There Will Always be a Bottleneck

Bringing industrial processes such as lean thinking, six sigma, and the theory of constraints to health problem-solving, Terry Young et al share this viewpoint:

“An interesting strategic perspective is that there will always be a bottleneck; the decision is where you want it. The idea of designing a system with the bottleneck placed where it can best be managed or responded to is powerful”. — T. Young

Similarly, for  Joan Middendorf and David Pace’s Decoding the Disciplines, strategically identifying and applying bottleneck resolution to curriculum design offers opportunities for unpacking the expertise of discipline literacy.  Middendorf and Pace identify seven bottlenecks which provide a general framework within which to systematically increase learning across a course:

Identify Bottlenecks. Where in a course are significant numbers of students  having difficulty mastering basic material?

Define the processes that students need to  master to get past the bottlenecks. What would  experts in the field or advanced students do to get past the bottleneck?

Model these processes. How can these steps be made clearly visible to students?

Create  opportunities to practice these processes and to get feedback on them. How can each of  the steps identified be captured in specific assignments or exercises?

Motivate students to move through these  processes. What emotional  obstacles interfere with this learning and how can they be minimized?

Assess student mastery of these processes. How can we know the extent to which these interventions have been  successful?

Share what has been learned. What has been discovered  in this process and how can they be most effectively shared with others?


Young et al, Using Industrial Processes to Improve Patient Care

Decoding the Disciplines

Identifying bottlenecks to learning in History courses

The History  Learning Project: A Department “Decodes” Its Students.