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The Alchemist and the Magician THE ALCHEMIST AND THE MAGICIAN: QUALITY IMPROVEMENT THROUGH EMPATHY AND LEARNING IN COMPLEX SYSTEMS ____________ A Thesis Presented to the Faculty of California State University, Dominguez Hills ____________ In Partial Fulfillment of the Requirements for the Degree Master of Science in Quality Assurance ____________ by Robert S. Davies Spring 2016 Copyright by ROBERT S. DAVIES 2016 All Rights Reserved This thesis is dedicated to every person that I have learned from. The experience of magic arises through wonder, imagination and revelation. iii ACKNOWLEDGMENTS I would like to thank those who have helped me through this learning process. A great debt of gratitude is owed to my professors Robert Spencer, Dr. Jim Clauson, and William Trappen. Your guidance and support have been instrumental in the development of this thesis. I would also like to thank Dr. Janine Montgomery, Associate Professor and Social Cognition Lab Co-Director at the University of Manitoba who has greatly helped me during my steep learning curve into psychology. It has been a fascinating academic journey. In addition to the CSUDH MSQA department and the University of Manitoba, I would like to thank the College of Medical Laboratory Technologists of Manitoba and the Saskatchewan Society of Medical Laboratory Technologists. I am grateful to both regulatory colleges for supporting this research project. We are a part of all things. iv TABLE OF CONTENTS PAGE COPYRIGHT PAGE…………………………………………………………………........ii DEDICATION …………………………………...……………………………....……….iii ACKNOWLEDGMENTS ……………………....……………...……………...……….... iv TABLE OF CONTENTS ...………………….………………………...………….....….... v LIST OF TABLES……………………………………………………..…….…...……….vii LIST OF FIGURES ………………………………………………………..….….….......viii ABSTRACT ………………….………………………….……………...…....………....... ix CHAPTER 1. INTRODUCTION ............................................................................................................. 1 Background ................................................................................................................ 1 Understanding the Medical Laboratory Workforce ................................................... 2 Asperger’s Syndrome and Autism Spectrum Disorders ............................................ 4 Machiavellianism and Change Management ............................................................. 5 The Machiavellian Change Agent versus the Autistic Process Controller ................ 9 Statement of the Problem ......................................................................................... 14 Purpose of Study ...................................................................................................... 14 Theoretical Bases and Organization ........................................................................ 15 Research Questions and Exploratory Hypotheses ................................................... 16 Limitations of the Study........................................................................................... 19 Definition of Terms.................................................................................................. 24 2. REVIEW OF THE LITERATURE ................................................................................. 27 Dr. Kurt Lewin’s theories on Group Dynamics and Social Change ........................ 27 Dr. Donella Meadows and System Dynamics ......................................................... 30 Dr. Albert Bandura and Social Cognitive Learning Theory .................................... 31 Dr. Robin Dunbar, Primate Behaviour, Language and Social Evolution ................ 33 The Human Brain, Qualia and Consciousness ......................................................... 35 Qualia, Empathy and fMRI Studies ......................................................................... 38 Mirror Neuron Systems and Action Learning ......................................................... 41 The Triadic Adaptive Learning System: An Evolutionary Learning System .......... 48 The Quality Leadership Learning System ............................................................... 64 v CHAPTER PAGE 3. METHODOLOGY .......................................................................................................... 68 Design of the Investigation ...................................................................................... 68 Ethical Approval ...................................................................................................... 69 Sample and Treatment ............................................................................................. 70 4. RESULTS AND DISCUSSION ...................................................................................... 71 Research Questions, Hypotheses, Results Tables and Discussion .......................... 71 Workforce Sample Data Quality Analysis .......................................................... 71 Research Question 1, Hypothesis and Analysis ................................................. 77 Research Question 2, Hypothesis and Analysis .................................................. 77 Research Question 3, Hypothesis and Analysis .................................................. 82 Research Question 4, Hypothesis and Analysis .................................................. 82 Research Question 5, Hypothesis and Analysis .................................................. 82 Research Question 6, Hypothesis and Analysis .................................................. 82 Research Question 7, Hypothesis and Analysis .................................................. 89 Introduction to the Clinical and Laboratory Standards Institute .............................. 95 Quality Leadership in Complex Systems ................................................................. 96 Organizational Commitment to Quality Improvement .......................................... 118 Organizational Learning and Profound Knowledge .............................................. 145 Happy and Healthy Workplace Environments ...................................................... 160 Ethical Leadership and Integral Permaculture ....................................................... 166 5. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS ................................ 173 Summary of Research and Areas for Future Investigation .................................... 173 Symphony of Mind and the Mozart Effect ............................................................ 175 ENDNOTES ...................................................................................................................... 179 REFERENCES .................................................................................................................. 188 APPENDICES ................................................................................................................... 216 A. TALiS, Learning Spaces and Change Management ......................................... 217 B. ASQ Quality Tools and TALiS ......................................................................... 219 C. Design for Six Sigma (DMADV) ...................................................................... 221 D. ISO 9001:2008 Quality Management System ................................................... 223 E. CSUDH IRB Study Approval April, 2014 ........................................................ 225 F. NIH Research Ethics Certificate ........................................................................ 227 G. Change Management Survey ............................................................................ 229 H. Pheromone Image Approval.............................................................................. 254 vi LIST OF TABLES PAGE 1. Studies of the Medical Laboratory Workforce (1983-2009) ............................................ 3 2. Google Scholar Search Hits (April 18, 2015) .................................................................. 10 3. Selected Psychometric Questionnaire Cut-Off (Discriminator) Values .......................... 23 4. Frequency Counts for Selected Variables (n=32) ............................................................ 72 5. Psychometric Characteristics for the Aggregated Scale Scores (n=32)........................... 76 6. Frequency Counts for Criteria Variables (n=32) ............................................................. 78 7. MLT Workforce versus Normal, ASD, Academic and Nursing Groups ......................... 80 8. MLT Workforce Mach-IV Values versus Normative Values .......................................... 81 9. Spearman correlations for the selected variables with AQ and EQ Scales (n=32) .......... 84 10. Spearman correlations for the selected variables with SQ and Mach-IV (n=32) .......... 87 11. Spearman Intercorrelations among the Aggregated Scale Scores (n=32) ..................... 90 12. Google Scholar Word Search May 29, 2015 ............................................................... 105 13. System Traps and Examples in Laboratory Medicine ................................................. 109 14. ASD Research Evidence and Opportunities for Training Supports ............................. 150 15. CLSI Laboratory Design, Ergonomics and HFE Countermeasures ............................ 161 vii LIST OF FIGURES PAGE 1. Autistic and Machiavellian vantage points of a Complex System .................................. 13 2. Customer Experience, Field Theory and Phase Spaces ................................................... 28 3. Bandura's
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