Self-organisation, integration and curriculum in the complex world of medical education

Abstract

The core process of complexity, self-organisation, requires a system that is open and far from equilibrium, with ill-defined boundaries and a large number of non-linear interactions involving short-loop feedback. In such a system, knowledge does not exist objectively 'out there'; rather, it exists as a result of the exchange between participants, an action that becomes knowing. Understanding is placed between participants rather than being contained in one or the other. Knowledge is not constructed separately in the mind of the knower, but, rather, it emerges; it is co-created during the exchange in an authentic recursive transactive process. Learning and knowing become adaptive responses to continuously evolving circumstances. An approach to curriculum based on self-organisation is characterised as rich, recursive, relational and rigorous and it illuminates how a curriculum can be understood as a complex adaptive system. The perspective of complexity applied to medical education broadens and enriches research questions relevant to health professions education. It focuses our attention onto how we are together as human beings. How we respond to and frame the issues of learning and understanding that challenge contemporary medicine and, by extension, medical education, in a complex and rapidly changing world can have profound effects on the preparedness of tomorrow's health professionals and their impact on society.

Is experimental research passé

“…Ironically, this was a review of predictive validity of assessment methods, based on correlational studies (Hamdy et al 2006). But no one would suggest that we abandon educational experiments although a few people (Regehr 2010;Mennin 2010), have suggested, or at least implied, just that. I don't agree.…”

Low mental health treatment participation and Confucianist familial norms among East Asian immigrants: A critical review

“…Studies have been accused of misinterpreting "self-organization". Mennin's (2010b) conception, for instance, would depend on members of a team consciously gathering to plan and design effective treatment in preparation for and particular to individuals from certain cultures. Order and design in this scheme become causally linked, running counter to their apparent dissociation intended by original complexity theory (Paley, 2010).…”

Educational Reform: A Journey Towards Accreditation

“…Scientific integration is the concept of merging scientific topics from different disciplines into one collective module [9] where the students learn about different aspects of a clinical condition from different scientific point of views without the restrictions of individual domains or specializations. An example was the introduction of the genomics and proteomics concept, where analytical and organic chemistry can be incorporated with basic biochemistry to yield a meaningful scientific unit with appropriate and applicable skills.…”