Wetland, one of the three major ecosystems on earth, can prevent flood, purify water quality and provide habitat for wildlife; also protects the shore line from erosion, and has many other functions and values. Owing to the economic development and the rapid population growth, the land resource has being inadequate to meet all demands. Thus, coastal wetlands have become the target of development. This tendency causes reduction and fragmentary of wetlands, degradation of ecosystem and depletion of ecological resources. To avoid the improper development on the wetland, it is necessary to integrate considerations over the social economy, ecosystem, and management strategy. Based on the unique feature of the wetland, it is therefore possible to effectively manage the wetland resources for achieving the goal of sustainable development. This study explores the group model building approach which design for the discussion of the various potential effects of the yacht industry park may have on Cheting Wetland. Participants of stakeholders in Cheting had met several times and the structured debates had been organized with them in order to promote the emergence of a consensual view of the main issues and their implications. And then, a system dynamic model was built to evaluate the development in the wetlands zone. The authentic results of the policies and scenario analyses inspected the effectiveness of the designate plans for Cheting Wetland development. Particular Wetland Zone, Artificial Floating Island and In Lieu Fee were adopted as management strategies in Cheting Wetland Zone case. The study concludes that: under single-policy condition, implementation of Particular Wetland Zone is the best management strategy; while under the multi-policy conditions, the combination of Wetland Zone and Artificial Floating Island would have the best managerial performance. Additional benefits of the GMB study include: (1) providing stakeholders with information and knowledge to understand the behavior of wetland environment system; (2) A revealing gap between system behavior patterns and participants¡¦ mental model. Both achievements will further promote the participants to introspect and to improve their mental model, eventually help the whole community to reach consensus about wetland management.

With increasingly complex safety-critical systems like healthcare being developed and managed, there is a need for a tool that allows us to understand their complexity, design better strategies and guide effective change. System dynamics (SD) has been widely used in modelling across a range of applications from socio-economic to engineering systems, but its potential has not yet been fully realised as a tool for understanding trade-off dynamics between safety and efficiency in healthcare. SD has the potential to provide balanced and trustworthy insights into strategic decision making. Participatory SD modelling and learning is particularly important in healthcare since problems in healthcare are difficult to comprehend due to complexity, involvement of multiple stakeholders in decision making and fragmented structure of delivery systems. Participatory SD modelling triangulates stakeholder expertise, data and simulation of implementation plans prior to attempting change. It provides decision-makers with an evaluation and learning tool to analyse impacts of changes and determine which input data is most likely to achieve desired outcomes. This thesis aims to examine the feasibility of applying participatory SD modelling approach to safe and efficient staffing level management within hospital pharmacies and to evaluate the utility and usability of participatory SD modelling approach as a learning method. A case study was conducted looking at trade-offs between dispensing backlog (efficiency) and dispensing errors (safety) in a hospital pharmacy dispensary in an English teaching hospital. A participatory modelling approach was employed where the stakeholders from the hospital pharmacy dispensary were engaged in developing an integrated qualitative conceptual model. The model was constructed using focus group sessions with 16 practitioners consisting of labelling and checking practitioners, the literature and hospital pharmacy databases. Based on the conceptual model, a formal quantitative simulation model was then developed using an SD simulation approach, allowing different scenarios and strategies to be identified and tested. Besides the baseline or business as usual scenario, two additional scenarios (hospital winter pressures and various staffing arrangements, interruptions and fatigue) identified by the pharmacist team were simulated and tested using a custom simulation platform (Forio: user-friendly GUI) to enable stakeholders to play out the likely consequences of the intervention scenarios. We carried out focus group-based survey of 21 participants working in the hospital pharmacy dispensaries to evaluate the applicability, utility and usability of how participatory SD enhanced group learning and building of shared vision for problems within the hospital dispensaries. Findings from the simulation illustrate the knock-on impact rework has on dispensing errors, which is often missing from the traditional linear model-based approaches. This potentially downward-spiral knock-on effect makes it more challenging to deal with demand variability, for example, due to hospital winter pressures. The results provide pharmacy management in-depth insights into potential downward-spiral knock-on effects of high workload and potential challenges in dealing with demand variability. Results and simulated scenarios reveal that it is better to have a fixed adequate staff number throughout the day to keep backlog and dispensing errors to a minimum than calling additional staff to combat growing backlog; and that whilst having a significant amount of trainees might be cost efficient, it has a detrimental effect on dispensing errors (safety) as number of rework done to correct the errors increases and contributes to the growing backlog. Finally, capacity depletion initiated by high workload (over 85% of total workload), even in short bursts, has a significant effect on the amount of rework. Evaluative feedback revealed that participatory SD modelling can help support consensus agreement, thus gaining a deeper understanding of the complex interactions in the systems they strive to manage. The model introduced an intervention to pharmacy management by changing their mental models on how hospital winter pressures, various staffing arrangements, interruptions and fatigue affect productivity and safety. Although the outcome of the process is the model as an artefact, we concluded that the main benefit is the significant mental model change on how hospital winter pressures, various staffing arrangements, interruptions and fatigue are interconnected, as derived from participants involvement and their interactions with the GUI scenarios. The research contributes to the advancement of participatory SD modelling approach within healthcare by evaluating its utility and usability as a learning method, which until recently, has been dominated by the linear reductionist approaches. Methodologically, this is one of the few studies to apply participatory SD approach as a modelling tool for understanding trade-offs dynamics between safety and efficiency in healthcare. Practically, this research provides stakeholders and managers, from pharmacists to managers the decision support tools in the form of a GUI-based platform showcasing the integrated conceptual and simulation model for staffing level management in hospital pharmacy.

Institutional and epistemological differences between science and management present a challenge to the implementation of sustainable environmental management. Environmental problems are complex and require at least multidisciplinary, but most effectively transdisciplinary approaches for learning, understanding, decision-making and problem solving. This means building bridges between institutional and epistemological differences. The role of system dynamics modelling in integrating environmental science and management is examined in this thesis. An action research methodology is adopted where, over cycles of case studies, the practical application of system dynamics modelling is evaluated. The role of system dynamics modelling in the management of coastal sand dunes, tourism, threatened species management and water management is explored in the case studies. It has been found that system dynamics modelling is a potentially powerful tool for integrating environmental science and management, principally assisting communication between scientists and management stakeholders. System dynamics group model-building, in particular, has the potential to facilitate stakeholder learning and assist stakeholders to think holistically about the complex systems they are trying to manage. It was also found that engaging stakeholders in system dynamics group model-building process is difficult. A model of factors influencing the adoption of system dynamics group model-building has been developed from this research. The model can be applied to assess the suitability of potential case studies and identify potential weaknesses that need to be addressed if the approach is to succeed.

Institutional and epistemological differences between science and management present a challenge to the implementation of sustainable environmental management. Environmental problems are complex and require at least multidisciplinary, but most effectively transdisciplinary approaches for learning, understanding, decision-making and problem solving. This means building bridges between institutional and epistemological differences. The role of system dynamics modelling in integrating environmental science and management is examined in this thesis. An action research methodology is adopted where, over cycles of case studies, the practical application of system dynamics modelling is evaluated. The role of system dynamics modelling in the management of coastal sand dunes, tourism, threatened species management and water management is explored in the case studies. It has been found that system dynamics modelling is a potentially powerful tool for integrating environmental science and management, principally assisting communication between scientists and management stakeholders. System dynamics group model-building, in particular, has the potential to facilitate stakeholder learning and assist stakeholders to think holistically about the complex systems they are trying to manage. It was also found that engaging stakeholders in system dynamics group model-building process is difficult. A model of factors influencing the adoption of system dynamics group model-building has been developed from this research. The model can be applied to assess the suitability of potential case studies and identify potential weaknesses that need to be addressed if the approach is to succeed.

Indigenous (Métis, First Nation, and Inuit) peoples and communities in Canada, especially in the prairies, continue to experience disproportionate levels of tuberculosis (TB) compared to the rest of the Canadian born population. This inequitable distribution of TB disease burden demands effective policy, program, and practice responses. These have so far failed to materialize, perhaps in part because of limitations in the approaches we have taken to understanding the issue. As well, these responses have largely been grounded in western scientific paradigms. Science is the search and the re-search for knowledge and this varies according to the perspectives and paradigms of the researcher(s) and stakeholders. In this project, the student researcher collaborated with the Métis Nation-Saskatchewan (MN-S) and two volunteer health researchers to adapt and ground a western paradigm and methodology (System Dynamics and Group Model Building) to a Métis research paradigm to understand experiences of tuberculosis (TB) among Métis people. Data collection took place in a 2-day Métis-adapted group model building (GMB) workshop. The outcome is a causal loop diagram with associated stories co-created by the team and the workshop participants. The workshop was evaluated using a storytelling and story listening method that explored the appropriateness of adapting GMB within a Métis research context. The approach was determined to be successful methodologically, and substantively new knowledge was created in our Métis community about the determinants of TB. This research was a journey of diversity, working at the intersection of knowledge systems to produce a new understanding of a health issue as complex as TB.

Although patterns of African American and white women breast cancer incidence and mortality in St. Louis, Missouri is consistent with those seen elsewhere in the United States, rates vary greatly across zip codes within the city of St. Louis. North St. Louis, whose neighborhoods are primarily African American, exhibits rates of breast cancer mortality that are among the highest in the city and higher than the state as a whole. Based on information that up to 50% of women in North St. Louis with a suspicious diagnosis of breast cancer never enter treatment, we conducted three 2-hour group model building sessions with 34 community stakeholders (e.g., breast cancer survivors or family members or caregivers and community support members such as navigators) to identify the reasons why African American women do not begin or delay breast cancer treatment. Participant sessions produced a very rich and dynamic causal loop diagram of the system producing disparities in breast cancer mortality in St. Louis. The diagram includes 8 major subsystems, causal links between system factors, and feedback loops, all of which shed light on treatment delays/initiation. Our work suggests that numerous intersecting factors contribute to not seeking treatment, which in turn may contribute to African American and white disparities in mortality.

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Although patterns of African American and white women breast cancer incidence and mortality in St. Louis, Missouri is consistent with those seen elsewhere in the United States, rates vary greatly across zip codes within the city of St. Louis. North St. Louis, whose neighborhoods are primarily African American, exhibits rates of breast cancer mortality that are among the highest in the city and higher than the state as a whole. Based on information that up to 50% of women in North St. Louis with a suspicious diagnosis of breast cancer never enter treatment, we conducted three 2-hour group model building sessions with 34 community stakeholders (e.g., breast cancer survivors or family members or caregivers and community support members such as navigators) to identify the reasons why African American women do not begin or delay breast cancer treatment. Participant sessions produced a very rich and dynamic causal loop diagram of the system producing disparities in breast cancer mortality in St. Louis. The diagram includes 8 major subsystems, causal links between system factors, and feedback loops, all of which shed light on treatment delays/initiation. Our work suggests that numerous intersecting factors contribute to not seeking treatment, which in turn may contribute to African American and white disparities in mortality.

In this thesis, the central interest is to better understand how participatory methods applied during participatory processes in natural resources management can serve as nuclei for social learning. Thereby, the main focus is on learning via interaction in groups. My approach begins with the aim of developing an analytical framework which reflects the main processes that are effective within participatory methods. The framework presents an analytical tool, including proposed methods to monitor and compare the results of participatory approaches with respect to social learning. Building upon this framework, I develop an agent-based model to simulate and explore group dynamics. This model is intended to support a theoretical exploration of whether or not and if so, at what stage, personal views of a problem evolve into a shared understanding of a problem (which can be seen as a key element of social learning), and an assessment of how individual mental models and group properties relate to each other. Results of the model are interpreted to offer suggestions about factors hindering or fostering social learning during the application of participatory methods.