Automatically Smarter
Nudging and Knowledge Translation (A Primer)
By Patrick Faucher
Editor’s Note: What’s in a name? Two years ago, we named this blog KnowledgeNUDGE — today, we begin examining the art of the ‘nudge’, and its implications for knowledge translation (KT). This is the first in a series of posts that will explore nudging and design thinking, exciting new frontiers in KT.
As a communications strategist, I’ve always been interested in social and cognitive psychology and behavioural economics. What motivates people to do what they do? How can we help people make optimal choices — for their health, the environment, and the community — while preserving their right to choose? And how can we do all of this without breaking the bank?
Enter the art of nudging — implementing low-cost innovations to choice architecture to influence behaviour without coercion.
In their influential book Nudge: Improving Decisions About Health, Wealth, and Happiness, University of Chicago economist Richard H. Thaler (recently awarded the Nobel Prize in Economics) and Harvard Law Professor Cass R. Sunstein explain that we rarely behave like members of homo economicus (also known as econs) — the perfectly rational decision makers described in so many economics textbooks.
We simply don’t have the time, awareness, knowledge, or desire to consciously reflect on every decision we make. Many interventions created to influence behaviour assume — somewhat falsely — that people will behave like econs so long as they are provided with all the information needed to make an informed choice (we’re looking at you, health pamphlets).
Instead of acting like econs and using a deliberate approach to decision-making (our ‘Reflective System’), we more often rely on our rapid, instinctive, and imperfect ‘Automatic System’ to complete most tasks — considered imperfect because our instincts are flawed by biases, heuristics, and fallacies.
Acknowledging the limitations of our Automatic Systems (and how much we rely on them), Thaler and Sunstein highlight the role of choice architects (or ‘nudgers’) in helping people to make optimal choices without limiting their ability to act ‘sub-optimally’, if they so choose. They also acknowledge the quandary of deciding what constitutes an ‘optimal’ choice — an area in which patient and public engagement could offer value in helping decision-makers determine what should be considered ‘optimal’ (which isn’t always directly correlated with health outcomes).
“A simple example of a nudge would be placing healthy foods in a school cafeteria at eye level, while putting less healthy junk food in harder-to-reach places. Individuals are not actually prevented from eating whatever they want, but arranging the food choices that way causes people to eat less junk food and more healthy food.” - https://en.wikipedia.org/wiki/Nudge_(book)
It’s important to note that regardless of how the food is arranged, the person arranging the food is acting as a choice architect, whether they mean to or not, even if they choose to simply leave things as they are.
The implications of nudging are wide-ranging, from helping to increase organ donation rates and retirement savings, to reducing spillage at men’s urinals. It’s an exceptional yet under-utilized instrument in the KT/mobilization/implementation toolbox.
We’ve recently applied nudging tactics at the George and Fay Yee Centre for Healthcare Innovation (CHI) to support initiatives like Choosing Wisely Manitoba (by altering the default option on forms) and the Optimizing Colonoscopy Project (through the deliberate choice of messenger). We’ll deconstruct these and other nudges in a later post.
I’ve been encouraged by webinars from others applying nudge theory in their KT-related work, including:
- Behaviour Sciences 101: How Behavioural Insights Can Help Reduce Unnecessary Care, by Dr. Meera Paleja (from the Ontario Behavioural Insights Unit) on behalf of Choosing Wisely Talks, and
- Expanding the KMb Toolkit: Nudging your way to lasting behaviour change by Dr. Travis Sztainert (an Ontario Knowledge Broker) on behalf of the Knowledge Into Practice Learning (KIPL) Network.
In future posts, I hope to introduce our readers to some of the tools, concepts, frameworks, and real-world examples of nudging. Until then, if any of this has sparked your interest in the art of the nudge, please watch the webinars above, or pick up the book, Nudge.
About the Author
Patrick Faucher is the Creative & Strategic Services Lead at CHI. A communications strategist with over 10 years experience, he specializes in creating content engineered to build awareness, understanding, engagement, and adoption through an approach rooted in design thinking (rapid prototyping) and behavioural insights (nudging).
