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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.


Helen Mawdsley, EdD
Director of Research, Office of Continuing Competency and Assessment
Assistant Professor, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba


Mila Kostic, CHCP, FACEHP

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
  • 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
  • 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

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