Accounting for complexity in medical education: a model of adaptive behaviour in medicine.
Context: Medicine is practised in complex systems. Physicians engage in clinical and operational problems that are dynamic and lack full transparency. As a consequence, the behaviour of medical systems and diseases is often unpredictable. Medical science has equipped physicians with powerful tools t...
| Published in: | Medical Education Vol. 53; no. 9; pp. 861 - 874 |
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| Format: | tables/charts Journal Article |
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Wiley-Blackwell
Sep2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138089126&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138089126 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03080110 ESF jtl: Medical Education issn: 03080110 maglogo: Y pubinfo: dt: Sep2019 vid: 53 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 138089126 138089126 138089126 10.1111/medu.13905 138089126 ppf: 861 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Accounting for complexity in medical education: a model of adaptive behaviour in medicine. aug: au: Woodruff, James N affil: Department of Medicine, The University of Chicago, Chicago Illinois, USA sug: subj: Education, Medical Adaptation, Psychological Models, Theoretical Medical Practice Professional Development Problem Solving Knowledge Technology Conceptual Framework ab: Context: Medicine is practised in complex systems. Physicians engage in clinical and operational problems that are dynamic and lack full transparency. As a consequence, the behaviour of medical systems and diseases is often unpredictable. Medical science has equipped physicians with powerful tools to favourably impact health, but a reductionist approach alone is insufficient to optimally address the complex challenges posed by illness and public health. Concepts from complexity science, such as continuous quality improvement and teamwork, strive to fill the gap between biomedical knowledge and the realities of practice. However, the superficial treatment of these systems‐thinking concepts in medical education has distorted their implementation and undermined their impact. 'Systems thinking' has been conflated with 'systematic thinking'; concepts which are adaptive in nature are being taught as standardised, reductionist tools. Methods: Using concepts from complexity science, the history of science and psychology, this problem is outlined and a theoretical model of professional development is proposed. Results: This model proposes that complex problem solving and adaptive behaviour, not technical expertise, are distinguishing features of professionalism. Discussion: The impact of this model on our understanding of physician autonomy, professionalism, teamwork and continuous quality improvement is discussed. This model has significant implications for the structure and content of medical education. Strategies for enhancing medical training, including interventions in recruitment, the curriculum and evaluation, are reviewed. Such adjustments would prepare trainees to more effectively utilise biomedical knowledge and tools in the complex high‐stakes reality of medical practice. Woodruff uses complexity science and psychology to argue that complex problem solving and adaptive behavior, not technical knowledge, are the distinguishing features of the medical professional. pubtype: Academic Journal doctype: tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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