2015 48th Hawaii International Conference on System Sciences Boundary Objects for Participatory Group Model Building of Agent-based Models Johnie Rose Case Western Reserve University [email protected] Laura Homa Case Western Reserve University [email protected] Peter Hovmand Washington University [email protected] Alison Kraus Washington University [email protected] Kelly Burgess Case Western Reserve University [email protected] Anindita Biswas Case Western Reserve University [email protected] Heide Aungst Case Western Reserve University [email protected] Sarah Cherng University of Michigan [email protected] Rick Riolo University of Michigan [email protected] Kurt C. Stange Case Western Reserve University [email protected] emerging from the actions and interactions of individuals within a responsive environment[1, 2]. Agent-based modeling takes a mechanistic approach, attempting to re-create the dynamics of an actual system as opposed to simple description [2-5]. An attractive aspect of the ABM approach is the intuitive structure that is easily understood by stakeholders who are not experts in modeling. The development of such models has typically been the domain of modeling experts, however. In contrast, another type of systems modeling approach—system dynamics (SD)—has long been coupled with a participatory approach to model building in which stakeholders meet with modelers and facilitators to iteratively turn their mental models of systems into simulation models. SD models re-create feedbacks that are hypothesized to generate a dynamic behavior. In these models, emergent behavior arises from the interaction of nonlinear balancing and reinforcing feedback mechanisms over time [6]. SD models are less helpful compared to ABMs for representing the heterogeneity of individuals or the impacts of random events.[1, 7, 8] While participatory group model building (GMB) of SD models has occurred for over two decades[9], there is little documented experience with group model building of ABMs[8]. Coupling ABM with a GMB process could allow researchers and decision makers to re-create systems from the level of heterogeneous individuals through the guidance of those with intimate system knowledge. The ultimate result would be better Abstract Boundary objects in participatory group processes help participants share their understanding of systems across disciplinary and social boundaries. We report development of a series of boundary objects in a group model building project in which stakeholders and modelers constructed agent-based models (ABMs) of health care seeking and delivery. We propose conventions for describing agent actions and interactions, and offer advice for effective use of boundary objects in a group process of building ABMs. We found that 1) an early boundary object was helpful for teaching stakeholders basic ABM concepts; 2) physical correspondence between boundary objects and model interfaces improved participant engagement; 3) group ownership of the model was threatened when the modeling team failed to capture needed model elements through the boundary object; 4) adherence to boundary object conventions improved when participants were given specific charges; 5) with hands-on exposure, the model graphical user interface became an effective boundary object. 1. Introduction Agent-based models (ABMs) are a type of systems model used increasingly in the social sciences, biological sciences, and beyond to model the outcomes 1530-1605/15 $31.00 © 2015 IEEE DOI 10.1109/HICSS.2015.357 2950 models, better reflecting truth, and leading to better decisions. Essential to this GMB process is a physical means through which diverse stakeholders can share their understandings of the system at hand across disciplinary or sociocultural boundaries. Such boundary objects for use in GMB of SD models have been well described and include, most prominently, behavior-over-time charts, causal-loop diagrams, and stock-and-flow diagrams [9]. Effective boundary objects should be capable of portraying important dependencies within a system, tangible with a minimal amount of text, and modifiable and adaptable by all group members [10, 11]. With these objects, participants can translate what is otherwise tacit knowledge of a system that is often inaccessible to members of other groups into explicit knowledge that can be universally understood and integrated by all participants [12]. There are special challenges to developing a boundary object for agent-based modeling. The emphases on agent-level decisions and multi-scale processes make the development of effective boundary objects for ABM difficult. Whereas SD model mapping requires depiction of a small set of actions and effects at an aggregate level, ABM model mapping requires depiction of possibly heterogeneous agent decision-making rules leading to actions in a responsive environment. The contribution of these agent actions to an aggregate effect must then be modeled. ABM is therefore a multi-level approach by definition, suggesting a need for a more complex set of boundary objects than typically used in system dynamics. Conventions do exist for describing the content of agent-based models. For instance statecharts, a component of standard UML® (Unified Modeling Language, uml.org), have been advocated as a means to graphically depict the transitions of agents between different states of being over time [13]. Perhaps better known is a standard proposed in 2006 by Grimm et. al. and subsequently applied in dozens of publications: ODD (Overview, Design Concepts, and Details) [14, 15]. The goal of the ODD developers was to standardize published ABM descriptions to help ensure completeness, understandability, and reproducibility. While ODD is a tremendously valuable tool to document and describe the operationalization of ABMs, it is not suitable as a boundary object. Instead, its intent is to describe ABMs which have already been developed and not necessarily as a tool for use during model development. ODD-compliant model descriptions require a significant amount of text targeted toward those who would program a similar model [15]. As such, neither UML statecharts nor ODD meet the criteria of completeness, relative parsimony, and transformability required of effective boundary objects. Here, we set out to provide guidance to investigators wishing to develop agent-based models using a participatory GMB process. We begin by reporting our experience with a particular GMB project in which we held a series of eight working sessions with patient, caregiver, and primary care provider stakeholders to develop an ABM of health care seeking and delivery. We describe a set of conventions for depicting agent actions and interactions, and we describe the series of boundary objects that evolved throughout development of this model and discuss their strengths and limitations. We conclude by offering generalized recommendations for the effective use of boundary objects in the development of ABMs through GMB. This work draws in part upon a theoretical foundation of design science. A fundamental motivation of design science lies in enhancing the capabilities of a group by creating and applying useful artifacts to be applied by the group. Design science holds that theory/truth inform design and vice versa.[16] In the work we describe, we sought to identify certain truths about a phenomenon-namely health care seeking and delivery-through a design process. We believe that the lessons we share here will be useful to others engaged in group design processes aimed at distilling theory or truth about a complex system. 2. Methods We convened a series of eight working sessions approximately monthly for a period of nine months. Participants were six primary care clinicians and nine patients or family caregivers (15 participants in total) recruited from local safety net practices in Cleveland, OH and from ResearchMatch.org. The goal for the group was to develop an agent-based model of health care seeking and delivery which helped explain the mechanisms and processes by which primary care adds value in terms of individual and community health beyond the treatment of illness alone. The design of sessions is described in detail elsewhere (pending) as are results and insights from the model itself (pending). Briefly, the plan was to spend the first session describing the goal as well as introducing and demonstrating agent-based modeling. The second session was spent developing a simple, preliminary model based on interaction of the core modeling team with participants. This preliminary model was demonstrated in the third session, revised extensively based on participant input, and presented 2951 back to the group in the following session. The same pattern was repeated for the fourth and fifth sessions. In the sixth session, the model was used to test various hypotheses that had emerged over the course of previous sessions. Based on discussion of results, further revisions to the model were planned. In session seven, additional hypotheses were tested using a newly revised model, and next steps for the group—including dissemination of findings—were discussed. In the final session, learning was consolidated, and participants were given practice describing the methodology and findings in a way that would enable them to share with others in the community. 2.1 Starting conventions boundary object for an introducing the drawing conventions shown in Table 1 to participants, the scenario below was given to participants. As each element was described, it was drawn on a white board using the conventions. “We have a world. In modeling, we call it an environment. In this environment, we have people, and these people we call agents. In this world, there are certain facts of the universe. One of these facts is that each day, a person can get sick or injured. We’re going to say that one of the facts of the world is that there are only two ways that people need health care. They either cut themselves and need stitches, or their diabetes is out of control. We’ll signify cutting yourself and needing stitches by green, and we’ll signal out-of-control diabetes by red. There are actions that these agents can take in response. They can go to one type of doctor – a family doctor. One of the facts of the world in this model is that family doctors are better at treating diabetes. Another action that these agents can take is that they can go to an emergency room or ER. One of the other facts of the world is that ER doctors are better at sewing up cuts. In taking these actions, there are rules for making decisions; we call these “decision rules”. We’re going to say in this simple example that the way people decide which action to take when they get sick is by flipping a coin: heads they go to their family doctor; tails they go to the ER.” initial In the first session, a concept model was used to teach agent-based modeling concepts to participants and to provide experience and comfort with the participatory process. This concept model was a highly simplified and obviously flawed model intended to induce active participant engagement. The scenario modeled and the resulting boundary object are reproduced in the Results section. First, though, we describe the diagramming conventions which we taught using this first boundary object. The core modeling team began developing these conventions prior to the first session in an attempt to capture the fundamental components needed to specify agent actions and interactions. The conventions are described in Table 1. Figure 1a re-creates the initial drawing based on the above vignette. After describing and drawing the scenario for the concept model, we then demonstrated how it could be represented in a computer model (programmed in NetLogo). The model interface (Figure 1b) was designed ahead of the meeting to resemble the boundary object drawing as it would be initially drawn. As each element of the model interface was introduced, its parallel in the drawn boundary object was indicated on the white board. Next, we asked participants what was wrong with the model and what needed to be added. We then edited the drawing, adhering to the conventions. Figure 1c shows the final drawing reflecting the changes and additions suggested by participants. Some of the suggestions from participants included addition of specialist provider agents, a decision rule as to source of care based on severity of signs and symptoms, a decision rule as to whether to seek care which took access to quality care into account, and a system fact that too much health care may do harm. In the second session, after reviewing boundary object drawing conventions, we divided participants into three small groups and asked them to use the conventions to create a drawing which addressed the question “how can primary care make individuals and 2.2 Subsequent boundary objects As the group model building sessions progressed, additional boundary objects emerged based on the communication needs of the group. The goal in the creation of all visual objects used to elicit and illustrate the model was to achieve boundary objects that were understandable and transformable by all participants. In the Results section below, we describe those different boundary objects and practical advice regarding their application. 3. Results 3.1 Boundary objects for depicting agent decisions and interactions We presented a “concept model” in session 1 as a device for teaching agent-based modeling concepts to participants and for providing experience and comfort with the participatory process. After 2952 Table 1 – Recommended drawing conventions for agent actions and interactions ABM component Description Environment A blank white board or piece of paper System facts Statements written on rays of sun Illustration/symbol Fact Agents Stick figures or buildings representing different types of people or organizations Agent states Coloring/shading of agent figure Agent decision rules Written in caption bubbles (e.g., as if/then statements) Agent actions and interactions Arrows showing impact on another agent or on another relationship (arrow pointing to an arrow) Flow of information* Arrows indicating the decision process(es) which this information impacts Agent traits* Indicated in perforated box under agent * Not included in original conventions but added based on demonstrated need communities healthier?”. Participants did not adhere tightly to the drawing conventions. We believe that this was partly due to an incomplete set of conventions. Two elements that we quickly realized were missing were 1) a means to convey the flow of information and 2) a way to portray agent traits. For the former, we decided to treat information flow as an interaction pointing to the relevant decision bubble that was affected. For the latter, we chose to list relevant agent traits in a box with a perforated border below the agent (Table 1). The broad nature of the question posed yielded wide-ranging answers from the three small groups. When the large group re-assembled, the core modeling team and participants collaboratively created a boundary object drawing which depicted one or more phenomena mentioned by all three groups (Figure 2). Specifically, we depicted 1) that multiple environmental determinants influence the health of individuals and that these determinants vary from individual to individual, and 2) that some patients only seek care when they are ill, while others seek regular preventive care as well as care when they are ill. This 2953 became the basis for the initial model that would be presented back to the group in the following session. The ensuing two group model building sessions consisted of iteratively demonstrating a model based on the most recent session, experimenting live with the model, soliciting input from participants, and collectively deciding what changes or additions to make next to the model. In these sessions, we found that the group tended to feel a loss of ownership of the model when situations arose which required the modeling team to make decisions about model content which had not been specified by the group via the boundary object. While it is inevitable that previously unforeseen assumptions will have to be made in the course of programming a model between sessions, the need to minimize such assumptions underscores the importance of creating and maintaining effective boundary objects. 3.2 Behavior-over-time graphs 1a A mainstay boundary object used in early development of system dynamics models is the behavior-over-time chart [9]. Here, participants are asked to free-hand sketch the behavior of some phenomenon of interest over time based on their understanding of system functioning. We found this tool useful as a boundary object for participatory ABM as well. For instance, when participants decided that including different types of diseases in the model was important, we used behavior-over-time charts to come to consensus understandings of what the major disease categories should be and how they would affect health over time (Figure 3). 1b 3.3 Boundary objects for predicting aggregate outcomes In the fifth GMB session, we sought predictions from participants about the health and health care utilization of two different types of patients receiving care in two different types of neighborhoods: patients with high versus low tendency to access care in neighborhoods where primary care was delivered by either providers with whom patients had long-term relationships or by urgent care providers (“relationship-based” versus “episodic” care). This was a change from asking patients to think mechanistically about how agents behave and why, as in previous sessions. The intent was to compare group predictions to outputs of the model with a goal of uncovering either unexpected aggregate behavior emerging from the actions of individuals, or unrealistic model assumptions. To facilitate this exercise, we 1c 2954 Figure 1. a) Re-creation of starting boundary object used to depict scenario given in concept model exercise, b) Corresponding NetLogo model interface, c) Final boundary object for concept model as modified based on participant input modeling team), it allowed them to express some part of their system understanding in a concrete way. Below, we consider the extent to which this interface itself functions as both boundary object and “microworld” [17-19]. Figure 2. Boundary object which served as the basis for the earliest model specified by the group Figure 3. Consensus behavior-over-time graphs showing health effects of four categories of disease over time - Multiple environmental determinants influence the health of individuals, and these determinants vary from individual to individual. Some patients only seek care when they are ill, while others seek regular preventive care as well as care when they are ill. 4. Discussion While long used for development of system dynamics models, participatory group model building has not been traditionally applied to agent-based model development. A challenge of doing so is the lack of established boundary objects with which diverse participants can communicate their multi-level system understandings across disciplinary, social, or cultural boundaries. Here, we have described the boundary objects that evolved in the course of the group development of an ABM of health care seeking and delivery. We have proposed a set of drawing conventions for depicting agent decisions and interactions (Table 1). In addition, we learned a number of valuable lessons which may be generalizable for other investigators wishing to apply GMB to ABM: developed another type of boundary object consisting of a two-by-two grid reproduced in Figure 4a. For each of the four scenarios represented by a square on the grid, a member of the modeling team wrote predictions from the group. Figure 4b shows the NetLogo interface for the iteration of the model that was used to test participant predictions. Participants seemed to respond intuitively to the 2x2 table and readily made the connection between the grid used to solicit predictions and the grid displayed on the model interface. 3.4 The model interface as boundary object If boundary objects are artifacts which are changeable by participants and allow participants to communicate their understandings of systems across boundaries of specialized knowledge and experience, the NetLogo model interface itself might be considered a boundary object. Because our model allowed participants to enter their own estimated parameter values using “sliders” (Figure 5 shows the final version of the model created by participants and the core x x 2955 An early boundary object is needed for teaching a group of non-expert stakeholders basic ABM concepts and rules/symbology for communicating through boundary objects To the extent possible, boundary objects and model interfaces should correspond in their x 4a x 4b Figure 4 – a) Boundary object used to elicit participant predictions about outcomes in four different patient groups; b) Corresponding model interface preserving 2x2 structure (health of individuals represented by saturation of color of person figure) x More specific questions led to more valuable input in general and to better adherence with boundary object conventions. We found that even when asked a broad question, groups tended to select a sub-question to answer that often reflected the specific interests of a small number of participants. When asked more specific questions, more energy seemed to have been spent on thinking mechanistically about how some part of the system works. As a concrete example, we asked participants early on in the GMB process to sketch out ways they felt that primary care could make individuals and communities healthier in small groups. Each group chose to address some different aspect of care delivery in their response so that, when the large group reconvened, there was little common ground to discuss. In contrast, we asked in a later session for participants to describe ways in which long-term relationships between providers and patients can improve health. The resulting ideas emerging from small groups were richer in the sorts of complementary detail which enabled the specification of mechanisms within the model. With hands-on exposure, the model graphical user interface itself became an effective boundary object. Unlike the boundary objects used in System Dynamics modeling, the set of boundary objects described here allow the description of system phenomena at both the level of the individual and the level of aggregated groups of heterogeneous individuals. These boundary objects are comprehensive in that they allow description of all the properties, rules, actions, and interactions of agents and environment relevant for an ABM. Yet, they are fairly simple to explain and demonstrate for any group. These boundary objects could prove useful in any design process where it is necessary to elicit ideas about a system from an individual agent perspective. More generally, some of the above insights may be useful for design processes requiring ongoing input from stakeholders with different specialized knowledge. One or more easily and universally understandable artifacts for eliciting tacit knowledge (i.e. boundary object) can help participants maintain a sense of ownership in the process and product. For this to occur, investments must be made by the facilitators. These investments include spending time to teach participants how to use the artifact(s) and physical layout. Doing so seems to minimize the cognitive barriers to participants’ linking the consensus mental models that have been created by the group to the actual simulation models generated. A feeling of group ownership of the model is vital. The group tended to feel a loss of ownership of the model when situations arose which required the modeling team to make decisions about model content which had not been specified by the group via the boundary object. Group ownership was restored in our process by the core modeling team being willing to redo major aspects of the model based on subsequent group input, and by participants gaining hands-on experience with running experiments using the model. 2956 from tools which can themselves serve as boundary objects in the model development process. For instance, a workspace where icons corresponding to symbols such as those in Table 1 could be “drug and dropped” to generate code for simple models of agent actions and interactions could be used live in a group setting to experiment with ideas in real time. Alternatively, such a tool could be used in a distributed group setting for participants to asynchronously “vote” on how they feel a system operates using a constrained process of boundary object modification. The resulting range of conceptual models would realistically reflect the heterogeneous worldviews of a broad group of participants. Still another example could be a utility allowing the creation of functions or distributions based on consensus-generated behavior-over-time graphs. demonstrating a willingness to truly allow participants to drive the process via the artifact(s). 4.1 The model interface as microworld and boundary object Any successful systems model should represent a “microworld” in that it realistically recreates the parts of a system that are relevant to the problem at hand [17-19]. We feel that an additional criterion for success of a group model building effort is that the model itself should serve some role as a boundary object. As a boundary object, the finished model will be transformable by users. The most obvious way to achieve this is through an intuitive interface which allows users to easily customize inputs or scenarios and clearly visualize outputs. Such a product can facilitate boundary-spanning communication within and, later, outside of the modeling group. The agentbased modeling approach, with its individual-centric orientation and explicit recognition of interactions within a responsive environment, is a framework that lends itself to intuitive understanding by non-modelers. Creating models based on stakeholder understanding of systems which are explicable and manipulable by stakeholders has the potential to serve as a powerful aid to dissemination and application by allowing the conversation to continue beyond the model development and formal analysis phases. A robust participatory process for creating and cyclically modifying these models fulfills the design science tenet of artifact informing understanding and understanding informing artifact.[16] 4.2 Implications development for modeling 4.3 Limitations and further work We have shared what we hope are generalizable lessons from a single—and to our knowledge, the first—experience with using a formal participatory group model building approach to develop an agentbased model of a system involving health care delivery system. The conventions and advice we provide will be relevant to many, but not all, scenarios which future modeling teams might encounter in similar efforts. We consider this work a starting point for expanding the scope of what can be achieved with a group model building approach and for re-thinking how agent-based models can be developed. We found the approach fruitful and rewarding as did stakeholder participants. We have no doubt that we finished with a very different, and probably more relevant, model than we would have constructed alone as “experts”. Much work remains in terms of developing better ABM boundary objects and techniques and perhaps integrating these into software packages used in ABM. software The need for effective participatory models to serve as boundary objects obviously suggests that modeling software used should ideally contain tools for creating user-friendly, intuitive model interfaces. A separate implication of our suggestion that boundary objects and model interfaces should correspond in their physical layout is that modeling software may benefit This work was supported by a methodology pilot grant from the Patient Centered Outcomes Research Institute (PCORI). 2957 Figure 5 – Interface for final agent-based model created through participatory group model building process 10. References 1. 2. 3. 4. 5. 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