Better Collaboration Needed Among Nurses and Physicians

The United States faces a looming physician shortage that threatens to deepen once the Affordable Care Act is fully implemented. This is a well-documented issue worried over in policy circles, around the dinner table and within the medical community, and discussed in a recent New York Times Sunday Dialogue. Yet it may be that the physician shortage is just one part of the problem when it comes to the supply of medical professionals in this country.

Nurse-practitioners can provide many medical services, especially in primary care and women’s health, and could therefore help fill the doctor shortage gap. Moreover, as provisions of the Affordable Care Act move forward, nurses will be increasingly called upon to improve care coordination, help reduce medical errors and avoidable rehospitalizations, and improve transitions and handoffs.

However, some research suggests that an existing nurse shortage will grow more acute, both because nursing education programs do not have sufficient capacity and because many nurses are reaching retirement. And relying on nurses to deliver care for less money assumes that nurses should be paid less than doctors.

Furthermore, in the 2010 National Survey of Registered Nurses, only one in ten nurses reported having an excellent relationship with a physician (link opens PDF). In fact, since the survey began in 2002, that figure has never been higher than 11%.

During recent deliberative focus groups with members of the public around the country, we heard many participants talk about their experiences with a lack of coordination among doctors, nurses and pharmacists. Such experiences, they felt, had put their health or their families’ health at risk and cost them money. The groups strongly supported helping medical professionals coordinate care.

The task therefore becomes not only to increase the number of doctors and nurses, but also to empower nurses to work effectively and collaboratively alongside other medical professionals. Such an approach can not only help address the need for more medical professionals but also seems relatively acceptable to members of the public.

Want to learn more about public views toward measures to make health care more cost-effective? Keep an eye on this space, or contact Megan at and we will email you the findings of our research when they are available.

The Rarely Told Story: Pirates as Radical Commoners

Kester Brewin, a teacher of mathematics in South East London, was wondering why his son has been invited to countless pirate-themed birthday parties, but not any aggravated robbery themed parties.  What's the reason for our fascination with pirates?

 Brewin’s answer is an amazing 13-minute video talk  for TEDx Exeter (UK) based on his 2012 book, Mutiny! Why We Love Pirates and How they Can Save Us. The talk is a powerful account of 18th century piracy and a plea for all of us to become pirates as acts of radical emancipation.

For the full effect, I urge you to watch the full video....but here is a key excerpt transcribed from Brewin’s talk:


What I want to propose is that whenever we see pirates, we see a system in some kind of trouble, whether it involves politics, economics, spirituality, culture or the arts.  Pirates send us a signal that something that should be held in the hands of common people, has been taken away.

Now if we look back in history, the golden age of pirates, the early 1700s, we see England, Spain, France and Holland trying to enclose the new world of the Americas into their empires.  At this time we are right at the birth of emerging global capitalism.  The engine of this movement is the ship.  And the petrol in the engines are sailors. 

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Taxation and Accountability: Experimental Evidence for Taxation’s Effect on Citizen Behavior

A paper by Lucy Martin (Yale)

In sub-Saharan Africa, low taxes co-exist with even lower government accountability, seen in high levels of corruption and low public goods provision. While there are existing theories of why taxation might be linked to better governance, many of the microfoundations of this effect remain unclear. I argue that taxation impacts governance by altering the expressive benefit citizens receive from sanctioning corrupt officials, making those who pay taxes more likely to hold leaders accountable. I provide new cross-national evidence that taxation and corruption are linked; I then formalize the theory and test the proposed mechanism using a set of laboratory-in-the-field experiments in Uganda. I find evidence that taxation activates a stronger fairness norm, leading citizens to demand more from leaders. This effect is strongest among adult, wage-earning men – exactly the group who has the most experience, historically, paying taxes in Uganda. I then propose additional tests, to be carried out in 2013, to strengthen and expand my findings.

And a tip for development professionals from the conclusion:

(…) aid professionals should seriously consider the role of formal taxation, as well as more informal community contributions, when designing development interventions. Adding some sort of community contribution to external aid programs could encourage give aid beneciaries more ownership over projects and, this paper suggests, make them more likely to hold local leaders accountable for how development funds are spent.

Read the full paper here [PDF].

The Passionate Localism of the New Cross Commoners

Some of the most interesting new commons are those that you don’t usually hear about, probably because they are so small or local.  I recently stumbled across the New Cross Commoners and was quite impressed with their zeal and ingenuity in exploring the meaning of commoning in their district of South London.  The “About” section of the New Cross Commoners website explains their mission quite nicely:

Capitalism is the term we can use to call the private / public system that dominates not only the economy but also our social relations and our lives. Our desires and efforts for a good life together get exploited by capitalism (see for example “Big Society”). Commoning can be a process of struggle to reclaim those efforts and desires for ourselves. A commoning that is worth of its name, one not entirely exploited by the private / public system, implies a degree of struggle against this private / public system. It also implies a negotiation amongst the people who produce it: we are “privatized” as well, we need to learn how to live together, how to take care of each other collectively.

To understand what is commoning in New Cross we’ll read and discuss texts together, and at the same time we’ll explore the neighbourhood to find out what processes of commoning are already part of the life of New Cross (we’ll start with communal gardens, housing associations, youth and community centres, and the New Cross library). We would like not only to understand the commoning already produced in New Cross, but also to produce new commoning here: to share and organize skills and resources in such a way that this sharing can become more and more autonomous from private / public interests, from the market, from interests that are not those of the people using them.

The New Cross Commoners website is an inspiration to other would-be commoners who may wish to rediscover commoning in their own neighborhoods and towns.  The group has held meetings at which they discuss essays by the commons historians such as Peter Linebaugh; Massimo De Angelis, and Silvia Federici, for example.  They have met together to brew beer and drink it when it was ready. 

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Sustaining the Commons, a Textbook Overview of Ostrom’s Research

For newcomers to the commons wishing to acquaint themselves with Elinor Ostrom’s work, it can be a hard slog.  Her scholarly treatises, while often quite insightful, can be quite dense in delivering their hard research results and refined insights.  It is a real pleasure, therefore, to greet Sustaining the Commons, a new undergraduate textbook that has just been published.  The book provides a general overview of the intellectual framework, concepts and applications of Ostrom’s research on the commons. 

Best of all, in a refreshing departure from most academic publishing, the authors of the 168-page book decided to make it available for free as a downloadable pdf file.  Just go to the book’s website and blog,

Sustaining the Commons is by John M. Anderies and Marco A. Janssen, both associate professors at Arizona State University and directors of the Center for the Study of Institutional Diversity, which is the publisher of the textbook.  Both authors worked with Ostrom from 2000 until her death in 2012.  Although Ostrom’s name is mostly associated with Indiana University, where she co-founded and ran the Workshop on Political Theory and Policy Analysis, Ostrom was also a part-time research professor at ASU from 2006-2012.

Anderies and Janssen taught a course at ASU on Ostrom’s work, with a special focus on her books Governing the Commons (1990) and Understanding Institutional Diversity (2005).  Out of that teaching arose the idea for this book.  Ostrom herself saw and approved of the first draft of the book in April 2012, shortly before her death. 

The book is a lucid, logically presented introduction to the key concepts of Ostrom’s research.  There are chapters on “defining institutions,” “action arenas and action situations,” and “social dilemmas.”  There are also a series of case studies on the management of various types of common-pool resources – water, forests, domesticated animals – and a review of “design principles to sustain the commons.”  

There are a number of chapters on human behavior as it is studied by social science.  How do people make decisions about collective matters and how do they develop trust?  How are these behaviors studied in the laboratory?  What sorts of rules and social norms matter? 

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Civic Leaders: Inspiring Engagement and Empowering Communities

"Once the light goes on about civic engagement – once you understand what your power is – it never goes out, and that is what we're counting on."

Often, people do not believe that they can make a difference when it comes to the decisions that shape their communities. But, when they are shown otherwise, many are ready to jump on the chance to get involved.

This is what we heard from the heads of twenty California nonprofits that organize and advocate in traditionally disenfranchised communities – immigrant, poor, and minority. We spoke to these civic leaders about their efforts to improve the public’s voice in government for our recent project on civic engagement in California.

Community members often don’t consider that they can solve the problems they see around them by organizing and engaging with government.

"They definitely are aware that, for instance, they don’t have a park in their neighborhood. … What they’re not aware of is the systemic change that’s possible. They might think, 'Oh, well, I could drive across town to the park.' That’s how they might think of solving the problem on an individual basis. Because they haven’t had the involvement and the training in thinking systematically."

Civic leaders tell us that immigrant communities often have preconceived notions about what they cannot do or change based on political cultures in their home countries, along with trepidation about engaging with a foreign system. Meanwhile, native-born individuals often assume that efforts to address local problems through government just don’t go anywhere, and that time is better spent on other pursuits.

These “myths and taboos” must be confronted to “demystify” engagement before nonprofits can begin teaching community members about the practical side of engaging with government, civic leaders told us.

Some civic leaders' organizations host small group discussions with locals concerned about a particular issue. Others told us that sharing “small victories” often does the trick.

"[We] create the space for them to experience change and experience a win. Oftentimes inviting that person … to a community forum with the decision-maker, where the decision-maker agrees to something, or inviting them to a … ribbon-cutting ceremony of a wellness center that we just won at a school in their neighborhood will help move that individual who doesn’t believe that people are willing to listen and that their voice doesn’t matter."

“Once the Light Goes On” – Generating Leadership Through Engagement

In engaging people who often assume they are not factored into government decision-making, civic leaders and their organizations bring voices to the table that were not previously there. These voices have valuable perspectives and – perhaps most importantly – are often the only ones who know about or understand the particular problems facing their neighborhoods, towns, cities and communities.

Perhaps the most common benefit of awakening the civic impulse, a number of leaders told us, is its potential to produce new, dedicated civic and community leaders, and even public officials.

"[Our organization] has put out literally hundreds of leaders, and they are on city councils. They are on boards and commissions. … We trained them on the importance of civic engagement, on the importance of economic policy and on healthcare policy … and how they could get along with their colleagues and how they work with the city."

Civic leaders are counting on the power of positive experiences with civic engagement to keep community members involved– and to show them, especially those inspired to lead, that neighborhoods, towns and cities are made better by greater public involvement in government.

Read more from our interviews with the heads of nonprofits working with traditionally disenfranchised communities, and from our statewide survey of over five hundred civic leaders, in our new report, “Beyond Business As Usual: Leaders of California's Civic Organizations Seek New Ways to Engage the Public in Local Governance.” Also, take a look at our other report on the state of civic engagement in California, “Testing the Waters: California's Local Officials Experiment with New Ways to Engage the Public.”

Quotes were recorded from in-depth interviews with leaders of organizations that engage traditionally disenfranchised communities. Read more on the Methodology here.

Does transparency lead to trust? Some evidence on the subject.

As open government gains traction in the international agenda, it is increasingly common to come across statements that assume a causal relationship in which transparency leads to trust in government. But to what extent are claims that transparency leads to trust backed up by evidence?

Judging from some recent publications on the subject, such a relationship is not as straightforward as sadvocates would like. In fact, in a number of cases, the evidence points in another direction: that is, transparency may ultimately decrease trust.

Below is a brief overview of research that has been carried out on the subject:

Transparency has been trumpeted by many as the key to trust in government. The assumption is that if government organisations open up and show the public what decisions are made, how they are made and what the results are, people will automatically have more trust in government. But does transparency really lead to more trust? Or will it only provide critical citizens with more information to blame government again and again for small mistakes? Transparency and Trustexamines the effects of transparency on trust in a government organisation. By using an experimental method this study moves beyond normative or correlational research on transparency. In doing so, causal inferences regarding the relation between transparency and trust are allowed. Several objects of transparency and dimensions of information are being put to the test in three experiments. The experiments show that transparency is merely a ‘hygiene factor’: it does not contribute to higher levels of trust and it can even lead to lower levels of trust if people are disappointed with the degree to which government is transparent. This conclusion challenges current overly optimistic assumptions concerning the effect of transparency on trust.

Building on the notion of transparency as a strong democratic value and theories of procedural justice, this article reports an explorative experimental test whether transparency in decision making may lead to increased perceived legitimacy in terms of decision acceptance and trust. This is done in a context of difficult decisions of high importance for citizens – namely priority setting in public health care. An experiment was designed in which ordinary citizens were presented with a description of a case of priority setting between two groups with different health care needs. One group was given no information at all on the decision-making procedure, as an example of non-transparent decision making, and six groups were presented with different descriptions of the decision-making procedure, as examples of transparency in decision making. The transparent procedures were derived from three basic forms of democratic decision making: representation, direct participation and expert decision making. A second manipulation framed the decision-making procedure alternatively in positive or negative terms in order to capture media framing effects as well. According to the findings of the study, transparent decision-making procedures tend to weaken rather than strengthen general trust in health care – a finding that might reveal obstacles to attempts to strengthen the legitimacy of health care by employing transparent procedures. The results also show that while the form of decision making had no significant impact on perceived legitimacy, positive or negative framing of a decision-making procedure influences public perceptions of both the procedure and the decision outcome.

Of course, the impact of transparency on trust may vary according to the context:

 Transparency is considered a key value for trustworthy governments. However, the effect of transparency on citizens’ trust across national cultures is overlooked in current research. This article compares the effect of transparency on trust in government in the Netherlands and South Korea. The effect is investigated in two similar series of three experiments. The authors hypothesize that the effect of transparency differs because the countries have different cultural values regarding power distance and short- and long-term orientation. Results reveal similar patterns in both countries: transparency has a subdued and sometimes negative effect on trust in government. However, the negative effect in South Korea is much stronger. The difference in the magnitude of transparency’s effect suggests that national cultural values play a significant role in how people perceive and appreciate government transparency.

But some evidence goes even further, suggesting that transparency may have a demobilizing effect on citizens. And, if context matters, such a demobilizing effect might be particularly strong in the context of developing countries:

International organizations, policy experts, and nongovernmental organizations promote greater governmental transparency as a crucial reform to enhance accountability and curb corruption. Transparency is predicted to deter corruption in part by expanding the possibilities for public or societal accountability, that is, for citizens and citizens associations to monitor, scrutinize, and act to hold public office holders to account. Although the societal accountability mechanism linking transparency and good government is often implied, it builds on a number of assumptions seldom examined empirically. This article unpacks the assumptions of principal-agent theories of accountability and suggests that the logic of collective action can be used to understand why exposure of egregious and endemic corruption may instead demobilize the demos (i.e., resignation) rather than enhance accountability (i.e., indignation). We explore these theoretical contentions and examine how transparency affects three indicators of indignations versus resignation—institutional trust, political involvement, and political interest—given different levels of corruption. The empirical analyses confirm that an increase in transparency in highly corrupt countries tends to breed resignation rather than indignation.

Democratic theory often assumes that offering more information to voters will enhance electoral accountability. However, it is unclear whether corruption information translates into higher political participation and increased support for challengers. For example, information on corruption could lower the utility one gets from participating in elections at all. We provide experimental evidence that such information not only decreases incumbent support in local elections in Mexico, but also decreases voter turnout and challengers’ votes, as well as erodes partisan attachments. Our results suggest that while information clearly is necessary to improve accountability, corruption information is not necessarily suficient, since voters may respond to it by withdrawing from the political process.

Surely, transparency remains an essential – although quite insufficient – ingredient of accountability. On the trust issue, one could easily think of a number of scenarios in which it is actually better that citizens do not trust their governments. In fact, systems of checks and balances and oversight institutions are not specifically conceived under the logic of trust. Quite on the contrary, such institutional designs assume some level of suspicion vis-à-vis governments: as put in the Federalist Paper No. 51, “If angels were to govern men, neither external nor internal controls on government would be necessary.”

Granted, in some cases a perfect world in which citizens trust their governments may well be desirable. It may even be that transparency leads – in the long run – to increased trust: a great way to sell transparency to governments. But if we want to walk the talk of evidence-based policymaking, we may consider dropping the trust rhetoric. At least for now.

Open Government, Feedback Loops, and Semantic Extravaganza

Tom Steinberg recently brought up one of the most important issues for those working at the intersection of technology and governance. It refers to the deficit/surplus of words to describe the “field” (I call it field in the absence of a better word) :

(…) what primary movement or sector is mySociety part of? Or Avaaz? Or Kiva? Or Wikileaks? When I ask myself these questions, no obvious words or names race quickly or clearly to mind. There is a gap – or at best quite a bit of fuzziness – where the labels should go.

This lack of good labels should surprise us because these groups definitely have aims and goals, normally explicit. Also, it is unusual because social and political movements tend to be quite good at developing names and sticking to them.

I personally have witnessed the creation of a number of names, including e-democracy, e-participation, e-governance, government 2.0, and open government. While some may argue that these names are different among themselves, no real consensus exists about what differentiates them. The common denominator is some fuzzy notion that technology may promote more democratic and/or efficient forms of government.

But why the absence of stable terms and the profusion of neologisms? And what are the implications?

The appeal to novelty (argumentum ad novitatem), which asserts that something is superior because of its newness, seems to be one of the reasons behind the constant reinvention of terms. Indeed, adhering to such a logical fallacy might be particularly tempting for the technology community, where new solutions tend to be an improvement over older ones. On top of that, some technological millennialism does not hurt. After all, a constant of humankind is our inclination to think we are living unique moments. Coming up with new names partially fulfils our natural desire to belong to a special moment in history.

But coming up with new terms also allows for “semantic plasticity”, which enables those who use the terms to expand and contract their meanings according to their needs. Take the example of the term “open government data” and its ambiguous meanings: sometimes it is about accountability, sometimes it is about service delivery, other times it is both. Such ambiguity, some might claim, is opportunistic. It creates a larger consumer base that does not only include governments interested in openness as a democratic good, but also less democratically inclined governments who may enjoy the label of “openness” by publishing data that have little to do with accountability. Malleable terms attract larger audiences.

Moreover, new terms (or assigning new meanings to existing ones) also provides additional market entry-points. While it may take 10,000 hours of deliberate practice to become an expert at something, it only takes a few tweets to qualify as a new Gov 2.0 “guru”, an open government “thinker”.

But Tom Steinberg hits the nail on the head when describing why the profusion of names and their terminological inconsistency is problematic:

And this worries me because consistent names help causes to persist over time. If the field of AIDS research had been renamed every 6 months, could it have lasted as it did? Flighty, narrowly used language confuses supporters, prevents focus and is generally the enemy of long term success.

Indeed, the lack of terminological consistency in the field is a major obstacle to cumulative learning. And  worse, this problem goes beyond the name for “the field” as a whole, also affecting practices that are part of that very field.

As an illustration, recently some people from the development/opengov worlds have started to unrestrainedly employ the term “feedback loop”. While the understanding around the term (in its latest usage) is imprecise, it normally alludes to an idea of citizen engagement followed by some kind of responsiveness. If there is a reason for the use of the term “feedback loop” in the context of citizen engagement, no serious effort has been made to explain what it is. A term is thus assigned a new meaning to describe things that have been largely studied by others under different names.

I myself haven’t resisted and have used the term a couple of times, but this is not free from implications. For instance, Nathaniel Heller, is a prominent and astute voice in the international Open Government space. Recently, Nathaniel wrote a blog post asking “Is There a Case Against Citizen Feedback Loops”. To date, his post goes unanswered. But had he asked for instance about “the case against (or for) citizen engagement”, I believe a productive conversation could have ensued, based on a couple of thousands of years of knowledge on the matter. But the language defines the audience, and the use of terms like feedback loops reduces the odds of engaging in a  conversation with those who hold relevant expertise.

The major problem with this semantic extravaganza relates to the extent to which it blocks  the connection with existing knowledge. As new terms come up, the “field” starts, again, to be considered as a new one.  And the fact that the majority is unaware of evidence that may exist under other terminology leads to a collective illusion that the evidence does not exist. Then, the “we know very little” sentence starts to be repeated ad nauseam, opening the floodgates to all kinds of half-baked hypotheses (usually masked as “theory of change”) and unbridled calls for “evidence”.

Questions that have been asked in the past, and that have been answered either entirely or partially, re-emerge as if they were new ones. The process of answering these new questions starts again from zero. With neologisms, so dear to those working in “the field”, comes what they claim to despise the most: the re-invention of the wheel.

And these calls for “evidence” are undermined by their very lack of terminological and conceptual consistency – and disinterest in existing knowledge. To further complicate things, researchers and scholars who could potentially debunk the novelty myth may lack incentives to do so, as with the novelty narrative comes the prospect for increased visibility and funding.

But an immediate way out of such a situation seems unlikely. An embargo on the creation of new terms – or assigning new meanings to existing ones – would be neither enforceable nor productive, let alone democratic. Maybe the same would be true for attempting to establish a broad convention around a common vocabulary. But recognition by those working in the field that the individual incentives for such a terminological carnival may be offset by the collective benefits of a more consistent and accurate vocabulary would be a first step.

In the meantime, a minimal willingness to connect with existing knowledge would help a lot, to say the least.

Citizen Engagement Improves Access to Public Goods in Mexico

A paper recently published in World Development brings new and fascinating evidence from Mexico of the impact of participatory governance mechanisms on access to services.

Below are a few excerpts from the paper by Diaz-Cayeros, Malagoni, and Ruiz-Euler “Traditional Governance, Citizen Engagement, and Local Public Goods: Evidence from Mexico” (emphasis are mine):

The goal of this paper is to assess the effects of traditional governance on local public good provision. We ask whether poor indigenous communities are better off by choosing to govern themselves through “traditional” customary law and participatory democracy, versus delegating decisions concerning the provision of public goods to “modern” forms of representative government, structured through political parties. This is a crucial question for developing countries seeking to enhance accountability, and a central problem in the theory of participatory democracy.

Our research design takes advantage of an important institutional innovation in the state of Oaxaca, Mexico, that in 1995 allowed indigenous communities to choose their forms of governance. The reform gave full legal standing to a form of traditional indigenous governance called usos y costumbres (usos hereafter), which entails electing individuals to leadership positions through customary law in non-partisan elections, making decisions through participatory democracy, and monitoring compliance through a parallel (and often informal) system of law enforcement and community justice. If they did not choose usos, municipalities could opt instead for party governance, which entails the selection of municipal authorities through electoral competition among political parties and the adjudication of conflicts only through the formal institutional channels, namely the state and federal judiciary.


Our results show that electricity provision increased faster in those municipalities governed by usos. They also suggest that traditional governance may improve the provision of education and sewerage. With respect to citizen engagement and elite capture, contrary to existing scholarly work, we find no evidence of entrenchment of local bosses (caciques) associated with the former ruling party, the Institutional Revolutionary party (PRI) in places ruled by usos. Our findings suggest that traditional participatory forms of governance do not handicap democratic development. Furthermore, municipalities governed by usos are more likely to hold open council meetings allowing citizens to participate in decisionmaking processes. We attribute better public goods coverage to differences in local governance and collective decisionmaking practices. We suggest three specific channels through which traditional governance affects local public good provision: the social embeddedness of municipal presidents, broader civic engagement in collective-decision making, and credible social sanctions. We argue that traditional governance practices (which include in our setting decision-making through direct participatory practices, the obligation to provide services for the community, and the establishment of a parallel system of justice), allow poor communities to better hold their political leaders accountable, prevent elite capture, and monitor and sanction non-cooperative behavior.


Systems of governance based on electoral competition among political parties differ essentially from usos because decisions are taken by politicians without an ongoing process of consultation with the citizenry. The monitoring and sanctioning dynamics that come into play when citizens gather in public assemblies are usually absent in party-run municipalities, and thus the allocation of resources for public goods seems sub-optimal.


Differences between the two types of governance that we presented in the paper point to a broader discussion of the organization of democracy. The delegated format of decision-making in electoral democracies dominated by political parties seems to bear a higher risk of agency loss than deliberative decision-making of what is often referred to as participatory democracy. (…) there are lessons to be extracted from the fact that, with regard to the provision of some basic services, a non-partisan political arrangement presented some advantages over the widespread electoral and party-based democratic organization. Participation and collective monitoring of authority are hugely important to maximize collective well-being.

Read the full paper here [PDF].


A 21st Century Freedom Movement

By: Harry Boyte and Jen Nelson

What do 21st century freedom movements look like?

There are still tyrannies where oppressors have a face and name. But the more difficult freedom struggles of our time may be those involving patterns of control animated by good intentions, clothed in the garb of science. High stakes testing, government regulations on sugar contents in food, and an ever-expanding number of other areas in which experts direct, or more gently "nudge" in the phrase of former Obama adviser Cass Sunstein, are cases in point.

Public Achievement in Fridley Middle School, just north of Minneapolis, offers a striking example of a freedom movement transforming subtle domination. In a Federal Setting III program, Project Star, "citizen teachers" Michael Ricci and Alissa Blood have changed special education into an empowering learning environment.


Michael Ricci and Alissa Blood

Kids take the lead in designing their own learning, built around largely self-directed public work projects of their own choosing. In the process, students labeled "EBD," subject to what are called "Emotional and Behavior Disorders," and "OHD," or "Other Health Disabilities," have become community leaders. "In all the other classes, the teachers tell you what to do," says 7th grader Whitney, in a video about Fridley Public Achievement called "Real Power." "In PA, the teacher says okay, what do you want to do?"

According to the Wikipedia definition, special education is designed for "the education of students with special needs in a way that addresses the students' individual differences and needs." Students with "OHD" are also in the Project Star because of behaviors that often interrupt the general education classroom.

The problem, as the Wiki definition of "EBD" also notes, is that "both general definitions as well as concrete diagnosis of EBD may be controversial as the observed behavior may depend on many factors."

Put differently, is the "problem" the kids or their environment? "The kids in our special education classroom weren't successful in mainstream classrooms, where the format has been the same for the last 100 years," explains Ricci. "The world has changed, but the classroom is pretty much the same."

Susan O'Connor, director of the Special Education graduate program at Augsburg College, wanted to try something different. "Special Education generally still uses a medical model, based on how to fix kids," she said. Working with Dennis Donovan, national organizer for Public Achievement with the Center for Democracy and Citizenship, O'Connor and other faculty and graduate students at Augsburg partnered with Ricci and Blood, graduates of their program, to design an alternative.

They created an experimental adaptation of the youth civic empowerment and education initiative called Public Achievement. Public Achievement was founded in 1990 by Harry Boyte as a contemporary version of the Citizenship Education Program (CEP) during the civil rights movement, which had shaped him as a college student. CEP taught African-Americans, and some poor whites as well, skills and concepts of constructive change. The experiences had often dramatic impact on identity, shifting people from victim-hood to agents of change and civic role models for the nation.

In Public Achievement, young people learn the skills, concepts and methods of empowering public work. They work as teams guided by coaches, who may be young adults, college students, or teachers. Coaches help guide the work but do not dominate. They also are highly attentive to the development of young people's public skills and capacities. The initiative has spread widely, now used in schools, colleges, and communities in the United States and many other societies, including Poland, the West Bank and Gaza, Israel, and Northern Ireland.

Both Ricci and Blood believed that an approach which gives students the chance to take leadership in designing their own learning was worth a try. "The idea of trying something different that might give school a purpose for our kids just made sense," Blood explained. Public Achievement offered resources.

In the self-contained Project Star classroom, where the primary concern is to teach students strategies that help them manage disruptive behaviors that interfere with learning in school, there is latitude for innovation. "More evidence would be needed [in a mainstream classroom] to allow us to go to the level we did, where we turned Public Achievement into a core part of the curriculum," Blood described.

As a result of the PA experiment, Setting III students who in many schools are confined to their classes became public leaders. They built relationships and received recognition not simply in the school, but also in the larger Fridley community.

Their Public Achievement work brought them into contact with school administrators, community leaders, elected officials, and at times media outlets like the local paper and Minnesota Public Radio. Kids once labeled "problem students" are becoming known as "problem solvers."

The PA approach also transformed the work of Ricci and Blood.

"My role is not to fix things for the kids but to say, 'this is your class, your mission. How are you going to do the work? Our main task is to remind them, to guide them, not to tell them what to do," explains Ricci.

The teachers became partners with their students, who choose the issues and learn how to work to address them effectively. Issues this last year included rewriting the school's bullying policy, hosting a district wide "Kindness Week" to reduce bullying, making murals to motivate peers to get exercise, visiting children in hospital waiting rooms, and educating the public about misconceptions regarding Pit Bulls.

Such work creates multiple opportunities for students to develop academically if teachers are intentional about making the connections. Students compose well-written letters to seek permission from the principal for a project. They use math to figure out what scale their mural will be so they know how much wall space they need.

Teachers also change -- from "teaching to the test," to working alongside young people as they develop. Their curriculum builds citizenship skills and habits such as negotiation, compromise, initiative, planning, organizing, and public speaking. It also develops what Blood calls "a public professional persona."

Both teachers are convinced that these skills, habits, and civic identity will serve the students well throughout life.

The change in the young people, eloquently described in their own words in the "Real Power" video, is inspiring. So is the new model of "citizen teacher" which Michael Ricci and Alissa Blood are pioneering.

In an educational environment today where teachers feel powerless, they are forging an alternative in which educators reclaim teaching as a great civic vocation. They are also helping to create a freedom movement not only for the students but for themselves, in which teachers and students are agents and architects, not objects, of educational reform.

Harry Boyte is Director of the Center for Democracy and Citizenship at Augsburg College and a Senior Fellow at the University of Minnesota's Humphrey School of Public Affairs. Jennifer Nelson is Producer and Director of "Real Power," and a graduate student in public policy at the Humphrey School of Public Affairs.