110 | Chapter 5 to a complex problem are charted).19 Another approach to complex problems that fulfils the criteria of systems thinking methodologies is described by the polarity thinkingTM framework. This framework focuses on polarities (also described as paradoxes or interdependent pairs) and offers a step-by-step approach to find a balance in which both poles of the polarity can co-exist.17,18 This paper describes how the polarity thinkingTM framework was applied in order to explore possibilities to manage the tensions that are inextricably linked to multipurpose portfolio use. Methods Reflexivity As described above the system thinking methodologies are characterised by - amongst others - a recognition of multiple perspectives. We believe this aligns with a constructivist paradigm, that acknowledges the social construction of reality. Therefore, we aimed to gather varying perspectives by utilising the different experiences, opinions and knowledge of the research team and including stakeholders with various backgrounds. In concern to the research team differences were amongst others the result of our professional backgrounds - psychology (RG, AT), educational science (BT, SH, MS), health science (SH) and medicine (BT, JM, NS) - and our own involvement with portfolios, as developer (BT, SH, MS), user (AT), or researcher (all authors). Methodological approach As described the polarity thinkingTM framework was selected as it fulfils the criteria of a systems thinking methodology, which was considered suitable due to the complex problems related to multipurpose portfolio use. Central to the polarity thinkingTM framework is the concept of polarities, which encompass different poles of a situation that appear to be in competition with each other, but in fact depend on and need each other to thrive. 17,18,22 Polarities are omnipresent and can for example be found within individuals (inhale vs. exhale), organisations (cost-effectiveness vs. service excellence) or nations (social security vs. self-reliance). Naturally, also medical education comes with polarities, as already shown by Govaerts et al., who outlined and reflected on two polarities of assessment: standardisation vs. authenticity and numbers (quantitative data) vs. words (qualitative data).17 Polarity thinkingTM is based on the observation that tensions between the different poles of a polarity are usually accommodated by solutions that focus on one of the two poles, which are referred to as either-or solutions. However, these types of solutions are generally too simplistic, as they do not take into account the interdependency between the two poles of the polarity. For this reason, polarity thinkingTM suggests that instead of an
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