Flexible study processes in ‘knotty’ system dynamics projects.

System dynamics is generally selected as an analytical approach because it is believed to be particularly good with complex issues both in terms of the core model and the environment. The SD literature devotes considerable space to study and intervention processes, often suggesting general models, protocols or procedures that have worked in specific applications or a range of similar applications. This paper describes an ongoing project in which a complex system operates within a complex and fast-changing environment with major and overlapping organizational changes, a wide and diverse set of stakeholders and difficult national political agendas. The project concerns the nature of ‘quality and effective training’ for junior doctors in the UK against the backdrop of major changes in working hours and conditions driven by national safety concerns and the overarching requirements of the EU Working Time Directive. Early models are already yielding valuable insights for those at a large teaching hospital wrestling with the seemingly impossible task of maintaining levels and quality of both doctor training and service to patients. However, the study is also highlighting that in such high-complexity the study process itself can be problematic. This paper considers the issues raised and relates them to the literature on model-based interventions and concludes that flexible and adaptive processes are needed to effectively manage such ‘knotty’ projects. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]