#Futureofmeded: thinking in systems

By Felix Ankel (@felixankel)

Recently, a paper came out describing the evolution of assessment along an assessment-as-measurement to assessment-as-judgment to assessment-as-system continuum.  It made me think of a parallel #meded-as-measurement to #meded-as-judgement to #meded-as-system journey.  If high value #meded and patient care are influenced by the systems they find themselves in, how can we inform ourselves on #meded through a systems lens? Below are some books and think tanks that may be of interest to clinician educators interested in learning more about systems thinking and complexity science.


1. Peter Senge. The Fifth Discipline  

This classic book discusses five disciplines that form a learning organization: Personal mastery, mental models, shared vision, team learning and systems thinking.  In a #meded-as-measurement model, personal mastery is the predominant force.  In a #meded-as-system paradigm, mental models, shared vision, and team learning become more important

2. Donella Meadows. Thinking in Systems

This book is a great primer to the basics of systems thinking.  It discusses stock and flow structures, appropriate feedback loops, and helpful rules to manage system resilience, self-organization, and hierarchy.

3. Brenda Zimmerman, Curt Lindberg, Paul Plsek. Edgeware  

These authors, connected to the Plexus Institute below, provide a great outline on managing complexity.  (See previous ICE blog book review here.)  #Mceded is a complex adaptive system (i.e. the value of the system is the sum of the value of the connections between the parts of the system). However, many of the current #meded structures such as finance, communication, IT, and planning are designed to support complicated systems (i.e. the value of the system is the sum of the value of the parts of the system.)  Edgeware provides a map on how to pivot to managing #meded as a complex adaptive system.

Think Tanks

The following think tanks have platforms that allow free access to blog and podcast archives, free newsletter sign up, and #SoMe followership.  It is a great way take a deeper dive in complexity science.

1. Plexus Institute

The Plexus Institute is an organization that supports health care practitioners interested in complexity science.  It has a wealth of blog posts and podcasts that discuss both the mental models underlying complexity science and real-world examples.  It also incorporates practices such as liberating structures and positive deviance to advance systems work.

2. Santa Fe institute

The Santa Fe Institute was founded by Los Alamos scientists interested in complexity science. It is a great resource for looking at systems outside of health care and medical education in a transdisciplinary fashion.

We are living in exponential times. The future of knowledge, the future of professional identity, and future of structure will be far different than what currently exists. Learning analytics and AI will have more prominent roles. In many cases current #meded is still using linear tools in an #meded-as-measurement environment to develop assessment practices, instructional methods, and learning experiences.  To move forward, medical educational leaders will need a core #systemthinking mindset to help manage complex adaptive systems. I hope that some of the resources above can help inform this journey.

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