INTRODUCTION TO SYSTEM DYNAMICS FOR HEALTH CARE SERVICES
Course Level: Beginner
Background: System Dynamics (SD) is a mathematical modeling approach for understanding the dynamic behavior and mechanism of complex systems over time. In health care domain, SD allows practitioners to investigate complex clinical and policy issues from a whole-system perspective instead of in a piecemeal fashion. This course encompasses an overview of SD methodology and its application in health care. Basic elements of SD will be introduced, including causal loops and stock and flow diagrams together with examples of how these can be used to represent the structure of a complex system involving feedback loops and delays. Participants will be introduced to software that facilitates the development of calculational models without explicitly formulating differential equations. At the end of course, participants will have a basic understanding of SD concepts, be introduced to common software for developing SD models, and develop a sense of health issues for which SD may be especially suitable.
Format Requirements: As an introductory course, the format of this course will be a mix of lecture-style presentation with three hands-on exercises to introduce key concepts (e.g. causal loops, stocks and flows, and causal tracking) of the SD. In order to gain most from the exercises, participants will be expected to bring their own laptop with a pre-installed, free, trial version of Vensim PLE, a common SD software program which they will use to construct simple models during the course.
Description and Objectives:
This class introduces the basics of SD as applied to health care issues. The session will be divided into three parts. First, the participants will be introduced to the development of the SD methodology, with a focus on its applications in health care. Second, key elements of SD models will be introduced, including causal loops (reinforcing and balancing), time delays, stocks and flows, and the relationship between endogenous structure and system behavior. Third, participants will be guided through hands-on exercises designed to introduce Vensim PLE to show users how to develop simple SD models.
By the end of the sessions, participants will:
- Develop a basic understanding of key concepts (feedback, causal loops, polarity of causal links, stocks and flows (including how to distinguish them);
- Understand the potential and limitations of SD models in resolving complex health issues;
- Be able to construct simple SD stock and flow models with use of Vensim PLE Software.
It is recommended that participants read the following articles, which provide background information on the history, iconography, potential and limitations of SD modeling.
- Homer JB, Hirsch GB. System dynamics modeling for public health: Background and opportunities. American Journal of Public Health. 2006 Mar; 96(3):452-8.
- John D. Sterman. System Dynamics modeling: Tools for learning in a complex world. http://www.systemdynamics.org/conferences/2002/proceed/papers/CAREVIEW/C2STERMA.PDF
- Richardson GP. Reflections on the foundations of system dynamics. System Dynamics Review. 2011 Jul-Sep;27(3):219-43.
David B. Matchar, MD
Duke-NUS Graduate Medical School
Program in Health Services Research
Steffen Bayer, PhD
DUKE-NUS GRADUATE MEDICAL SCHOOL