Latest / Deep Dive Ortho — Orthopaedic Surgery, AI & Digital Health Podcast. / Getting New Things Done

Transcript

Getting New Things Done · Deep Dive Ortho — Orthopaedic Surgery, AI & Digital Health Podcast.

• 0:00
  Welcome to the deep dive. Have you ever noticed
• 0:03
  how some, well, brilliant ideas just seem to
• 0:06
  take off, while others, maybe just as good, sort
• 0:08
  of fade away? Yes, it's a common frustration,
• 0:11
  isn't it? Absolutely. Whether it's, say, a groundbreaking
• 0:14
  surgical technique, a fresh approach to patient
• 0:17
  care, or even just a new way to organize your
• 0:20
  operating theater list. getting innovative action
• 0:23
  to really stick and spread, well, it's much trickier
• 0:26
  than it looks, especially, I think, in today's
• 0:28
  fast -moving, very interconnected healthcare
• 0:31
  world. It's spot on. Today, we're embarking on
• 0:33
  a fascinating deep dive into the hidden dynamics
• 0:36
  of how innovative action actually gets done.
• 0:39
  We're going to explore the, well, the surprising
• 0:41
  interplay of networks, knowledge, and creative
• 0:44
  projects, uncovering the mechanisms that truly
• 0:46
  drive significant change, particularly perhaps
• 0:49
  within complex environments like hospitals and
• 0:52
  research institutions. Indeed. Our mission today,
• 0:55
  if you like, is to peel back those layers, to
• 0:58
  uncover the practical skills and the processes
• 1:02
  that transform these nascent ideas into impactful
• 1:05
  realities. It really is about understanding the
• 1:08
  invisible work, the stuff that goes on behind
• 1:09
  the scenes, that underpins significant change.
• 1:12
  Right. Whether that's developing a new surgical
• 1:15
  pathway, implementing a patient -centered approach,
• 1:18
  or maybe fostering interdisciplinary collaboration
• 1:21
  in, say, orthopedic research. That's exactly
• 1:25
  what we aim to do. By the end of our conversation,
• 1:27
  you should have, hopefully, a clearer lens to
• 1:30
  understand and maybe even orchestrate change
• 1:32
  in your own professional life. We'll be looking
• 1:35
  at how you might develop a new approach within
• 1:37
  your department, or perhaps mobilize a team for
• 1:40
  a critical project. So yeah, let's unpack this.
• 1:42
  Let's do it. OK, so thinking about the fundamentals.
• 1:45
  Every large organization, right? From a massive
• 1:48
  pharmaceutical company down to a national health
• 1:51
  service, it all started small. Inevitably. So
• 1:54
  the fundamental question we face is, how do these
• 1:58
  small entities actually expand? How do they evolve
• 2:01
  and achieve significant widespread impact? What
• 2:04
  allows maybe a brilliant idea born from a single
• 2:07
  surgeon's insight or a small research team's
• 2:10
  discovery to ripple outwards and redefine practice
• 2:14
  on a much larger scale? That's precisely it.
• 2:17
  And historically, the ability to effectively
• 2:19
  manage relationships and, crucially, the resources
• 2:23
  these relationships provide, that's always been
• 2:25
  central for strategic actors. Yeah. You know,
• 2:27
  careful cultivation of connections was needed
• 2:29
  to secure what was necessary for growth. You
• 2:32
  mentioned the surgeon. Perhaps they built relationships
• 2:33
  with philanthropists, hospital administrators
• 2:35
  to fund a new unit, that sort of thing. Right,
• 2:38
  the traditional patrons almost. Yes. But what's
• 2:40
  fascinating really is how profoundly this dynamic
• 2:43
  has changed in recent decades. And it really
• 2:45
  has changed dramatically, hasn't it? The way
• 2:47
  we engage with networks feels irrevocably altered,
• 2:50
  accelerated, I suppose. by digital tools, mobile
• 2:53
  phones, emails, social media platforms. How has
• 2:56
  that shift specifically impacted how people manage
• 2:59
  relationships and resources today? Does it just
• 3:02
  make communication faster or does it change the
• 3:06
  nature of coordination itself? That's a powerful
• 3:08
  point. It's more than just speed. Thomas Friedman's
• 3:11
  work on globalization, for instance, highlights
• 3:13
  this accelerated freedom, this velocity in combining
• 3:16
  people, ideas, and the means for production.
• 3:20
  It's created an environment where innovation
• 3:22
  can, well, it can spread at an unprecedented
• 3:24
  pace. And the very structure of work has evolved
• 3:27
  to reflect this. We're moving away from rigid
• 3:31
  sort of industrial hierarchies towards something
• 3:33
  much more fluid. And that brings us neatly to
• 3:35
  what the sociologists Luke Boltanski and Ithekia
• 3:38
  Pello call the new spirit of capitalism. They
• 3:40
  talked about a shift towards a project -oriented
• 3:42
  society. What does that actually mean for how
• 3:44
  work gets done in, say, a modern hospital department?
• 3:47
  Well, it suggests a profound move away from those
• 3:50
  rigid top -down structures. We're now seeing
• 3:53
  organizations that are highly flexible, predominantly
• 3:55
  organized around projects, and operating in quite
• 3:58
  intricate networks with far fewer hierarchical
• 4:01
  levels. That traditional sort of vertical flow
• 4:03
  of information is being replaced by transversal
• 4:06
  flows, communication and collaboration happening
• 4:09
  across, rather than just up and down, the organizational
• 4:13
  chart. OK, so across departments, across teams.
• 4:15
  Exactly. And for an individual, this means their
• 4:18
  professional life becomes, in essence, a series
• 4:20
  of projects. It requires them to continually
• 4:23
  assemble quite disparate groups of people, often
• 4:26
  for relatively short, focused periods. In a medical
• 4:29
  context, you see this all the time. multidisciplinary
• 4:32
  teams forming around complex patient cases, a
• 4:35
  knee replacement needing input from surgeons,
• 4:37
  anesthetists, physio, social workers, or research
• 4:40
  consortium formings for specific clinical trials,
• 4:43
  bringing together geneticists, statisticians,
• 4:45
  clinical specialists. It's project -based. So
• 4:47
  with work increasingly organized around these
• 4:50
  flexible project structures, who's actually making
• 4:54
  these networked organizations, these networked
• 4:56
  departments, hum? Who are the essential players
• 4:59
  in this fluid environment? Well, Boltanski and
• 5:02
  Chiappello identify them as mediators. These
• 5:04
  are individuals who possess a unique sort of
• 5:06
  art. The ability to reconcile opposites, to bring
• 5:10
  very different people together, and crucially
• 5:12
  to put them into contact. Their skills are paramount.
• 5:16
  coordinating, connecting, locating new sources
• 5:19
  of information vital for innovation, inspiring
• 5:21
  trust among those they coordinate, and demonstrating
• 5:24
  remarkable flexibility and adaptability. The
• 5:26
  social glue, almost. In essence, yes. They're
• 5:29
  the social glue that enables this dynamic, project
• 5:31
  -based work. Think of the senior registrar who
• 5:34
  seamlessly connects the surgical team with the
• 5:35
  nursing staff, ensuring smooth handovers. Or
• 5:38
  the research coordinator who links basic scientists
• 5:40
  with clinical trial specialists. They're mediating,
• 5:43
  connecting, and enabling new solutions to emerge
• 5:45
  from those connections. It sounds like so much
• 5:47
  of this hinges on connections between people.
• 5:50
  We often talk about networking as simply linking
• 5:53
  two individuals, a one -to -one. But how important
• 5:56
  is it to move beyond just two people for true
• 5:59
  coordination and impact? especially when you're
• 6:02
  trying to innovate. That's a critical distinction.
• 6:05
  Karl Weick, a key thinker here, introduced the
• 6:07
  concept of the double interact. That's a communicative
• 6:10
  exchange between two individuals. One sends a
• 6:13
  message, the second responds, the first adjusts.
• 6:16
  Simple feedback loop. OK, like a surgeon discussing
• 6:19
  a case with a colleague or explaining a procedure
• 6:22
  to a patient. Exactly. It forms the core coordinative
• 6:25
  unit in organizing. However, while it's foundational,
• 6:28
  the double interact is fundamentally inert in
• 6:30
  scale. It assumes a pre -existing pair and is
• 6:33
  limited to dyadic possibilities. It doesn't easily
• 6:35
  account for larger, more complex social phenomena
• 6:38
  or dynamic expansion. You simply can't scale
• 6:40
  a new medical protocol or launch a hospital -wide
• 6:43
  initiative just through a series of two -person
• 6:45
  conversations. It doesn't work. Right. So where
• 6:48
  does true coordination begin to scale up then?
• 6:51
  If two isn't enough, what's the magic number
• 6:54
  for an idea to really take flight? The crucial
• 6:57
  shift occurs when we move from two to three the
• 6:59
  triad. In a triad, the third party, the broker,
• 7:04
  no longer simply engages with one other person.
• 7:06
  Instead, the broker represents the position or
• 7:09
  viewpoint of one party to another individual
• 7:12
  or group. And this, in my view, is the fundamental
• 7:15
  template for the coordinated act in organizing.
• 7:17
  Okay. Can you give an example? Sure. Think of
• 7:19
  a clinical lead advocating for a new treatment
• 7:21
  protocol within a hospital. They represent the
• 7:24
  potential benefits, world one, to the hospital
• 7:26
  management or ethics committee, world two, or
• 7:29
  a pharmaceutical entrepreneur mobilizing support
• 7:31
  for a new drug development representing the science
• 7:34
  to investors, or an activist initiating collective
• 7:37
  action for public health awareness representing
• 7:39
  the community's needs to policymakers. All of
• 7:42
  these involve three or more actors, and the broker
• 7:44
  is absolutely central to linking those disparate
• 7:47
  interests and bringing them into some kind of
• 7:49
  alignment. That really clicks into place. And
• 7:51
  the broker's role in this triad sounds incredibly
• 7:54
  nuanced. It's not just about passing messages
• 7:56
  back and forth, is it? Not at all. The representational
• 7:59
  act, the very core of triadic coordination, is
• 8:02
  inherently complex. Now... Some have noted, like
• 8:05
  Ron Bird, that a strategic actor might intentionally
• 8:09
  misrepresent or adjust knowledge between parties
• 8:11
  for their own gain. The Tertius Gardens we might
• 8:14
  get to later. Precisely. But a more common and
• 8:17
  arguably more effective long -term approach involves
• 8:20
  the broker continually shaping representations.
• 8:23
  This is done carefully, to maximize understanding
• 8:26
  perhaps, or to ensure receptivity from the other
• 8:29
  party, or maybe to highlight the perceived value
• 8:31
  of connecting. Ultimately, the aim is often to
• 8:34
  engender trust in the representation itself,
• 8:38
  trust in the broker, or trust in the other actors
• 8:40
  involved as a necessary prelude to collaborative
• 8:42
  effort. Right, building that foundation. Think
• 8:44
  as an orthopedic department head. Trying to convince
• 8:47
  the hospital board, they need a new robotic surgery
• 8:49
  system. They need to understand the board's financial
• 8:52
  concerns. They need to understand the surgeon's
• 8:54
  clinical needs. And then they have to articulate
• 8:57
  the robotic system's value in a way that resonates
• 9:00
  with both, building trust that this investment
• 9:02
  is worthwhile. It's a delicate balancing act.
• 9:05
  So effective coordination, especially in these
• 9:07
  dynamic, often quite political environments,
• 9:10
  requires a certain social dexterity. What exactly
• 9:13
  does that entail? How would you recognize it
• 9:16
  in someone, say, a leading surgeon or a medical
• 9:18
  innovator? Social dexterity. It encompasses a
• 9:21
  range of attributes, really. It involves a command
• 9:24
  of the specific social hygiene of a given context,
• 9:28
  basically, understanding the unwritten rules,
• 9:29
  the etiquette of that particular group or industry.
• 9:31
  Like knowing when it's okay to phone a busy consultant
• 9:34
  versus sending an email. Exactly that. Or knowing
• 9:38
  how to subtly raise a sensitive issue in a team
• 9:40
  meeting without causing offense. It also requires
• 9:43
  the ability to forge trust across a broad spectrum
• 9:46
  of people, familiar and less familiar. A talent
• 9:50
  for accurately assessing the character and interests
• 9:52
  of those you don't know intimately, that's crucial.
• 9:54
  And a capacity to make effective appeals, to
• 9:57
  enlist and connect people to shared causes or
• 9:59
  projects. Can you think of historical examples?
• 10:02
  Well, historically, you see this dexterity in
• 10:04
  figures like Cosimo de' Medici, skillfully managing
• 10:07
  relationships to cultivate power in 15th century
• 10:10
  Florence, or Abraham Lincoln assembling support
• 10:12
  to abolish slavery by bringing together really
• 10:15
  diverse, often conflicting factions. Even in
• 10:18
  the arts, Paul Sacks building New York's Museum
• 10:20
  of Modern Art that required definitely connecting
• 10:22
  support from various institutions and patrons.
• 10:24
  And in modern health care. Think of the clinical
• 10:26
  director who navigates complex hospital politics
• 10:29
  to secure funding for a new research unit. or
• 10:32
  the researcher who builds a consortium across
• 10:34
  competing institutions for groundbreaking clinical
• 10:37
  trial. That is social dexterity in action, enabling
• 10:41
  collaboration across traditional silos, overcoming
• 10:44
  inertia, getting things done. Okay, so we understand
• 10:46
  the foundations. networks, coordination, the
• 10:50
  importance of the triad, and this idea of social
• 10:52
  dexterity. Let's now try and deconstruct brokerage
• 10:54
  itself. You highlighted earlier that it's crucial
• 10:56
  to distinguish between brokerage as a static
• 10:58
  structure, just the map of connections, and brokerage
• 11:01
  as a dynamic process. Why is that distinction
• 11:04
  so important when we talk about getting new things
• 11:06
  done? Precisely. Because when we talk about getting
• 11:08
  new things done, achieving innovation, we absolutely
• 11:12
  must consider both. The social network structure,
• 11:15
  provides the architecture, if you like, the accounting
• 11:17
  of activity. But the social process explains
• 11:20
  how ties form an aggregate, or indeed why they
• 11:24
  sometimes fail to form. The problem is, social
• 11:27
  network research often tends to subordinate process
• 11:30
  to structure. Why? Well, frankly, because structure
• 11:33
  is much easier to measure. You can map connections.
• 11:36
  Right. You can draw the network diagram. You
• 11:37
  can draw the diagram. But that can lead to process
• 11:40
  just being inferred from the structural data,
• 11:42
  which is a limitation. We need to focus on the
• 11:44
  dynamic, actionable aspects of brokerage, what
• 11:47
  the broker actually does within that structure.
• 11:49
  OK, so let's look at network structure first
• 11:51
  then. The literature often talks about open versus
• 11:54
  closed networks. Can you define those and what
• 11:56
  are their implications for, say, fostering innovation
• 11:59
  in medical research? Sure. Open networks are
• 12:02
  characterized by what Ronald Burtt famously called
• 12:04
  structural holes. These are essentially gaps
• 12:07
  or separations between non -redundant contacts.
• 12:11
  Someone who bridges such a hole connects otherwise
• 12:14
  disconnected groups or individuals. Such a structure
• 12:17
  offers that bridging actor an ideal opportunity
• 12:19
  for accessing new information. Because the groups
• 12:22
  they connect don't talk to each other, the information
• 12:24
  isn't redundant. It also provides potential control
• 12:27
  benefits by allowing the broker to leverage these
• 12:29
  disconnected actors. Okay, so good for fresh
• 12:32
  ideas, but what's the downside? The challenge
• 12:34
  in open networks lies in mobilizing these disparate
• 12:38
  actors. You often have very diverse interests,
• 12:40
  different ways of working, maybe even conflicting
• 12:42
  goals. This was often referred to as the action
• 12:45
  problem. Imagine a brilliant orthopedic researcher.
• 12:48
  They might know cutting edge bioengineers and
• 12:50
  have connections to patient advocacy groups.
• 12:52
  That's an open network structure, fantastic for
• 12:55
  generating novel ideas at the intersection. But
• 12:57
  getting the engineers and the patient groups
• 12:59
  to agree on a collaborative project, that can
• 13:01
  be tough. Right. And closed networks. Closed
• 13:04
  or dense networks are the opposite. They're more
• 13:07
  interconnected, more homogenous. People within
• 13:10
  them tend to know each other, share similar backgrounds,
• 13:13
  values, information. Think of a tight -knit surgical
• 13:16
  team that's worked together for years. These
• 13:19
  networks are much more conducive to mobilization
• 13:21
  and coordination because there's greater alignment
• 13:23
  of attributes and interests. Trust is often higher.
• 13:26
  communication easier. But the drawback. The drawback
• 13:29
  is they're less likely to import novel ideas
• 13:32
  from the outside. Information tends to be redundant.
• 13:35
  Everyone already knows what everyone else knows.
• 13:37
  This presents what we might call the idea problem.
• 13:40
  So it sounds like a bit of a dilemma for any
• 13:43
  leader trying to innovate. Open networks are
• 13:45
  great for new ideas, but hard to get things done.
• 13:47
  Closed networks are great for getting things
• 13:49
  done, but maybe less good for truly novel ideas.
• 13:52
  In simplistic terms, yes, that's the classic
• 13:55
  trade off. But the reality, of course, is far
• 13:58
  more hybrid. Most real -world networks combine
• 14:01
  open and closed characteristics. Overly simplistic
• 14:04
  distinctions can lead to oversimplified inferences
• 14:07
  about what works. For instance, my own research
• 14:09
  in an automotive design environment focusing
• 14:11
  on incremental innovation, mind you, found something
• 14:14
  interesting. It found that a combination of dense
• 14:16
  or closed networks, along with an action -based
• 14:19
  measure of actors' orientation to connect others,
• 14:21
  what we call Tushis iEngines brokerage, the uniting
• 14:24
  function, that combination, was actually predictive
• 14:27
  of innovation involvement. So it's not just the
• 14:29
  structure, but the activity within it. Exactly.
• 14:32
  It suggests that sophisticated analysis of network
• 14:35
  patterns demands a grasp of the social dynamics
• 14:38
  associated with those ties. It's about the process
• 14:41
  of brokering within that structure. For example,
• 14:44
  A senior surgeon might use their established
• 14:46
  dense network within the hospital to mobilize
• 14:49
  support for a new surgical approach that's the
• 14:51
  closed network advantage. But they also need
• 14:53
  to actively broker new connections to external
• 14:56
  experts or technologies to bring genuinely novel
• 14:59
  ideas into that network that's leveraging openness.
• 15:02
  This is where it really comes alive for me. Moving
• 15:05
  beyond just seeing connections as static lines
• 15:06
  on a map and into how brokerage is a truly dynamic
• 15:10
  action. It's not just about having connections,
• 15:13
  is it? It's about what you do with them. And
• 15:15
  you've identified three core ways people act
• 15:17
  as brokers, these orientations. Let's get into
• 15:19
  those. Absolutely. Because skillful leaders and
• 15:22
  innovators, they don't just sit in a network
• 15:24
  position. They strategically employ these three
• 15:27
  core brokerage orientations. The first is conduit
• 15:30
  brokerage. The information pipe. You can think
• 15:32
  of it like that, yes. But it's more active than
• 15:35
  just a pipe. This is where the broker curates
• 15:37
  from the flow of ideas and opportunities, determining
• 15:40
  what is relevant and how best to pass it on.
• 15:43
  It involves reformatting knowledge for successful
• 15:46
  transit and reception by the target audience.
• 15:49
  It's far more complex than simple knowledge transfer.
• 15:52
  It involves search, discovery, maybe embellishment,
• 15:55
  reconfiguration. It also requires sense -making,
• 15:58
  that crucial step of noticing, bracketing, and
• 16:01
  labeling new ideas so others can grasp their
• 16:03
  significance. So like a clinician attending a
• 16:06
  cutting edge conference. Precisely. They bring
• 16:09
  back a new insight, perhaps about prosthetic
• 16:11
  design. They're not just relaying raw information.
• 16:14
  They're interpreting it for their team, explaining
• 16:16
  its relevance, maybe even adapting it for their
• 16:19
  specific patient population or hospital context.
• 16:22
  That's conduit brokerage in action. And the classic
• 16:24
  non -medical example often cited is Steve Jobs
• 16:27
  and the Xerox PRC mouse, isn't it? That wasn't
• 16:30
  just seeing a mouse. It was about vision and
• 16:32
  transformation. Exactly. A perfect illustration.
• 16:35
  When Steve Jobs visited Xerox BR Xi and saw the
• 16:38
  graphical user interface and the mouse, he didn't
• 16:41
  just transfer the idea back to Apple. He recognized
• 16:44
  its revolutionary potential. He ferried these
• 16:47
  tokens, as the story goes, back to his own company.
• 16:50
  But crucially, this was a significant reconfiguration.
• 16:53
  He famously instructed his engineers to transform
• 16:56
  the clunky, expensive $300 Xerox mouse, which
• 16:59
  apparently broke within two weeks into something
• 17:01
  manufacturable, for less than 15 bucks. And durable
• 17:04
  enough for, as he put it, for Micah and my blue
• 17:07
  jeans. That's definitely transformation. It absolutely
• 17:09
  is. Transformation for a completely new context
• 17:12
  in market. Paul Carlyle's 3T model helps us understand
• 17:16
  these nuances. Transfer is the simplest. Crossing
• 17:20
  a syntactic boundary where differences are known.
• 17:22
  Like describing a function you observed. Translation
• 17:25
  is needed when crossing semantic boundaries different
• 17:27
  interpretations due to context. Like jobs explaining
• 17:31
  how the mouse made sense for the lisa and macintosh,
• 17:34
  its strategic fit. And transformation involves
• 17:36
  that significant rearrangement or new synthesis
• 17:39
  of knowledge, often necessary when incompatible
• 17:42
  interests or contexts prevent shared meaning
• 17:44
  being easily established. So applying that to
• 17:47
  medicine. A surgeon might transfer information
• 17:49
  about a new implant they saw demonstrated, but
• 17:51
  they then have to translate it for their theater
• 17:54
  team. What does it mean for instruments, for
• 17:56
  workflow? And if it requires a whole new approach,
• 17:58
  they might need to transform the entire surgical
• 18:00
  protocol to integrate it effectively, which involves
• 18:03
  negotiation and change management. OK, that's
• 18:06
  conduit. The second orientation you mentioned
• 18:08
  is Tertius -Gaudens brokerage. This sounds a
• 18:10
  bit more strategic, perhaps even Machiavellian,
• 18:14
  the divide and conquer strategy. Indeed, it can
• 18:16
  be perceived that way. Tertius Godden's literally
• 18:20
  the third who enjoys involves the broker maintaining
• 18:23
  or even exploiting unfamiliarity, competition,
• 18:26
  or conflict between other parties. This can be
• 18:28
  done actively or sometimes through purposeful
• 18:31
  inaction. George Simmel, the classical sociologist,
• 18:35
  described this as the third who benefits from
• 18:38
  the disunion of the two others. Ron Bird elaborated,
• 18:41
  noting this often means playing conflicting demands
• 18:44
  or interests against one another. How might that
• 18:46
  look in practice? Well, it can take various forms.
• 18:49
  Playing actual or hypothetical alters against
• 18:51
  one another. A classic example is claiming other
• 18:54
  suppliers offer lower prices to gain a negotiating
• 18:56
  advantage. It could also involve subtly keeping
• 18:59
  alters apart, perhaps by declining invitations
• 19:01
  to critical joint meetings, citing competitiveness
• 19:04
  or timing issues when the real goal is to prevent
• 19:06
  them aligning. The most active form is devide
• 19:09
  et impera, divide and conquer intentionally producing
• 19:12
  or exacerbating conflict to gain a dominant position.
• 19:15
  And the goal here? The goal is typically to reinforce
• 19:18
  boundaries, or at least leave them in force,
• 19:21
  often by blocking or distorting information flow
• 19:23
  between the other parties, with the broker positioned
• 19:26
  as the disproportionate beneficiary. It often
• 19:29
  aims for immediate concrete profit or advantage.
• 19:33
  You could imagine, perhaps, a hospital administrator
• 19:36
  playing two competing orthopedic suppliers against
• 19:39
  each other to secure a better deal on implants.
• 19:42
  Or maybe subtly creating a slight tension between
• 19:45
  two departments to gain leverage for their own
• 19:47
  budget proposal. It happens. Right. And the third
• 19:50
  orientation, Tertius Ingen's brokerage, seems
• 19:53
  to be the polar opposite the uniter. This is
• 19:56
  about bringing people together. That's right.
• 19:58
  Tertius Ingen's the third who joins. Here, the
• 20:01
  broker actively introduces or facilitates a connection
• 20:04
  between two other parties, specifically pursuing
• 20:06
  coordination and collaboration. This can manifest
• 20:10
  as a brief engines, perhaps a single introduction
• 20:12
  where ongoing coordination isn't needed, or it
• 20:14
  can be a sustained engines where the broker maintains
• 20:17
  a continuous coordinated role over time. Can
• 20:20
  you give an example of that? Let's take our senior
• 20:22
  orthopedic surgeon again wanting to initiate
• 20:24
  a new clinical study. They might first pitch
• 20:26
  the idea separately to a promising junior researcher,
• 20:29
  and then to a potential funding body representative.
• 20:32
  Crucially, they tailor the story of the project
• 20:35
  to each party's specific interests. Let's call
• 20:38
  them PG for Gloria the researcher, PJ for Joanne
• 20:41
  the funder. Once trust is built individually,
• 20:44
  the surgeon then introduces the project to them
• 20:46
  together, perhaps with a third blended version
• 20:49
  of the proposal, PGJ, which reflects what was
• 20:51
  learned from the individual interactions. This
• 20:54
  involves both translation making the project
• 20:56
  make sense to both and potentially transformation
• 20:59
  of the initial idea to create something new that
• 21:01
  appeals jointly and enables collaboration. So
• 21:03
  is the motivation for Tertius I -Engines always
• 21:06
  altruistic? It sounds very collaborative, very
• 21:08
  win -win. Well, it certainly can be associated
• 21:11
  with altruism. Think of transformational leaders,
• 21:14
  facilitating their staff's advancement by making
• 21:16
  key introductions or efforts in international
• 21:19
  public health cooperation, bringing different
• 21:21
  agencies together. But it's also a powerful strategic
• 21:24
  means to get new things done. The broker might
• 21:27
  consciously forgo an immediate rent or benefit
• 21:30
  for their coordinated services. Why? because
• 21:33
  they anticipate unspecified future gains, things
• 21:36
  like long -term trust, reciprocity, or simply
• 21:39
  the successful completion of a high -impact project
• 21:42
  they care about. An investment in the network.
• 21:44
  Exactly. In a medical setting, this might be
• 21:46
  a senior consultant connecting a junior doctor
• 21:48
  with a leading researcher in another institution.
• 21:51
  There's no immediate personal gain, perhaps,
• 21:53
  but it fosters innovation within the field, builds
• 21:56
  the institution's reputation, and strengthens
• 21:58
  future collaborative potential. It's an investment,
• 22:01
  anticipating future dividends for the broader
• 22:03
  system or network. What's particularly fascinating
• 22:05
  here, I think, is that these orientations aren't
• 22:08
  mutually exclusive. You're suggesting people
• 22:10
  often blend them strategically. Can you give
• 22:13
  an example of that interplay, showing how these
• 22:15
  different roles might be combined to achieve
• 22:17
  a complex outcome? Absolutely. Skillful blending
• 22:20
  is not only common, but often highly effective.
• 22:23
  It can happen simultaneously, in parallel, or
• 22:26
  sequentially over the course of a project. Consider
• 22:28
  a music producer, for instance. They might act
• 22:31
  as a church's iEngines by getting a promising
• 22:34
  new band, a showcase at a larger club, and, importantly,
• 22:38
  inviting representatives from multiple record
• 22:40
  labels. That's the joining function. Then simply
• 22:43
  by having those multiple label heads present
• 22:45
  in the same room, aware of each other's interest,
• 22:48
  the producer naturally creates competition. They
• 22:50
  are now implicitly acting as Turch's Gaudens.
• 22:53
  This competitive market dynamic facilitated by
• 22:56
  the broker often leads to a better broker deal
• 22:58
  for the band. So the uniting sets the stage for
• 23:01
  the beneficial division in a way. Precisely.
• 23:04
  A convening act, Yamjins, sets the stage for
• 23:07
  a competitive situation. Gaudens. which ultimately
• 23:11
  leads to a positive outcome through brokered
• 23:14
  negotiation. We see this pattern in many real
• 23:17
  -world applications. Think about mergers and
• 23:19
  acquisitions brokers are involved before, during,
• 23:22
  and after, facilitating connections, managing
• 23:25
  competing interests. Supply chains often involve
• 23:28
  firms brokering between multiple suppliers and
• 23:30
  buyers. Even complex international diplomacy
• 23:32
  relies on these blended strategies. And in healthcare.
• 23:35
  You could easily imagine a hospital executive
• 23:37
  acting as Atertius Unions to bring together a
• 23:40
  medical device company and a university research
• 23:42
  institute to collaborate on developing a new
• 23:44
  diagnostic tool. Then, perhaps later in the negotiations,
• 23:47
  they might subtly use Atertius Godden's approach
• 23:50
  by hinting an interest from other potential commercial
• 23:52
  partners, just to accelerate the deal -making
• 23:54
  process. The ultimate goal is getting that cutting
• 23:57
  -edge technology to their patients. The key is
• 23:59
  the dynamic strategic orchestration of these
• 24:02
  different orientations to achieve a desired outcome.
• 24:04
  It's clear that brokerage is about connecting
• 24:06
  people, orchestrating relationships. But what
• 24:09
  about the ideas themselves? How do you make those
• 24:11
  ideas not just travel across the network, but
• 24:13
  actually stick and lead to action? Especially
• 24:15
  in complex fields like medicine, where precision,
• 24:17
  clarity, evidence, they're all paramount. This
• 24:21
  brings us, I think, to the indispensable role
• 24:23
  of knowledge articulation. Indeed. Brokerage
• 24:26
  gets the connections made, but it isn't enough
• 24:29
  on its own. Knowledge needs to be moved, yes,
• 24:33
  but also translated and crucially put to practical
• 24:35
  use. The very term articulate is quite instructive
• 24:39
  here. It has two relevant meanings, to join or
• 24:41
  unite, which links nicely back to Tertius Engels's
• 24:44
  brokerage. But also, and this is our focus now,
• 24:48
  to express distinctly, making things clear, understandable,
• 24:51
  compelling. Knowledge isn't just something static
• 24:54
  in the know, your education, your experience,
• 24:56
  nor is it just flowing through a passive pipe.
• 24:58
  It's profoundly relational. It's influenced by
• 25:01
  what you bring to an exchange, your perspective,
• 25:03
  your expertise, but also how that relates to
• 25:06
  your interlocutors, to their understanding, their
• 25:07
  context. So communicating a complex surgical
• 25:10
  technique to a new resident. Exactly. It's not
• 25:14
  just about listing the steps. It's about tailoring
• 25:16
  that explanation to their current level of understanding,
• 25:20
  their practical experience, maybe anticipating
• 25:23
  their questions or anxieties. It's making the
• 25:25
  knowledge accessible to them. So it's about making
• 25:27
  knowledge actionable. You've mentioned before
• 25:29
  a continuum from tacit to explicit knowledge.
• 25:33
  Could you elaborate on that and where articulation
• 25:36
  really fits in for, say, a medical professional
• 25:39
  trying to share an innovation? Certainly. At
• 25:42
  one end, we have tacit knowledge. This is our
• 25:44
  unconscious, automatic, often taken for granted
• 25:46
  understanding, things we just know how to do.
• 25:48
  Like riding a bike or maybe performing a complex
• 25:52
  orthopedic maneuver during surgery. Precisely.
• 25:54
  It's difficult to surface fully. difficult to
• 25:57
  communicate directly in words. At the other end
• 26:00
  is explicit knowledge, which is highly codified,
• 26:03
  easily expressed. Think of a published medical
• 26:06
  protocol, a textbook diagram, a drug dosage chart.
• 26:10
  What's crucial for innovation, though, is often
• 26:12
  the middle ground. This is where knowledge is
• 26:15
  emerging from its tacit state, but isn't yet
• 26:17
  fully codified or formalized. I call this emergent
• 26:21
  explicit knowledge. Can you give an example?
• 26:23
  It's that moment when you've just figured out
• 26:24
  a clever workaround for a recurring surgical
• 26:26
  challenge during a procedure. Or you see a new
• 26:30
  way to optimize patient flow on the wart. You
• 26:32
  haven't written it down yet, it's not in any
• 26:33
  manual. But you need to explain it to a colleague
• 26:36
  right now, or convince your team it's the new
• 26:38
  best practice. This is precisely where new knowledge
• 26:40
  and potential action emerge. It's driven by the
• 26:43
  practical need to share, to move understanding
• 26:45
  across different communities, like from surgeons
• 26:48
  to nurses, to persuade others, or eventually
• 26:50
  to codify a practice for wider, more consistent
• 26:53
  use. Articulation is the engine here. This reminds
• 26:56
  me of Carlisle's 3T model again, transfer, translation,
• 26:59
  transformation. How do those nuances of knowledge
• 27:03
  movement apply specifically to articulation in,
• 27:08
  say, a clinical setting where you're trying to
• 27:10
  introduce something new? They are absolutely
• 27:12
  central. Transfer is the simplest form of articulation.
• 27:15
  It occurs across what Carlyle calls a syntactic
• 27:17
  boundary, where differences are known and a common
• 27:20
  lexicon usually suffices. Like noting a specific
• 27:23
  characteristic on an X -ray image. Exactly. Or
• 27:25
  describing a straightforward functionality observed.
• 27:28
  Translation, however, becomes necessary when
• 27:31
  you cross semantic boundaries where different
• 27:33
  interpretations exist due to varied contexts
• 27:36
  or professional backgrounds. For example, explaining
• 27:39
  how a new medical technology applies to a specific
• 27:41
  patient group or how it fits into the existing
• 27:43
  workflow in this particular hospital. This requires
• 27:46
  active reformatting of knowledge and a real pursuit
• 27:49
  of shared understanding. You can't just state
• 27:51
  the facts. You have to explain the meaning in
• 27:53
  their context. And transformation. Transformation
• 27:56
  involves a significant rearrangement or even
• 27:59
  a new synthesis of knowledge. This is often required
• 28:03
  when fundamentally incompatible interests or
• 28:06
  deeply ingrained assumptions prevent shared meaning
• 28:09
  being reached through simple translation. It's
• 28:12
  often an inherently political process, needing
• 28:14
  common interests to be established or negotiated
• 28:17
  to move forward. So applying that 3T model again.
• 28:20
  A radiologist might transfer the findings of
• 28:23
  an MRI scan. There's a tear in the meniscus.
• 28:26
  The orthopedic surgeon then has to translate
• 28:28
  those findings into the context of surgical planning.
• 28:32
  Okay, given this type of tear and the patient's
• 28:34
  activity level, here's how it impacts our approach.
• 28:36
  Finally, if the findings are truly unprecedented,
• 28:39
  perhaps revealing a condition not previously
• 28:41
  understood, it might require a transformation
• 28:43
  of the entire diagnostic or treatment pathway,
• 28:46
  which involves convincing multiple specialties,
• 28:48
  changing protocols, a much bigger shift. So when
• 28:51
  we're articulating knowledge, especially in these
• 28:53
  more complex translation or transformation scenarios,
• 28:56
  what are the key processes we're aiming for in
• 28:58
  a practical sense? What outcomes make articulation
• 29:01
  successful? Primarily, I'd say there are three
• 29:04
  key outcomes we're striving for through articulation.
• 29:08
  First, mutual intelligibility. Simply establishing
• 29:11
  a shared understanding. This is the absolute
• 29:13
  precondition for any kind of influence or enlistment.
• 29:16
  Do they actually get what I'm saying? Second,
• 29:18
  persuasion. Going beyond understanding to actually
• 29:21
  convincing others to adopt an idea or a proposed
• 29:23
  course of action. This often builds on mutual
• 29:26
  intelligibility, but you can sometimes persuade
• 29:29
  even without perfect shared understanding, perhaps
• 29:31
  through trust or authority. And third, perhaps
• 29:35
  most critically for innovation, is enlistment.
• 29:38
  This means mobilizing active support and commitment
• 29:40
  from others, getting them on board to the point
• 29:42
  where they engage in joint, coordinated action.
• 29:45
  Getting them to actually do something together.
• 29:47
  Exactly. This last one, enlistment, is arguably
• 29:50
  the single most important articulation outcome
• 29:53
  for actually getting new things done. And these
• 29:56
  processes, especially in fast -moving innovation
• 29:58
  contexts like medicine, often involve what we
• 30:01
  might call provisional knowledge dialogue, PKD.
• 30:04
  Quick exchanges, iterative understanding rather
• 30:07
  than deep knowledge dialogue, DKD, simply due
• 30:10
  to the speed and uncertainty involved. You often
• 30:13
  don't have time for exhaustive discussion. That
• 30:16
  makes a lot of sense, the need for speed and
• 30:18
  agility. Let's try and bring this to life with
• 30:20
  some practical examples. You've used the new
• 30:22
  car automotive cases, which offer a really rich
• 30:25
  lens into these organizational dynamics. You
• 30:28
  identified five key communicative dimensions
• 30:30
  of how knowledge articulation happens in practice.
• 30:33
  Yes. These are active, often quite fleeting,
• 30:36
  representational activities that are crucial
• 30:38
  for generating collaborative action. They really
• 30:40
  mirror how new ideas get traction or fail to
• 30:42
  in any complex field. Okay, first. Moving between
• 30:45
  backstage and front stage. How does this play
• 30:47
  out in everyday organizational life? What does
• 30:49
  that mean? This involves the constant often subconscious
• 30:52
  choices we make about what information to share
• 30:55
  publicly, front stage, versus what to keep private
• 30:59
  or share only with trusted confidants. backstage.
• 31:02
  It's about deciding how and when to surface privately
• 31:05
  held ideas, doubts, or opinions versus what to
• 31:08
  withhold. You could think of it as the social
• 31:11
  correlate of moving knowledge from tacit, often
• 31:13
  private, unarticulated, to explicit, publicly
• 31:16
  stated. Okay, and the new core example. There
• 31:18
  was a situation involving Dan from program management
• 31:21
  and Brad from the body division. Brad, because
• 31:24
  he trusted Dan, revealed his backstage skepticism
• 31:27
  about a new central database, the paper car,
• 31:30
  during an informal hallway chat. This was a critical
• 31:32
  view he likely wouldn't have voiced in a formal
• 31:34
  meeting. Dan, understanding this private concern,
• 31:37
  then responded strategically in the front stage
• 31:39
  by reframing Newcar's mission not just as a car
• 31:42
  company, but as an information company, thereby
• 31:44
  justifying the database's value in a way that
• 31:47
  addressed Brad's underlying worry without exposing
• 31:49
  his skepticism. Both selectively move private
• 31:52
  understanding into the public domain to reach
• 31:54
  a shared path forward. So it's about strategic
• 31:57
  disclosure, often built on trust. Precisely.
• 32:00
  In a hospital, this might be a nurse sharing
• 32:02
  backstage concerns about usability issues with
• 32:06
  the new electronic patient record system with
• 32:08
  a trusted IT lead. That allows the IT lead to
• 32:11
  then address those potential issues constructively
• 32:14
  in a front -stage planning meeting, perhaps by
• 32:16
  reframing the training plan or highlighting specific
• 32:19
  benefits that counter the concerns. Okay. Second
• 32:21
  dimension. Moving between complex and simple.
• 32:24
  This seems particularly relevant in medicine
• 32:27
  where concepts can be incredibly intricate, technical.
• 32:30
  Absolutely vital. Articulation frequently involves
• 32:33
  reducing complexity, stripping away what might
• 32:36
  be seen as irrelevancies for a particular audience
• 32:38
  or situation to convey only what's most essential.
• 32:41
  As the philosopher Michael Polanyi famously said,
• 32:44
  we know much more than we can tell. Effective
• 32:46
  articulation is often about selecting the right
• 32:48
  subset of what we know. How do people do that
• 32:50
  effectively? often through using articulation
• 32:52
  devices. Tools like analogies, metaphors, stories,
• 32:56
  even informal sketches or physical objects. Things
• 32:59
  that clarify and simplify. For instance, at Newcar,
• 33:02
  an engineer named Rick was trying to convey specific
• 33:05
  design goals for a car armrest. Instead of complex
• 33:09
  engineering specs, he used vivid metaphors. Avoiding
• 33:12
  a certain texture was Barbie Doll's stipple.
• 33:15
  Achieving a desired close fit was tight like
• 33:18
  a scuba outfit. Instantly understandable. Exactly.
• 33:21
  They simplified complex aesthetic objectives,
• 33:23
  making them immediately understandable and actionable
• 33:25
  for other engineers. In orthopedics, a consultant
• 33:29
  might explain a complex joint replacement to
• 33:31
  a patient using a simple analogy comparing the
• 33:34
  joint to hinges and levers. Or to a junior surgeon,
• 33:36
  they might explain a new fixation method by comparing
• 33:39
  it to a familiar, simpler technique providing
• 33:41
  an accessible entry point. Third, moving among
• 33:44
  past, present, and future. How does weaving in
• 33:47
  history or experience play into getting new things
• 33:49
  done? This is about strategically bringing knowledge
• 33:52
  gleaned from past experience to bear on present
• 33:54
  situations, usually with the aim of eliciting
• 33:57
  support for future joint action. Knowledge, especially
• 34:01
  tacit knowledge gained through experience, often
• 34:04
  resides in our memories associated with its original
• 34:06
  context. At Newcar, there was a great example
• 34:09
  where a senior VP named Frank told a story. He
• 34:12
  recounted how, as a young engineer nearly two
• 34:14
  decades earlier, he and his team solved a really
• 34:17
  difficult technical problem called Terminal Powerhop.
• 34:20
  This informal narrative, told retrospectively,
• 34:22
  wasn't just a war story. It illustrated and burnished
• 34:25
  Newcar's cherished cowboy culture, its history
• 34:28
  of risk -taking, of figuring things out on the
• 34:30
  fly. The implied message to the present -day
• 34:33
  engineers was, embrace that spirit. tackle today's
• 34:36
  challenges, achieve future innovative outcomes,
• 34:39
  using the past to inspire the future. Precisely.
• 34:42
  Similarly, a seasoned surgeon might share an
• 34:44
  anecdote from an early challenging case in their
• 34:46
  career, not just to reminisce, but perhaps to
• 34:49
  illustrate resilience, problem solving under
• 34:51
  pressure, and encourage a junior team facing
• 34:54
  a new, difficult procedure. It grounds future
• 34:57
  ambition in past successes and shared cultural
• 34:59
  values. Fourth, balancing familiarizing and defamiliarizing.
• 35:04
  These sound like opposing forces. How do they
• 35:07
  work together? They are indeed opposing forces,
• 35:09
  and using them strategically, often in sequence,
• 35:12
  is key to shifting perspectives. Familiarizing
• 35:15
  aims to make new ideas comfortable, relatable.
• 35:17
  It deepens understanding and encourages buy -in
• 35:20
  by connecting the new to the known. Rick's scuba
• 35:23
  outfit analogy did this. It used a familiar image
• 35:25
  to explain a new design goal. Defamiliarizing,
• 35:28
  conversely, aims to disrupt taken for granted
• 35:31
  meanings, to challenge assumptions, and ultimately
• 35:33
  change attitudes. It naturally lends itself to
• 35:36
  driving transformation. And the new car example
• 35:38
  for this. Henry, the NVH noise vibration harshest
• 35:42
  expert we mentioned earlier. He initially tried
• 35:45
  to familiarize engineers with proposed NVH design
• 35:47
  changes using data and technical explanations,
• 35:51
  linking them to existing principles. But this
• 35:53
  yielded minimal support. They were resistant.
• 35:56
  So he shifted tactics. He adopted a more contentious
• 35:59
  stance, forcibly asserting the absolute necessity
• 36:02
  of a specific design, the double boot. This acted
• 36:05
  to defamiliarize their resistance, shocking them
• 36:08
  out of their complacency, and forcing a re -evaluation
• 36:10
  of their assumptions about NVH's importance.
• 36:13
  So you might start by making it comfortable,
• 36:15
  but if that doesn't work, you shake things up.
• 36:17
  Sometimes that's exactly what's needed. In healthcare,
• 36:20
  you might familiarize staff with a new patient
• 36:21
  safety checklist by showing how seamlessly it
• 36:23
  integrates with their existing workflow. But
• 36:26
  if compliance remains low, You might then defamiliarize
• 36:30
  their complacency by presenting stark data on
• 36:33
  a critical incident that the old system failed
• 36:35
  to prevent, creating urgency and prompting a
• 36:37
  real shift in mindset and behavior. And finally,
• 36:40
  the fifth dimension, establishing credibility
• 36:43
  by laying down markers. This sounds like using
• 36:46
  your expertise strategically to lead or influence.
• 36:50
  Precisely. This involves deliberately using specific
• 36:53
  details, telling anecdotes that showcase deep
• 36:56
  experience, or employing specific jargon to validate
• 36:59
  your assertions and establish your expertise.
• 37:02
  It's particularly potent in cross -functional
• 37:04
  or inter -departmental discussions where different
• 37:07
  professional languages and knowledge bases exist.
• 37:10
  Dan, the program manager at Newcar, was very
• 37:12
  effective at this. He's successfully pushed for
• 37:14
  crucial design changes, partly by leveraging
• 37:17
  his own engineering background and using precise
• 37:20
  engineering jargon, what he explicitly called
• 37:22
  engineer talk, to counter resistance, even from
• 37:24
  senior executives. He'd assert things like, damn
• 37:27
  it, guys, I'm a product engineer. Been there,
• 37:29
  done that, managed product, managed people. And
• 37:31
  tell me what you want me to do because I know
• 37:33
  this will work. This created undeniable credibility
• 37:36
  based on demonstrated expertise and influenced
• 37:38
  the outcome. Asserting your credentials, but
• 37:41
  through specific knowledge. Exactly. For an orthopedic
• 37:44
  surgeon, it might involve citing specific anatomical
• 37:47
  details, referencing outcomes from a particular
• 37:50
  surgical theories they performed, or using precise
• 37:53
  biomechanical terminology in a discussion with
• 37:56
  hospital management about the clinical necessity
• 37:58
  of a new piece of equipment. It's using their
• 38:01
  deep professional knowledge not just to explain,
• 38:04
  but as a marker of authority and credibility
• 38:06
  to support their case. Okay, these five dimensions
• 38:09
  provide a great framework. Let's now put these
• 38:11
  concepts into action by exploring how Newcar,
• 38:14
  our automotive manufacturer, actually mobilized
• 38:16
  innovation, looking both at innovation within
• 38:18
  existing routines and the launch of entirely
• 38:21
  new creative projects. First, tell us a bit more
• 38:23
  about Newcar's unique cowboy culture. What defined
• 38:26
  it? Well, Newcar had this really distinctive
• 38:28
  cowboy culture that genuinely permeated his approach
• 38:31
  to innovation. The physical environment played
• 38:34
  a part, and the Mayflower Road office building,
• 38:37
  MROB, wasn't some sleek, modern corporate HQ.
• 38:41
  It had a history of housing under capitalized
• 38:43
  companies, which bred a necessity to do more
• 38:46
  with less. This fostered a really scrappy, inventive,
• 38:50
  risk -taking culture. And it yielded significant
• 38:52
  results, things like entirely new vehicle categories
• 38:55
  and the early, quite pioneering adoption of 3D
• 38:58
  digital design tools. And the train metaphor.
• 39:01
  Ah, yes. The iconic image they often used internally
• 39:04
  was the steam train laying down tracks just ahead
• 39:07
  of itself as it sped along. It perfectly symbolized
• 39:10
  their ethos of figuring things out as they unfolded.
• 39:12
  improvising, adapting. Of course, this culture
• 39:15
  often created tension with the larger, more bureaucratic
• 39:17
  parent company, Alcar, which generally preferred
• 39:20
  established processes and predictability. It
• 39:22
  sounds like a familiar dynamic, the innovative
• 39:25
  unit versus the larger organization. Very much
• 39:27
  so. You could easily see parallels with an innovative
• 39:30
  clinical department within a larger, more traditional
• 39:33
  hospital structure, constantly pushing boundaries
• 39:35
  while needing to navigate those bureaucratic
• 39:37
  constraints and expectations. So within that
• 39:40
  culture, How did innovation happen within their
• 39:43
  established routines, especially when things
• 39:45
  went, well, off track? Let's look at the manual
• 39:48
  shifter redesign initiative you studied. Right.
• 39:50
  The context here was complex automotive design
• 39:53
  work relying heavily on cross -functional teams,
• 39:55
  not unlike, say, how an orthopedic team might
• 39:58
  collaborate on designing custom implants or planning
• 40:00
  complex reconstructive surgery. A critical problem
• 40:03
  emerged with the design of the manual shifter
• 40:05
  console for a specific vehicle, the G5. It stalled
• 40:09
  due to issues with a highly complicated digital
• 40:11
  simulation, the move macro simulation, and the
• 40:15
  initial attempt to resolve this through knowledge
• 40:17
  articulation actually failed spectacularly. Two
• 40:20
  engineers, Clay and Seth, put together this incredibly
• 40:22
  long, overly detailed presentation showing all
• 40:25
  152 possible shifter moves. Oh dear, too much
• 40:28
  information. Way too much. It completely violated
• 40:32
  the complex to simple rule of effective articulation.
• 40:36
  It led to executive impatience, total confusion.
• 40:39
  The emergency crunch team formed to fix it felt
• 40:43
  In their words, like, wrestling with a huge ball
• 40:46
  of yarn. They couldn't interpret the simulation
• 40:48
  findings, and there was a real lack of clear
• 40:50
  leadership. It's a classic example of information
• 40:52
  overload completely hindering progress, something
• 40:55
  we often see when raw data is dumped without
• 40:57
  proper synthesis or focus. That sounds like a
• 41:00
  moment absolutely ripe for a skilled broker or
• 41:02
  articulator to step in and sort things out. What
• 41:04
  happened next in that rather chaotic environment?
• 41:06
  It was indeed. And Henry, the NVH expert we talked
• 41:09
  about earlier, saw this disrupted routine as
• 41:12
  his opportunity. NVH noise, vibration, harshness
• 41:17
  was often dismissed by other engineers, sometimes
• 41:19
  crudely referred to as a crock of shit. Henry
• 41:23
  aimed to reposition it as a genuinely worthy
• 41:25
  design objective. He didn't just complain about
• 41:27
  the problem, though. He developed an informal
• 41:30
  NVH presentation, drawing on his two decades
• 41:32
  of experience. He then met individually with
• 41:35
  key stakeholders across different teams to establish
• 41:38
  mutual intelligibility, making sure they understood
• 41:40
  the basics and why it mattered. He marshaled
• 41:43
  data commissioning specific lab studies on boot
• 41:45
  designs, importing best practices from other
• 41:47
  manufacturers, effectively acting as a conduit
• 41:49
  broker to bring in external validation and legitimate
• 41:52
  his proposed solution, a double boot design.
• 41:55
  So building the case methodically? Methodically,
• 41:58
  yes. He initially used familiarization tactics,
• 42:02
  explaining the benefits in terms engineers could
• 42:04
  relate to their own work. But when he still met
• 42:06
  resistance, rooted in old assumptions, he shifted
• 42:09
  gears. He moved to defamiliarization, forcefully
• 42:13
  asserting the double boots absolute necessity,
• 42:16
  challenging their ingrained ways of thinking.
• 42:18
  And he succeeded. He mobilized enough support,
• 42:21
  persuaded the team, and they adopted the double
• 42:23
  boot. It's a fantastic example of how continuous
• 42:27
  knowledge articulation combined with periodic
• 42:29
  bursts of brokerage can achieve significant innovation
• 42:32
  even within a routine, especially when that routine
• 42:35
  is disrupted and creates a window for change.
• 42:37
  And there was another example of successful routine
• 42:40
  -based innovation from that same crunch team,
• 42:42
  wasn't there? Alex and Joe's master cross -section
• 42:44
  approach. How did these two designers intervene
• 42:47
  when the larger team was floundering? Yes, Alex
• 42:49
  and Joe. They were designers, and they stepped
• 42:52
  significantly outside their typical, often more
• 42:54
  passive roles when the crunch team really got
• 42:57
  bogged down. There was confusion over supplier
• 43:00
  responsibilities, fundamental misunderstandings
• 43:03
  about the design itself. They responded by aggressively
• 43:06
  pursuing mutual intelligibility. They went straight
• 43:09
  to the suppliers, questioning them directly,
• 43:12
  literally asking, are there two different proposals
• 43:14
  here? What are we actually working from? They
• 43:16
  even intercepted people after meetings to force
• 43:19
  clarification and establish consistent design
• 43:21
  criteria. Taking charge. Very much so. It was
• 43:25
  a short -lived, but highly effective, tertius
• 43:27
  -iongian strategy, quickly uniting disparate
• 43:30
  perspectives that weren't connecting. Then, crucially,
• 43:32
  they introduced a novel technical approach, a
• 43:35
  2D cross -sectional approach, which they called
• 43:37
  the master cross -section. This provided a simplified
• 43:40
  shared visual frame for problem -solving. Now,
• 43:43
  this was dramatic departure from the team's usual
• 43:45
  complex 3D modeling routine, and it initially
• 43:48
  met considerable resistance, particularly from
• 43:51
  the engineers. So how did they overcome that?
• 43:52
  They really had to twist arms to maintain cooperation,
• 43:56
  as they put it. They even strategically threatened
• 43:59
  to act as Tertius Gaudens, using the potential
• 44:01
  for conflict to their advantage. They hinted
• 44:04
  they might foment alter -alter conflict by suggesting
• 44:07
  they'd have the powertrain division explain the
• 44:09
  necessary design changes directly to the styling
• 44:11
  team and even more worryingly for the engineers,
• 44:15
  to hire management. Ah, the threat of escalation.
• 44:18
  Exactly. A very unwelcome prospect for the engineers
• 44:21
  and managers involved, which influenced them
• 44:24
  to cooperate with the new 2D approach. Alex and
• 44:27
  Joe's success stemmed from their intimate understanding
• 44:29
  of the interests and pressures on multiple parties,
• 44:32
  their command of the digital design languages
• 44:34
  involved, and deploying this novel network and
• 44:37
  brokered strategy. And importantly, they operated
• 44:40
  largely through provisional knowledge dialogue,
• 44:43
  quick iterative conversations, because the situation
• 44:46
  was constantly changing. It's a great lesson
• 44:48
  in how knowing the political landscape and your
• 44:51
  audience's specific pain points can be leveraged
• 44:53
  to drive a solution forward. So that covers innovation
• 44:56
  within a routine, often sparked by a crisis or
• 44:59
  disruption. But how did entirely new creative
• 45:02
  projects get mobilized at Newcar, those initiatives
• 45:05
  outside the established framework? Let's turn
• 45:08
  to the Prototype Parts Purchasing, or PPP, redesign
• 45:11
  initiatives. First, what was the existing PPP
• 45:15
  routine like? The PPP routine was a core, essential
• 45:18
  process for Nucar, much like managing surgical
• 45:21
  equipment procurement or ordering bespoke implants
• 45:24
  in a hospital. It involved a standard sequence,
• 45:27
  engineering requests for prototype parts, getting
• 45:29
  quotes from suppliers, issuing purchase orders,
• 45:32
  and finally, the part delivery to the vehicle
• 45:34
  build units. This process spanned four distinct
• 45:37
  communities of practice. The design engineers
• 45:39
  making the requests, the external suppliers providing
• 45:42
  the parts, the internal purchasing department
• 45:44
  managing the finances, and the build units actually
• 45:46
  assembling the prototypes. Craig, the manager
• 45:49
  overseeing PPP, maintained notoriously tight
• 45:52
  controls. He felt he had to in order to corral
• 45:55
  engineers who had a reputation for making last
• 45:57
  -minute, often unauthorized design changes that
• 46:00
  threw the whole process off. Sounds like a source
• 46:02
  of tension. Huge tension. The process was predictable
• 46:05
  enough, ironically, for Craig to anticipate problems
• 46:08
  and even budget for the inevitable cost overruns
• 46:11
  caused by these changes. But this constant waywardness,
• 46:14
  as he saw it, from the engineers led to significant
• 46:16
  friction and inefficiency. Everyone knew this
• 46:19
  system wasn't ideal. And how did the Alcarpe
• 46:21
  PPP redesign project, the first creative project,
• 46:24
  emerge from this background of predictable tension?
• 46:26
  This was a clear example of a creative project
• 46:29
  driven by a high -level vision, originating from
• 46:32
  senior management's awareness of the systemic
• 46:34
  PPP issues, the budget overruns, the delays,
• 46:37
  the frustration. They projected a trajectory
• 46:39
  towards a solution. The core group tasked with
• 46:42
  this engaged in what we call trajectory management.
• 46:45
  This involved several key activities. First,
• 46:48
  Fixing, which meant collectively articulating
• 46:50
  the group's often tacit knowledge about the routine's
• 46:53
  specific flaws. They did this through intensive
• 46:55
  whiteboard sessions, detailed process mapping,
• 46:59
  making the invisible problems and bottlenecks
• 47:01
  explicit and shared. Then came pitching, persuading
• 47:04
  key stakeholders of the need for change and the
• 47:07
  proposed solution. They developed a powerful,
• 47:09
  relatable metaphor arguing for a new centralized
• 47:12
  PPP unit that would operate like Craig, meaning
• 47:15
  with consistent controls, but system -wide. Using
• 47:17
  the existing figurehead as a model. Exactly.
• 47:20
  And finally, scheming, which sounds negative,
• 47:22
  but here means strategically enlisting support.
• 47:26
  They carefully identified potentially receptive
• 47:28
  influential individuals from multiple functions
• 47:31
  and invited them to a crucial off -site retreat.
• 47:34
  They even practiced anticipatory contingency
• 47:36
  management. They suddenly engineered, you might
• 47:39
  say, the appearance of a spontaneous consensus
• 47:41
  emerging at the retreat. They recruited a purchasing
• 47:44
  manager, Alan, who independently introduced the
• 47:47
  idea of the centralized purchasing unit, the
• 47:49
  very idea the core group had already meticulously
• 47:52
  developed beforehand. Very carefully orchestrated.
• 47:54
  Extremely. a carefully sequenced set of brokerage
• 47:57
  and articulation actions designed to launch a
• 47:59
  major new initiative and overcome expected resistance.
• 48:02
  And the G5 PPP creative project that was another
• 48:05
  distinct creative project focused on PPP. How
• 48:09
  was its mobilization different? Yes, this one
• 48:11
  was different. It was driven more bottom up,
• 48:14
  specifically by Dan's urgency and sheer frustration
• 48:17
  after that difficult executive meeting where
• 48:19
  his program was criticized for delays. His pitch
• 48:22
  was incredibly sharp, born of that pressure.
• 48:25
  getting the right parts and the right cars at
• 48:26
  the right time. Simple, direct, action oriented,
• 48:30
  because it had a much shorter, more urgent time
• 48:32
  frame. The trajectory projection, the vision
• 48:35
  and the scheme, the plan to get there, were much
• 48:38
  more closely intertwined from the very beginning.
• 48:40
  Knowledge articulation here was explicitly used
• 48:43
  not just to make tacit problems explicit, but
• 48:45
  to make the case for change persuasive. Unlike
• 48:47
  in the analysis of the original routine, the
• 48:50
  pitching activity constantly circled back to
• 48:52
  and reinforced those specific taglines like the
• 48:54
  right parts and the right cars at the right time
• 48:56
  to build the creative case and maintain momentum.
• 48:59
  And contingency management. How did Dan handle
• 49:01
  obstacles? Dan was constantly dealing with contingencies,
• 49:05
  particularly resource constraints. There was
• 49:07
  a company -wide hiring freeze, so he had to continually
• 49:09
  negotiate to borrow staff from other areas. He
• 49:13
  described this challenge very vividly, saying,
• 49:15
  and I'm quoting him here, I have identified a
• 49:17
  hand. It's called Kurt. the person he wanted
• 49:20
  to lead the team, but I don't have a glove to
• 49:23
  slip him in an official job slot, so I'm running
• 49:25
  around trying to find a glove. He successfully
• 49:28
  navigated these kinds of obstacles by orchestrating
• 49:31
  both anticipatory responses, planning ahead for
• 49:34
  likely problems, and incredibly deft reactive
• 49:36
  responses when unexpected issues cropped up.
• 49:40
  It really illustrated profound contingency management
• 49:42
  in action. These cases really demonstrate just
• 49:44
  how complex and multifaceted social skill truly
• 49:47
  is when it comes to orchestrating innovation
• 49:49
  and change. You've identified three deeply intertwined
• 49:53
  competencies that seem to define this mastery,
• 49:55
  bringing all these threads together. Yes, I think
• 49:57
  they capture the essence of it. First, there's
• 50:00
  brokerage competency. This isn't just about occupying
• 50:03
  a structural position, but the strategic deployment
• 50:05
  of those different orientations, conduit, tertius
• 50:08
  gaudens, tertius aeongens dynamically over time.
• 50:12
  It also includes the broader ability to identify,
• 50:15
  recruit, and orchestrate participation from the
• 50:18
  right people as a project unfolds. Second, knowledge
• 50:22
  articulation competency. This is that crucial
• 50:24
  ability to read your audience and tailor your
• 50:27
  communications effectively to the specific context.
• 50:30
  It's fundamentally about perspective taking,
• 50:32
  or if you prefer, empathy, understanding where
• 50:34
  the other person is coming from. And third, Projective
• 50:37
  competence. This is the more strategic, forward
• 50:40
  -looking ability to consider which actors need
• 50:42
  to be assembled, when they need to be brought
• 50:44
  in, and how best to engage them to advance a
• 50:46
  project towards its goal. And these aren't separate
• 50:48
  skills, are they? Not at all. They are deeply
• 50:51
  intertwined. Effective brokerage, for example,
• 50:54
  almost always implicates knowledge articulation
• 50:56
  you need to articulate effectively to build rapport,
• 50:59
  establish common interests, and persuade people
• 51:01
  to connect or collaborate. You need projective
• 51:04
  competence to even know who to broker between.
• 51:07
  Think of a chief of surgery trying to introduce
• 51:09
  a significant new orthopedic technique into the
• 51:12
  hospital. They need brokerage skills to connect
• 51:15
  with the right surgeons, nurses, administrators,
• 51:18
  maybe even external experts. They need articulation
• 51:20
  skills to clearly explain the technique, its
• 51:23
  benefits, the evidence behind it, addressing
• 51:25
  concerns. And they need projective competence
• 51:28
  to plan the entire rollout training, equipment,
• 51:31
  scheduling, managing the change process. It all
• 51:33
  works together. Let's delve a bit deeper into
• 51:36
  one aspect of articulation you highlighted, perspective
• 51:39
  articulation, that ability to understand and
• 51:41
  express others' worlds. How did you see this
• 51:44
  manifest in practice in your research? It seems
• 51:46
  incredibly powerful. It was genuinely one of
• 51:49
  the most effective articulation behaviors I observed.
• 51:53
  This capacity to truly understand and then accurately
• 51:57
  express the perspective of others, whether it's
• 52:00
  articulating your own knowledge in a way they
• 52:02
  understand or articulating their perspective
• 52:04
  back to them or to a third party. There was a
• 52:07
  great example with Carl, that non -engineer at
• 52:09
  Newcar, who had decades of experience working
• 52:11
  closely with engineers. He was explaining to
• 52:14
  Aaron, an engineer from a newly merged, more
• 52:16
  bureaucratic company, how the original Newcar
• 52:19
  design engineers typically worked. Carl articulated
• 52:22
  their tacit experience, their mindset, saying
• 52:24
  something like, Look, I want to show it my design
• 52:27
  to you until it's done. Because half of engineering
• 52:29
  should be trying new dumb things. But that's
• 52:32
  not socially acceptable in a formal review. Capturing
• 52:34
  the culture. Exactly. He successfully conveyed
• 52:37
  a complex, nuanced cultural understanding, validating
• 52:41
  the engineer's perhaps unexpressed feelings and
• 52:44
  potentially enlisting Aaron's support, or at
• 52:46
  least understanding, for a new design initiative
• 52:48
  by bridging that cultural gap. In a medical context,
• 52:52
  this might be a senior nurse explaining to a
• 52:54
  newly qualified doctor the unwritten rules of
• 52:57
  patient flow or communication norms on a busy
• 53:00
  ward, articulating the nurse's operational perspective
• 53:03
  to help the doctor navigate the system more effectively
• 53:05
  and build collaborative relationships. That's
• 53:08
  fascinating. And then there's this related concept
• 53:10
  you mentioned, ventril equation or riffing, essentially
• 53:13
  speaking through another's voice or perspective.
• 53:15
  What does that sound like in practice? Yes. This
• 53:18
  is a particularly powerful variant of perspective
• 53:21
  articulation. It's where one person effectively
• 53:23
  speaks as or through another voice or voices,
• 53:28
  often relying on shared understandings of social
• 53:31
  speech types or social languages, like professional
• 53:34
  jargons or typical ways of framing arguments
• 53:36
  within a certain group. Karl, again, was a master
• 53:39
  of this. During intense process innovation efforts,
• 53:42
  he would often use riffing to advocate points
• 53:45
  or frame conversations. He'd hypothetically speak
• 53:47
  as an engineer, saying things like, OK, if I'm
• 53:50
  a product you're looking at this, I'm thinking
• 53:52
  about XYZ coordinates. Carl wasn't an engineer,
• 53:57
  but doing this showcased his deep understanding,
• 53:59
  his mastery of their privileged knowledge and
• 54:01
  way of thinking. It created credibility, made
• 54:03
  complex technical ideas accessible to the non
• 54:06
  -engineers in the room, and allowed the conversation
• 54:08
  to move forward without getting bogged down in
• 54:10
  misunderstandings or defensiveness. It's quite
• 54:13
  a performative skill. bridging knowledge divide
• 54:15
  dynamically. So like a medical director ventriloquating
• 54:17
  the perspective of a busy ward manager when talking
• 54:20
  to hospital executives about staffing needs.
• 54:23
  Precisely. Framing the issue using the language
• 54:25
  and priorities that resonate with both the operational
• 54:28
  front line and the strategic decision makers.
• 54:31
  It's a sophisticated articulation technique.
• 54:32
  And Dan, the G5 program manager you studied closely
• 54:35
  seems to embody this apex of social skill. What
• 54:38
  specifically made his approach so virtuous and
• 54:41
  effective? You paint a picture of real mastery.
• 54:44
  Dan's virtuosity was truly remarkable. operating
• 54:46
  on multiple levels. Firstly, his ability to navigate
• 54:50
  divides was exceptional. As one of Alcar's relatively
• 54:53
  few black senior executives at the time, he consistently
• 54:56
  and skillfully brokered across both racial and
• 54:59
  organizational divides. He deftly handled incredibly
• 55:02
  sensitive situations, like one where a white
• 55:04
  finance manager was publicly, quite harshly,
• 55:07
  rebuked by a very senior VP. But Dan managed
• 55:10
  to smooth things over afterwards by explaining
• 55:12
  the nuanced perspectives of each party, fostering
• 55:15
  understanding where there could easily have been
• 55:17
  lasting resentment and damaged relationships.
• 55:20
  Secondly, his multifaceted communication style
• 55:22
  was key. He masterfully used humor, often quite
• 55:25
  direct, earthy humor, using phrases like, beavering
• 55:28
  away, or calling engineers cheating, lying sons
• 55:31
  of bitches, affectionately, or even playfully
• 55:33
  threatening to pull a gun to assert authority
• 55:35
  lightly. But this was always coupled with incredibly
• 55:38
  insightful perspective articulation. He could
• 55:40
  grasp the complexities of a situation instantly
• 55:43
  and articulate the different viewpoints sympathetically,
• 55:46
  while always offering pragmatic solutions. This
• 55:48
  built an incredibly broad base of trust and rapport
• 55:51
  across very diverse groups. And how did he manage
• 55:54
  those really complex, high -stake situations
• 55:57
  when tensions were running high between teams,
• 55:59
  like the PPP example? Ah yes, the example of
• 56:02
  rising tensions between his new PPP team, led
• 56:05
  by Kurt, and the established manufacturing personnel,
• 56:09
  represented by Tim. This was a critical potential
• 56:12
  roadblock for his project. Dan didn't just send
• 56:15
  emails or hold meetings in his office. He literally
• 56:18
  stepped onto manufacturing's turf, went down
• 56:21
  to the plant floor, got a first -hand look at
• 56:23
  the issues from their perspective. He used his
• 56:26
  acute social insight to capture the operational
• 56:28
  details, but also the underlying frustrations.
• 56:31
  He could then translate the issues effectively,
• 56:34
  speaking engineering language in one meeting
• 56:35
  and manufacturing language in the next. He orchestrated
• 56:39
  the network, bringing the right people together
• 56:41
  at the right time to talk directly, but facilitated
• 56:43
  by his understanding. Ultimately, he resolved
• 56:46
  the conflict, keeping the project on track by
• 56:48
  demonstrating that profound understanding of
• 56:50
  each party's pressures, interests, and ways of
• 56:53
  working. So it's a blend of empathy and strategic
• 56:55
  action. Exactly. Dan's mastery involved a complex
• 56:59
  blend of cognitive perspective -taking, understanding
• 57:02
  their rational arguments and emotional perspective
• 57:04
  -taking, grasping their feelings and motivations.
• 57:07
  This allowed him to constantly adapt his approach
• 57:10
  and language precisely to his audience, which
• 57:12
  is absolutely crucial for achieving high -impact
• 57:15
  innovation in any field, certainly including
• 57:17
  the complex, high -pressure environment of healthcare.
• 57:20
  It really highlights that the most effective
• 57:22
  leaders aren't just technically brilliant, but
• 57:25
  also deeply empathetic and socially adept orchestrators.
• 57:28
  It's very clear how these principles – brokerage,
• 57:31
  knowledge, articulation, project management,
• 57:33
  social skill – apply within a large corporation
• 57:35
  like Newcar. But you argue that this DKE model,
• 57:39
  as you call it, has universal application, extending
• 57:41
  far beyond the corporate boardroom. Where else
• 57:44
  do we see these dynamics powerfully at play?
• 57:46
  Absolutely. The underlying mechanisms are remarkably
• 57:49
  consistent. One compelling historical example,
• 57:52
  far removed from corporate life, is Serge Diaghilev
• 57:54
  and his Ballet Roses in the early 20th century.
• 57:57
  A cultural earthquake. Diaghilev acted as a master
• 58:00
  conduit broker. He was perpetually seeking out
• 58:03
  new and important artistic elements. Revolutionary
• 58:06
  music from Stravinsky, avant -garde design from
• 58:09
  Picasso, groundbreaking choreography from Nijinsky,
• 58:12
  sourcing them from exhibitions, concerts, studios
• 58:15
  across Europe, and adapting them, reconfiguring
• 58:17
  them. for his ballet productions. He was also
• 58:20
  a superb Tertius Eugens. He had an incredible
• 58:23
  knack for uniting often fragmented, argumentative
• 58:26
  avant -garde artists, bringing them together
• 58:28
  in novel collaborations. And crucially, linking
• 58:31
  this potentially shocking artistic world with
• 58:33
  the conservative moneyed elites, the patrons
• 58:35
  who actually funded the performances, bridging
• 58:37
  worlds. And did he use Tertius Gaudens too? Oh,
• 58:40
  certainly. He simultaneously employed Tertius
• 58:42
  Gaudens tactics, explaining differences or creating
• 58:45
  competition to his advantage. For instance, he
• 58:48
  might commission music from rival composers for
• 58:51
  consecutive seasons, generating creative tension
• 58:53
  and leverage that constantly pushed artistic
• 58:55
  boundaries. His knowledge articulation was phenomenal,
• 58:59
  synthesizing these vast, disparate artistic contents,
• 59:02
  skillfully blending radical classicism with startling
• 59:05
  experimentation. He created, as one critic put
• 59:08
  it, radical novelty translated into a language
• 59:11
  rich in classical references, making the new
• 59:13
  palatable yet still revolutionary. A true impresario
• 59:17
  of innovation. Precisely. It showcases how local
• 59:20
  micro -level brokerage and articulation actions
• 59:22
  can aggregate to have broader systemic impact.
• 59:25
  The IONGEN's broker, like Diagelev, often trades
• 59:28
  immediate control or profit for wider network
• 59:30
  growth and influence, acting as an impresario
• 59:33
  who enables the whole ecosystem. And what about
• 59:35
  entrepreneurial action? How does the assembly
• 59:37
  view of entrepreneurship connect to this model?
• 59:40
  Starting a new venture or maybe a medical tech
• 59:42
  startup? Entrepreneurial efforts fundamentally
• 59:44
  involve continually joining people and resources
• 59:47
  together in new combinations. That's almost the
• 59:49
  definition. This assembly view suggests that
• 59:52
  an entrepreneurial startup doesn't just spring
• 59:54
  fully formed from a single brilliant idea. It
• 59:57
  usually begins with a trajectory projection,
• 1:00:00
  a vision for the goal, however hazy or evolving
• 1:00:03
  it might be initially. But then it unfolds to
• 1:00:05
  what you could call cascades of tertius engines
• 1:00:09
  connecting work. Each connection enables the
• 1:00:12
  next. This assembly action can evolve serially,
• 1:00:15
  one connection leading logically to the next,
• 1:00:17
  sometimes in parallel, multiple connections being
• 1:00:20
  forged simultaneously, and usually expansively,
• 1:00:23
  adding more people, more resources, more capabilities
• 1:00:25
  over time. Brokerage, particularly the iEngines
• 1:00:28
  form, is effectively the primary engine by which
• 1:00:30
  venture growth is accomplished. How does that
• 1:00:32
  compare to other theories like effectuation?
• 1:00:35
  It offers a slightly different emphasis. Effectuation
• 1:00:38
  theory highlights starting with the means you
• 1:00:39
  have available and letting goals emerge. The
• 1:00:43
  assembly view, while acknowledging adaptability,
• 1:00:45
  argues that the trajectory projection, that initial
• 1:00:47
  guiding vision or stake in the ground, is still
• 1:00:50
  a critical orienting element, even if it gets
• 1:00:52
  refined along the way. For a medical startup
• 1:00:55
  developing a new orthopedic device, it's that
• 1:00:57
  constant process of assembling the right engineers,
• 1:01:00
  clinicians, investors, regulatory experts, each
• 1:01:03
  iEngines connection, building the venture piece
• 1:01:06
  by piece towards that initial guiding projection.
• 1:01:08
  And collective actions, social movements, they
• 1:01:11
  also underpin by these same fundamental dynamics
• 1:01:14
  of brokerage and articulation. It feels like
• 1:01:16
  a different world from corporate innovation or
• 1:01:18
  entrepreneurship. Fundamentally, yes, the underlying
• 1:01:20
  mechanisms are remarkably similar. As I sometimes
• 1:01:24
  say, innovation is not as far removed from the
• 1:01:26
  street as might be imagined. Getting new things
• 1:01:29
  done, whether it's launching a product or sparking
• 1:01:31
  a movement, relies on connecting people, shaping
• 1:01:34
  understanding, and mobilizing action. Think about
• 1:01:37
  historical examples like the 1936 General Motors
• 1:01:40
  sit -down strike in Flint, Michigan Blue -collar
• 1:01:43
  workers through incredibly sophisticated internal
• 1:01:46
  brokerage and articulation Mobilized collective
• 1:01:49
  action that fundamentally disrupted and ultimately
• 1:01:51
  restructured an entire social and economic system
• 1:01:54
  That involved countless acts of connecting workers
• 1:01:56
  sharing information conduit uniting factions
• 1:01:59
  young juns and strategically managing conflict
• 1:02:02
  gardens with management and authorities And in
• 1:02:05
  our increasingly digital world, how have these
• 1:02:08
  mechanisms adapted? Has technology made human
• 1:02:11
  brokers less relevant? Facebook, Twitter, LinkedIn
• 1:02:13
  connect people automatically. That's a key question.
• 1:02:16
  Digital tools have undoubtedly dramatically increased
• 1:02:20
  information availability and the speed of coordination.
• 1:02:23
  Algorithms can sometimes shift some of the connection
• 1:02:25
  work from human brokers to digital platforms
• 1:02:28
  matching users with shared interests, facilitating
• 1:02:31
  introductions. However, this certainly doesn't
• 1:02:33
  eliminate the advantages of skilled, hands -on
• 1:02:35
  human brokering, or the complex task of orchestrating
• 1:02:38
  projects across multiple venues, both online
• 1:02:41
  and offline. If anything, future strategic actors
• 1:02:44
  need to be adept at navigating both worlds, possessing
• 1:02:47
  the traditional in -person analog skills of relationship
• 1:02:50
  building and nuance, and the digital skills to
• 1:02:53
  leverage online platforms effectively. Can you
• 1:02:55
  give an example of that blend? Wael Ghonim's
• 1:02:57
  pivotal role in the Egyptian -Arab Spring is
• 1:02:59
  a powerful illustration of this analog -digital
• 1:03:02
  straddling. He was a Google executive, comfortable
• 1:03:04
  in the digital world. He created high -impact
• 1:03:07
  Facebook pages, like Kalina Khalid said, in an
• 1:03:11
  extremely politically charged environment. But
• 1:03:14
  crucially, his knowledge articulation was exceptional.
• 1:03:17
  He used colloquial Egyptian dialect in his posts,
• 1:03:20
  consciously avoiding formal Arabic or dense activist
• 1:03:22
  jargon, allowing him to connect deeply and authentically
• 1:03:25
  with young Egyptians online. His activism displayed
• 1:03:29
  a potent composite of brokerage skill. Conduit,
• 1:03:32
  moving critical information and narratives rapidly
• 1:03:34
  online. Tertius Unions. mobilizing collective
• 1:03:37
  action both digitally through calls to protest
• 1:03:40
  and then coordinating in person on the ground,
• 1:03:42
  and crucially, Tertia's gaudens, strategically
• 1:03:45
  keeping the authorities separate and in the dark
• 1:03:47
  about their plans for as long as possible, a
• 1:03:49
  vital protective function. This collective action
• 1:03:52
  truly was a creative project, developed rapidly
• 1:03:54
  in the absence of established routines, with
• 1:03:57
  constantly evolving goals and activist identities,
• 1:03:59
  all driven by a powerful blend of digital reach
• 1:04:01
  and human brokerage skill. Finally, you suggest
• 1:04:04
  this whole BKAP model brokerage knowledge articulation
• 1:04:07
  projects even has implications for broader societal
• 1:04:10
  issues like social inequality and education.
• 1:04:12
  How so? That seems quite a leap from automotive
• 1:04:15
  design or the Arab Spring. Well, the model's
• 1:04:17
  emphasis on social skill as a key enabler of
• 1:04:20
  effective action can indeed be extended. If social
• 1:04:24
  skill helps people navigate complex systems and
• 1:04:27
  mobilize resources to achieve goals, then fostering
• 1:04:30
  it could potentially help address barriers related
• 1:04:32
  to income inequality. Higher education for all
• 1:04:35
  its challenges remains a primary institution
• 1:04:38
  for facilitating upward mobility. The model seems
• 1:04:41
  particularly relevant when thinking about students,
• 1:04:44
  perhaps, at what are sometimes called comprehensive
• 1:04:46
  universities, often regional public institutions.
• 1:04:49
  Many students there demonstrate remarkable resilience
• 1:04:52
  and motivation. often achieving dramatic upward
• 1:04:54
  mobility despite significant financial or social
• 1:04:57
  disadvantages. Developing social skill, the ability
• 1:05:01
  to network effectively, articulate ideas persuasively,
• 1:05:04
  manage projects, navigate different social contexts
• 1:05:06
  to their education, offers these students a crucial
• 1:05:08
  pathway to success. It equips individuals not
• 1:05:11
  just with subject matter knowledge, but with
• 1:05:13
  the practical ability to orchestrate that knowledge
• 1:05:15
  and their networks for impactful change in their
• 1:05:17
  own lives and careers. It's about empowering
• 1:05:19
  them. to become effective brokers and articulators,
• 1:05:23
  regardless of their starting point. So let's
• 1:05:25
  try and bring this all together. What does this
• 1:05:27
  deep dive mean for you, our listeners, whether
• 1:05:29
  you're a surgeon leading a team, a researcher
• 1:05:32
  trying to get funding, an administrator managing
• 1:05:34
  change, or anyone working in orthopedics or health
• 1:05:37
  care generally? We seem to live in an era increasingly
• 1:05:40
  defined by this project -based work where Organizing
• 1:05:44
  maybe even life itself revolves more and more
• 1:05:46
  around dynamic networks, less rigid hierarchy
• 1:05:49
  and a real premium being placed on this ability
• 1:05:52
  to function effectively as a broker, as an articulator.
• 1:05:55
  Precisely. While having the right network structure
• 1:05:58
  and possessing individual knowledge or expertise
• 1:06:00
  have always been fundamental They aren't sufficient
• 1:06:02
  on their own anymore the social skill involved
• 1:06:05
  in actively orchestrating those networks and
• 1:06:07
  articulating knowledge effectively for different
• 1:06:09
  audiences and Critically the capacity to formulate
• 1:06:12
  launch and navigate novel projects. These are
• 1:06:15
  increasing perhaps paramount Importance in our
• 1:06:18
  rapidly evolving world. It's really about more
• 1:06:20
  than just what you know individually It's about
• 1:06:22
  the art the skill of putting that knowledge into
• 1:06:25
  action through and with others. It reminds me
• 1:06:27
  of that quote about the knowledge of how to combine.
• 1:06:30
  I think it was Alexis de Tocqueville who observed
• 1:06:32
  way back in the 19th century in democratic countries
• 1:06:35
  the science of association is the fundamental
• 1:06:37
  science. Progress and all the other sciences
• 1:06:40
  depends on progress in this one. That's a profoundly
• 1:06:42
  relevant thought isn't it. And it transcends
• 1:06:45
  specific political systems or organizational
• 1:06:47
  contexts. Understanding this science of association
• 1:06:50
  as he put it the dynamics of brokerage. articulation,
• 1:06:54
  and collaboration helps us grasp not just how
• 1:06:56
  routine things get done, but how genuinely new
• 1:06:59
  things get done, how larger processes like collective
• 1:07:02
  action, entrepreneurial innovation, and indeed
• 1:07:04
  scientific and medical breakthroughs truly unfold.
• 1:07:07
  In healthcare specifically, it means getting
• 1:07:09
  better at understanding how we combine deep clinical
• 1:07:12
  expertise, rapid technological advancements,
• 1:07:15
  diverse human resources, patient perspectives,
• 1:07:18
  how we bring all those elements together effectively
• 1:07:20
  through skilled association to achieve real breakthroughs
• 1:07:23
  in patient care, research, and public health.
• 1:07:26
  That's how we transform the landscape. Absolutely.
• 1:07:28
  Well, we hope this deep dive has given you some
• 1:07:31
  powerful new insights, maybe a new language,
• 1:07:33
  to consider for your own professional journey,
• 1:07:36
  whether that's leading your team more effectively,
• 1:07:38
  launching that new quality improvement initiative,
• 1:07:41
  or simply navigating the complex collaborations
• 1:07:44
  that are part of everyday life in medicine. If
• 1:07:46
  you found this deep dive valuable, please do
• 1:07:49
  take just a moment to rate the show or perhaps
• 1:07:51
  share it with a colleague who you think might
• 1:07:52
  also find it insightful. We're always keen to
• 1:07:55
  hear what stands out to you. Until next time,
• 1:07:58
  keep exploring, keep connecting and keep getting
• 1:08:00
  new things done.