Sticking with messy realities: how ‘thinking with complexity’ can inform health professions education research

Navigating Confidentiality Dilemmas in Student Support: An Institutional Ethnography Informed Study

“…How personal tutors used and related to the concept 'confidentiality' largely aligned with the notion that confidentiality is a 'god term' [27][28][29] and an institutional discourse [17,30] in student support. To elaborate, confidentiality is a widely accepted, unquestioned principle that is cherished for its role in promoting trust and building relationships, and a principle to be fervently preserved except in exceptional circumstances such as when there is a potential harm to the student or others, or if it is required by law to disclose the information.…”

Making Sense of Patient Safety Through Cultural-Historical Activity Theory and Complexity Modeling

“…This article explores how patient “safety” can be reframed as a series of calculated innovations rather than static protocols through appropriate application of a complex model: CHAT 6,7 . Where people work together intensively and across disciplines, as in healthcare, complexity is inevitable 1,2 . “Complex” should be distinguished from “complicated.” Sending a person to the moon is complicated, but can be engineered through predictable, linear, closed systems planning and execution.…”

“…Embedding patient safety initiatives, however, is not just about establishing linear protocols, but changing the habits of complex organizations, beginning at the level of the clinical team. For this, we need more knowledge on complexity theory 1,2 . With the introduction of Safety II, there is upcoming attention for the complexity in health care.…”