SACME Virtual Journal Club September 2021

CPD and Complexity: Learning in healthcare systems
Thursday, September 30, 2021, 3:00 - 4:00 PM CT

Health professionals live and work in the healthcare system, and this system is magnificently complex. This means that outcomes of the system are driven by those within the system or engaging with the system, as well the relationships and interactions experienced within and external to the system. Concepts of systems and complexity matter to CPD. Health and education are complex, and CPD is the coupling of health and education systems. While at times we view issues within health and education as singular, solvable, or predictable:

(Identified need + educational intervention = need met/problem solved),

perhaps we need to consider a nonlinear aspect to CPD as well. The description above works well when CPD is based on acquiring known best practices; however, perhaps the health care system needs CPD to grapple with uncertainty and support the development of next practices for health professionals as well.

Questions for discussion:

• How can we structure CPD to promote the acquisition of known best practices as well as support the development of next practices?
• Extending data sources to include art in addition to words and numbers mirrors how medicine is both art and science. How can arts-based data inform pedagogical approaches in HPE?
• How can conceptualizing CPD as a complex adaptive system inform our practice, as either educators, clinicians, or both?

Presenter

Strategic Advisor, Center for Continuing Medical Education
Stanford University School of Medicine

Recommended Reading

Main References:

• Fraser SW, Greenhalgh T. Coping with complexity: educating for capability. BMJ. 2001;323(7316):799-803. doi:10.1136/bmj.323.7316.799
  Link: Coping with complexity: educating for capability - PubMed (nih.gov)

• Cordovani L, Wong A, Monteiro S. Maintenance of certification for practicing physicians: a review of current challenges and considerations. Can Med Educ J. 2020;11(1):e70-e80. Published 2020 Mar 16. doi:10.36834/cmej.53065
  Link: Maintenance of certification for practicing physicians: a review of current challenges and considerations - PubMed (nih.gov)

• Molinaro ML, Cheng A, Cristancho S, LaDonna K. Drawing on experience: exploring the pedagogical possibilities of using rich pictures in health professions education [published online ahead of print, 2021 Jun 21]. Adv Health Sci Educ Theory Pract. 2021;10.1007/s10459-021-10056-9. doi:10.1007/s10459-021-10056-9
  Link: Drawing on experience: exploring the pedagogical possibilities of using rich pictures in health professions education - PubMed (nih.gov)

Supporting References:

• Cristancho SM, Bidinosti SJ, Lingard LA, Novick RJ, Ott MC, Forbes TL. What’s Behind the Scenes? Exploring the Unspoken Dimensions of Complex and Challenging Surgical Situations. Academic Medicine. 2014;89(11):1540-1547. doi:10.1097/acm.0000000000000478
  Link: What’s Behind the Scenes? Exploring the Unspoken Dimensions... : Academic Medicine (lww.com)

• Mennin S. Complexity and health professions education: a basic glossary. J Eval Clin Pract. 2010;16(4):838-840. doi:10.1111/j.1365-2753.2010.01503.x
  Link: Complexity and health professions education: a basic glossary - PubMed (nih.gov)

• Von Bertalanffy L. The History and Status of General Systems Theory. Academy of Management Journal. 1972;15(4):407-426. doi:10.5465/255139
  Link: The History and Status of General Systems Theory | Academy of Management Journal (aom.org)