spiraling feedback loop.

Figure 1. Representation of CAPA functionality.

Each of these four modal forces introduces different types of change that continually embody (i.e. become real) by virtue of their relatedness. The pattern dialectically generates the topical and dialogical modes through digital feedback, and the ecological and pragmatic modes through analogue feedback⁷⁷. This happens in four core generative coordinations described below as a cycle. The functionality of the cycle is always emergent and unfixed; it has its own, and potentially flexing or deconstructive life due to its complex relating pattern.

The Topical Mode fixes topics as the matters of concern talked about in normal organisational interactions; these can be formalised to a greater or lesser degree in a particular language or discourse. These discourses create an organisational topography.

The Dialogical Mode gives shape to ordering frameworks such as tools and methods, or more embedded practices such as guidelines, rules, procedures and technologies as well as disciplines, constitutions, principles, values, and assumptions.

The topical and dialogical modes generate each other (or are coordinated) through digital feedback (i.e. code) and embody purpose/positionality as a less tangible organisational phenomenon (and force).

The Ecological Mode characterises the social arrangement and artistry of power distributed through organisational settings, structures and project arrangements. This mode is ecological, more than simply environmental because (like the pragmatic mode described below) coordination is constrained by conditions here and now (a form of bounded situation and rationality). The ecology is more or less a resource for change depending on the quality of relations generating it.

Finally, the Pragmatic Mode determines particular actions emerging in, as and for the ongoing cycle. Actions include decisions-made, contracts agreed, budgets distributed etc. In other words, actions change the landscape in ways that empirically matter and therefore generate new topics, which reboots the dialectic cycle. This mode (like the ecological) is constrained by environment and situational capacity giving it its pragmatic character. It is fundamentally characterised as itself because what is done is done, specifically in a place (space) and at a time. This pragmatic mode grounds the whole process of change.

The ecological and the pragmatic modes generate each other (or are coordinated) through analogue feedback (i.e. data) since they are experienced as one thing after another in time and space - there is no (or little) superposition of observation. The ecological and pragmatic modes are experienced as the flow of life about which (in the dialectic pattern) the digital modes (topical and dialogical) create meaning and sense.

Each of the identified modes introduces difference and variability whilst their relatedness generates embodiment or ‘reality’ in a dialectic pattern, i.e. Topical discourse generates dialogical frameworks through the ecological mode; Dialogical frameworks generate topical discourse through the pragmatic mode; Ecologies generate pragmatic actions through the dialogical mode and finally, Pragmatic actions generate ecologies through the topical (or propositional) mode. These complex relating patterns take shape in the meaningful coordinations, whether conceptual or practical, that participants in any social system are both ordered by, and through which they proactively order their lives.

These are complex relating patterns that function in various forms of organisational discourse (private, public and presentational), creating order, disorder and change as organisations and systems fix and flex coordinated meanings to empower objectives¹. Organisational objectives are of course myriad and often not aligned; they include intervention and implementation, improvement and innovative practice, governance and strategy as well as more challenging and at times institutionalised phenomena such as resistance to change, silo-building and protectionism.

Results

Through this analysis, contextualisation is highlighted as an important determinant of implementation success and an approach for working-with it as a distinct phenomenon established using CAPA. A range of complex interpretive organisational forces are captured through CAPA which defines them as a dialectic pattern of topical, ecological, dialogical, and pragmatic sensemaking modes. CAPA is presented as a useful conceptual and framing resource for nuanced implementation work in complex adaptive systems.

Discussion – possible applications for CAPA

CAPA is a processual approach to system functionality taking sensemaking in organisational contexts as its unit of analysis, and therefore as an important resource for implementing organisational change. It is useful for working with less tangible or implicit elements of complexity such as culture. It engages uncertainty and emergence on their own terms. CAPA enables a language of participation as a critical determinant of reform⁷⁸. It aims to empower stakeholders collectively recognising that power is distributed according to organisational capability to topicalise issues, to progress them as legitimised knowledge, language and discourse^79,80 and to frame them in practical actions coherent with organisational ends. There is an assumption here that empowering all stakeholders contributes to successful systems.

CAPA assumes that participation in explicit sensemaking as practical learning enables decisions that make a difference for implementation. An implementing team or group can use CAPA as a reflexive tool to ‘generate a view’ of their own context for example; it can frame-for-action some of the otherwise tacit complexities involved. CAPA can also be used in understanding the challenges of scaling or spreading innovation through large systems at a time when local autonomy and engagement, customisation and distributed leadership emerge as critical factors for implementation success^60,81. The question of how large public service delivery systems can distribute decision-making powers and resources whilst also being accountable is a large one^82,83.

Given that stakeholder purposes and positionalities often do not align, the need to discover higher order goals to drive change can be important. CAPA offers an opportunity to socialise and locally interpret policy goals for example, drawing on the translation process itself to generate ownership, local application and meaningfulness. The ‘people-centered care’ discourse of the WHO is such a policy level goal that needs local and practical interpretation in order to make any outcome-difference for patients and providers⁸⁴. Despite the varying purposes and positions of stakeholders, CAPA engages purpose/positionality as a relating practice and organisational complexity that becomes a resource for analysis and change insofar as participants are empowered to fulfill the potential of their task and situation, moving beyond the siloed lens¹. CAPA aims to shift stakeholders from silo to system whilst remaining a ‘bottom-up’ approach to implementation.

From the research and practice perspectives, CAPA can potentially generate language for engaging elements of deeply embedded institutional and bureaucratic practices that have become problematic. In line with an appreciative approach⁸⁵ as a reflective practice its aim is to enable and empower local insight, ownership and buy-in. To this end CAPA is particularly well suited to the challenges of regionalising integrated care for which new organisational forms of governance, knowledge management, resource allocation, and service delivery are required⁸⁶.

In the Irish context CAPA has been used for case study research focussed on the contextual challenges of delivering integrated care for older persons⁸⁷. The assumption here is that CAPA can enable a different, distributed organisational imagination. CAPA may also be useful for engaging organisational conflict, particularly across departmental or unit boundaries through a two-staged process of reflexive and multiperspective analysis. Learning how to implement change at scale is a critical challenge for health and social care systems around the world given current population health needs for which they are ill designed and ill equipped^5,88.

The approach is relevant across several literatures. For example, CAPA can contribute to realist evaluation aimed at generating evidence for complex settings and processes and for understanding how to manage timely adaptation as it takes account of many confounding factors in organisational life. These include discursive engagement, contingency, politics, the structuring dimension, social norming and the like. As an organisational learning tool, CAPA can be useful in the context of quality assurance and risk management as an appraisal method that engages practical service delivery contexts on their own terms. It has the potential to create language and reflection space for naming risk and generating improvement by topicalising issues that traditional, linear frameworks can miss.

Conclusions

Given the challenges of distributing processes such as policy interpretation, shared understanding and implementation at local levels and in context, as well as enabling greater functionality with leadership, governance and change coordination for example, this paper addresses the call for better theory to underpin practical applications. It offers a path of organisational learning with complexity and a method developed from empirical research for practical situated learning about, and with context¹. The hope is that by framing the pragmatic, heuristic and contingent sensemaking work of everyday organisational settings, and rendering this complexity for local learning and general analysis CAPA can make a useful contribution towards overcoming the implementation conundrum and the challenges of health system reform and system change generally.

Ethics approval

Ethical approval for the source study informing the research underpinning CAPA was given by the Centre for Health Policy and Management and Centre for Global Health Ethics Committee, Trinity College Dublin.

Data availability

No data is associated with this article.

All textual data used in the analytical generation and conceptualisation of CAPA is available at: https://www.taosinstitute.net/resources/dissertations/other-noteworthy-dissertations/sarah-elizabeth-dissertation¹. Organisational Learning on “Another Map” - phenomenological explorations with ecological epistemology as practical learning for development-aid organising: https://www.taosinstitute.net/resources/dissertations/other-noteworthy-dissertations/sarah-elizabeth-dissertation¹.

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Author details Author details

Centre for Health Policy and Managment, Trinity College Dublin, Dublin 2, Ireland

Sarah Barry
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

Research conducted in the development of the doctoral dissertation that underpins CAPA was part-funded by the Irish Research Council for the Humanities and Social Sciences (IRCHSS) and Leitrim County Council, Ireland. No additional funding supported the production of the current paper.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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© 2021 Barry S. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Barry S. Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems [version 1; peer review: 2 approved with reservations]. HRB Open Res 2021, 4:18 (https://doi.org/10.12688/hrbopenres.13199.1)

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Reviewer Report 29 Mar 2021

Sheila McNamee, Department of Communication, University of New Hampshire, Durham, NH, USA

Approved with Reservations

https://doi.org/10.21956/hrbopenres.14347.r28869

Is the rationale for developing the new method (or application) clearly explained?
The author points out the difficulty in effectively and successfully implementing change in complex systems (the “implementation conundrum”): fear of change, government failure to plan, lack ... Continue reading

Is the rationale for developing the new method (or application) clearly explained?
The author points out the difficulty in effectively and successfully implementing change in complex systems (the “implementation conundrum”): fear of change, government failure to plan, lack of method, top-down nature of change initiatives, siloed initiatives, unintended consequences, etc. and proposes Contextual Analysis for Practical Action (CAPA) as an alternative. This alternative focuses on the sensemaking aspects of organizational complexity with special attention devoted to how contextualizing factors serve as critical aspects of organizational change. The author argues (correctly in my view) that attention to organizations as communities of meaning redirects our attention to the situated nature of interaction where meaning is constructed.

Is the description of the method technically sound?
I found it necessary to read and re-read the description of CAPA and the “modal dialectics” entailed (topical, ecological, dialogical, and pragmatic modes). It is clear that this approach invites reflexivity into the change process which is critical in my view. The modal dialectics invite reflexive inquiry into taken-for-granted assumptions and practices that, dialectically, generate new forms of action. All important contributions. However, I think a concrete illustration would go a long way in clarifying and simplifying CAPA and thereby make it more accessible to the reader.

Are sufficient details provided to allow replication of the method development and its use by others?
As mentioned above, I think this article would be greatly enhanced by including a detailed illustration of the method. A case study would help the reader envision putting this approach into practice.

Are the conclusions about the method and its performance adequately supported by the findings presented in the article?
Since there are not any concrete findings (due to the omission of a case illustration), the conclusions about this method are generic. The author concludes that the article “offers a path of organizational learning with complexity and a method developed from empirical research for practical situated learning about, and with, context.” She also argues that CAPA may be useful for engaging organizational conflict. Given the emphasis on situated practices (contextualization), I agree. The article’s conclusions are sound but would be more evident and thus more powerful had a case illustration been included.

Is the rationale for developing the new method (or application) clearly explained?

Yes
Is the description of the method technically sound?

Partly
Are sufficient details provided to allow replication of the method development and its use by others?

Partly
If any results are presented, are all the source data underlying the results available to ensure full reproducibility?

No source data required
Are the conclusions about the method and its performance adequately supported by the findings presented in the article?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Conflict transformation, psychotherapy, relational approaches to education, community building, & organizing.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Reviewer Report 05 Mar 2021

Ninna Meier, Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark

Approved with Reservations

https://doi.org/10.21956/hrbopenres.14347.r28872

For the author,

I really appreciate the opportunity to review this conceptual paper, which discusses important aspects of implementation in practice through the CAPA model.

While I read the paper with interest and applaud ... Continue reading

For the author,

I really appreciate the opportunity to review this conceptual paper, which discusses important aspects of implementation in practice through the CAPA model.

While I read the paper with interest and applaud the author’s ambition to further theory and methods relating to 'the implementation conundrum', I think there are problems with the current version of the paper. I address these and offer comments and suggestions for improvement below.

To me, the most important shortcoming is the lack of theoretical definition and discussion of the main concepts, particularly the concepts of context, contextualization, and sensemaking. Depending on the purpose of the paper (developing practical learning approach or theoretical underpinnings), this can either be fixed relatively easy or is essential.

The author states that “contextualisation is highlighted as an important determinant of implementation success and an approach for working-with it as a distinct phenomenon established using CAPA.” However, I could not discern what the concept of contextualization refers to in the paper. This becomes a problem, because the lack of conceptual clarity makes it difficult for me as a reader to follow the author’s argumentation and to understand what sentences such as this one refers to: “contextualising factors emerge as important drivers and critical determinants of change management and implementation success”. Because this phenomenon, ‘contextualization’, is identified as important determinant of implementation success and change management, I need to understand what the term refers to, if I am to understand the claim made by the author. Based on my reading of the paper, my best guess is that ‘organizational sensemaking’ is ‘contextualisation. However, the lack of definition or discussion of the term means that it is not clear to me if the author recognizes that contextualization can be individual and social – and that this has important implications for CAPA. As I read this paper, the author focuses on social processes of contextualization and does not touch upon individual processes of contexualisation. This introduces a disconnect between contextualization and sensemaking, because the author uses this latter term to refer to primarily individual phenomenon (although there are contributions to this theoretical field that address collective sensemaking in organizations).

Organizational life is also referred to as ‘sensemaking in context’. But because the term ‘sensemaking’ is only briefly discussed and defined as ‘the embodied and interactive ability to understand an environment and respond appropriately’, I am not sure the author means to equate sensemaking with contextualization. If so, I suggest that the term is given more careful theoretical attention and consideration about what ‘appropriately’ refers to? Who decides if a response is appropriate? And how does this relate to the purpose of CAPA – what if people can’t agree on what counts as ‘an appropriate’ response?

Unfortunately, the same lack of conceptual clarity characterizes the key term ‘context’. The author states that ‘context is understood and generated in local social coordination. These are made on the basis of what is known, by the underpinning principles and values, and characterised by the language-used for communication’. However, as a reader I am left with the pressing question of what does context mean? What does the term refer to in the paper? My best guess is that context in this paper refers to shared constructions of meaning that can become ‘the background’ or frame for action (i.e. the ‘intervention’) for a group of people and therefore an important coordination mechanisms in the organizational change process that involves organizations and people from different professional and disciplinary fields.

The CAPA model uses four basic questions to facilitate participants’ discussions and - co-creation? - of meaning (this, I think, is the collective contextualization, the sensemaking in context): What are we talking about? How is our organization? What tool, technologies, methods are we using? What decisions and actions are we using?

The author states that “an implementing team or group can use CAPA as a reflexive tool to ‘generate a view’ of their own context”. She also states that CAPA is useful “for working with less tangible or implicit elements of complexity such as culture”. CAPA “may also be useful for engaging organisational conflict, particularly across departmental or unit boundaries through a two-staged process of reflexive and multiperspective analysis”. Lastly, she suggests that CAPA can “potentially generate language for engaging elements of deeply embedded institutional and bureaucratic practices that have become problematic”.

I suggest that the author focuses on sharing how CAPA can be used for these important purposes and that in this, she provides examples from the work she has done in this area. The stated aim of the paper is to present “a practical learning approach to implementing change in complex systems and organisations using a new framework for analysing the functional or modal dynamics of contextualization” and I think that there is real potential for this – especially if the author considers the following suggestions:

Revise the manuscript with the imagined audience in mind. Who should read this paper? If the audience is a practitioner who needs to use the tool, then this should be guiding the revision. If the audience is an academic who needs to understand the role of context in implementation processes, then I suggest a more focused and developed theoretical discussion of the key concepts above will help the author carve out her contribution to those of us, who research the link between context, action and organizational change.
Edit the paper for clarity of language – sometimes the text is very convoluted and it is difficult for me to understand what the author wants me to learn. I provide three examples here to point to what I mean:
a) "This mode (like the ecological) is constrained by environment and situational capacity giving it its pragmatic character. It is fundamentally characterised as itself because what is done is done, specifically in a place (space) and at a time".
b) "The functionality of the cycle is always emergent and unfixed; it has its own, and potentially flexing or deconstructive life due to its complex relating pattern"
c) "Each of the identified modes introduces difference and variability whilst their relatedness generates embodiment or ‘reality’ in a dialectic pattern".
In these examples I struggle to understand what the sentences actually mean. I sympathise with the author, here, because context, contextualization and complexity are in my experience difficult topics to write clearly about. However, perhaps some examples of ‘how’ the modes introduce difference and variability, into what, and how their relatedness generates embodiment or reality in a dialectic pattern – I think this would be very helpful for the reader.
Lastly, I would love to learn more about how CAPA has been used to create the ‘we’ that is embedded into the four questions. In my experience, this step is crucial and yet can be difficult. Also, this is where dynamics of power, culture, and disagreement are likely to arise. I suspect there is an important contribution that can be added here.

I hope my review of the paper can be useful in the next step of the process.

All the best,
Ninna Meier

Is the rationale for developing the new method (or application) clearly explained?

Yes
Is the description of the method technically sound?

Partly
Are sufficient details provided to allow replication of the method development and its use by others?

Partly
If any results are presented, are all the source data underlying the results available to ensure full reproducibility?

No source data required
Are the conclusions about the method and its performance adequately supported by the findings presented in the article?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Context, organizational change, coordination and leadership in clinical settings.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Version 1 10 Feb 21	read	read

Ninna Meier, Aalborg University, Aalborg, Denmark
Sheila McNamee, University of New Hampshire, Durham, USA

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Reviewer Report

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29 Mar 2021 | for Version 1

Sheila McNamee, Department of Communication, University of New Hampshire, Durham, NH, USA

17 Views Cite this report Responses(0)

Approved With Reservations

Is the rationale for developing the new method (or application) clearly explained?
The author points out the difficulty in effectively and successfully implementing change in complex systems (the “implementation conundrum”): fear of change, government failure to plan, lack of method, top-down nature of change initiatives, siloed initiatives, unintended consequences, etc. and proposes Contextual Analysis for Practical Action (CAPA) as an alternative. This alternative focuses on the sensemaking aspects of organizational complexity with special attention devoted to how contextualizing factors serve as critical aspects of organizational change. The author argues (correctly in my view) that attention to organizations as communities of meaning redirects our attention to the situated nature of interaction where meaning is constructed.

Is the description of the method technically sound?
I found it necessary to read and re-read the description of CAPA and the “modal dialectics” entailed (topical, ecological, dialogical, and pragmatic modes). It is clear that this approach invites reflexivity into the change process which is critical in my view. The modal dialectics invite reflexive inquiry into taken-for-granted assumptions and practices that, dialectically, generate new forms of action. All important contributions. However, I think a concrete illustration would go a long way in clarifying and simplifying CAPA and thereby make it more accessible to the reader.

Are sufficient details provided to allow replication of the method development and its use by others?
As mentioned above, I think this article would be greatly enhanced by including a detailed illustration of the method. A case study would help the reader envision putting this approach into practice.

Are the conclusions about the method and its performance adequately supported by the findings presented in the article?
Since there are not any concrete findings (due to the omission of a case illustration), the conclusions about this method are generic. The author concludes that the article “offers a path of organizational learning with complexity and a method developed from empirical research for practical situated learning about, and with, context.” She also argues that CAPA may be useful for engaging organizational conflict. Given the emphasis on situated practices (contextualization), I agree. The article’s conclusions are sound but would be more evident and thus more powerful had a case illustration been included.

Is the rationale for developing the new method (or application) clearly explained?

Yes
Is the description of the method technically sound?

Partly
Are sufficient details provided to allow replication of the method development and its use by others?

Partly
If any results are presented, are all the source data underlying the results available to ensure full reproducibility?

No source data required
Are the conclusions about the method and its performance adequately supported by the findings presented in the article?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Conflict transformation, psychotherapy, relational approaches to education, community building, & organizing.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

24 Views

05 Mar 2021 | for Version 1

Ninna Meier, Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark

24 Views Cite this report Responses(0)

Approved With Reservations

For the author,

I really appreciate the opportunity to review this conceptual paper, which discusses important aspects of implementation in practice through the CAPA model.

While I read the paper with interest and applaud the author’s ambition to further theory and methods relating to 'the implementation conundrum', I think there are problems with the current version of the paper. I address these and offer comments and suggestions for improvement below.

To me, the most important shortcoming is the lack of theoretical definition and discussion of the main concepts, particularly the concepts of context, contextualization, and sensemaking. Depending on the purpose of the paper (developing practical learning approach or theoretical underpinnings), this can either be fixed relatively easy or is essential.

The author states that “contextualisation is highlighted as an important determinant of implementation success and an approach for working-with it as a distinct phenomenon established using CAPA.” However, I could not discern what the concept of contextualization refers to in the paper. This becomes a problem, because the lack of conceptual clarity makes it difficult for me as a reader to follow the author’s argumentation and to understand what sentences such as this one refers to: “contextualising factors emerge as important drivers and critical determinants of change management and implementation success”. Because this phenomenon, ‘contextualization’, is identified as important determinant of implementation success and change management, I need to understand what the term refers to, if I am to understand the claim made by the author. Based on my reading of the paper, my best guess is that ‘organizational sensemaking’ is ‘contextualisation. However, the lack of definition or discussion of the term means that it is not clear to me if the author recognizes that contextualization can be individual and social – and that this has important implications for CAPA. As I read this paper, the author focuses on social processes of contextualization and does not touch upon individual processes of contexualisation. This introduces a disconnect between contextualization and sensemaking, because the author uses this latter term to refer to primarily individual phenomenon (although there are contributions to this theoretical field that address collective sensemaking in organizations).

Organizational life is also referred to as ‘sensemaking in context’. But because the term ‘sensemaking’ is only briefly discussed and defined as ‘the embodied and interactive ability to understand an environment and respond appropriately’, I am not sure the author means to equate sensemaking with contextualization. If so, I suggest that the term is given more careful theoretical attention and consideration about what ‘appropriately’ refers to? Who decides if a response is appropriate? And how does this relate to the purpose of CAPA – what if people can’t agree on what counts as ‘an appropriate’ response?

Unfortunately, the same lack of conceptual clarity characterizes the key term ‘context’. The author states that ‘context is understood and generated in local social coordination. These are made on the basis of what is known, by the underpinning principles and values, and characterised by the language-used for communication’. However, as a reader I am left with the pressing question of what does context mean? What does the term refer to in the paper? My best guess is that context in this paper refers to shared constructions of meaning that can become ‘the background’ or frame for action (i.e. the ‘intervention’) for a group of people and therefore an important coordination mechanisms in the organizational change process that involves organizations and people from different professional and disciplinary fields.

The CAPA model uses four basic questions to facilitate participants’ discussions and - co-creation? - of meaning (this, I think, is the collective contextualization, the sensemaking in context): What are we talking about? How is our organization? What tool, technologies, methods are we using? What decisions and actions are we using?

The author states that “an implementing team or group can use CAPA as a reflexive tool to ‘generate a view’ of their own context”. She also states that CAPA is useful “for working with less tangible or implicit elements of complexity such as culture”. CAPA “may also be useful for engaging organisational conflict, particularly across departmental or unit boundaries through a two-staged process of reflexive and multiperspective analysis”. Lastly, she suggests that CAPA can “potentially generate language for engaging elements of deeply embedded institutional and bureaucratic practices that have become problematic”.

I suggest that the author focuses on sharing how CAPA can be used for these important purposes and that in this, she provides examples from the work she has done in this area. The stated aim of the paper is to present “a practical learning approach to implementing change in complex systems and organisations using a new framework for analysing the functional or modal dynamics of contextualization” and I think that there is real potential for this – especially if the author considers the following suggestions:

Revise the manuscript with the imagined audience in mind. Who should read this paper? If the audience is a practitioner who needs to use the tool, then this should be guiding the revision. If the audience is an academic who needs to understand the role of context in implementation processes, then I suggest a more focused and developed theoretical discussion of the key concepts above will help the author carve out her contribution to those of us, who research the link between context, action and organizational change.
Edit the paper for clarity of language – sometimes the text is very convoluted and it is difficult for me to understand what the author wants me to learn. I provide three examples here to point to what I mean:
a) "This mode (like the ecological) is constrained by environment and situational capacity giving it its pragmatic character. It is fundamentally characterised as itself because what is done is done, specifically in a place (space) and at a time".
b) "The functionality of the cycle is always emergent and unfixed; it has its own, and potentially flexing or deconstructive life due to its complex relating pattern"
c) "Each of the identified modes introduces difference and variability whilst their relatedness generates embodiment or ‘reality’ in a dialectic pattern".
In these examples I struggle to understand what the sentences actually mean. I sympathise with the author, here, because context, contextualization and complexity are in my experience difficult topics to write clearly about. However, perhaps some examples of ‘how’ the modes introduce difference and variability, into what, and how their relatedness generates embodiment or reality in a dialectic pattern – I think this would be very helpful for the reader.
Lastly, I would love to learn more about how CAPA has been used to create the ‘we’ that is embedded into the four questions. In my experience, this step is crucial and yet can be difficult. Also, this is where dynamics of power, culture, and disagreement are likely to arise. I suspect there is an important contribution that can be added here.

I hope my review of the paper can be useful in the next step of the process.

All the best,
Ninna Meier

Is the rationale for developing the new method (or application) clearly explained?

Yes
Is the description of the method technically sound?

Partly
Are sufficient details provided to allow replication of the method development and its use by others?

Partly
If any results are presented, are all the source data underlying the results available to ensure full reproducibility?

No source data required
Are the conclusions about the method and its performance adequately supported by the findings presented in the article?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Context, organizational change, coordination and leadership in clinical settings.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

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Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems

Abstract

Keywords

Introduction

Methods

Analysis

Addressing the implementation conundrum

Learning for a change

Situatedness and the nature of context

Sensemaking and learning in four interpretive modes

CAPA and modal dialectics

Figure 1. Representation of CAPA functionality.

Results

Discussion – possible applications for CAPA

Conclusions

Ethics approval

Data availability

References

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Contextual Analysis for Practical Action (CAPA): a framework for understanding how context works and how to apply it for practical learning and implementing change in complex systems

Abstract

Keywords

Introduction

Methods

Analysis

Addressing the implementation conundrum

Learning for a change

Situatedness and the nature of context

Sensemaking and learning in four interpretive modes

CAPA and modal dialectics

Figure 1. Representation of CAPA functionality.

Results

Discussion – possible applications for CAPA

Conclusions

Ethics approval

Data availability

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Competing Interests Policy

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