By: Daniel Cabrera (@CabreraERDR), Elissa Hall (@erhall1), Dan Pesut (@DanielPesut), Glenn Paetow (@GlennPaetowMD), Felix Ankel (@felixankel)
“You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”
You are a postgraduate dean hired to transform health professions education from an information-based to a competency-based system. You are also part of an academic health system with aspirations to improve the health of the state by focusing on multidisciplinary health professions education (mHPE). When performing your environmental scan with one-to-one meet and greets, you find many favor this approach. However, two years later, you find that not much has changed. Although many support mHPE in theory, in practice most continue to focus on the status quo and the primacy of professional identity, citing policy, fiduciary, and accreditation limitations to change. You suspect one limitation to mHPE may be current organizational structures inclined towards unidirectional governance and binary professional identity (you are either a physician or not a physician, a nurse or not a nurse) that hinders progress to true mHPE. You decide to create a new structure to allow for multidirectional communication, transdisciplinary intraprofessional identity expression, and interprofessional responsibility futurecasting hard trends in HPE.
How do you create these new structures? Where do you start? What are your goals? The case study below demonstrates how one group of educators self-organized to address similar questions and challenges. This group of educators is called MinnesotaFutura and together they futurecast health professions education in a non-hierarchical network which promotes multi-directional communication, transdisciplinary intraprofessional identity expression, and interprofessional responsibility.
MinnesotaFutura sprang organically from informal interactions among health professional educators interested in the emergence of knowledge-based networks with the growing irruption of communities of practice and social media-based education. The group created a physical and digital space to foster collaboration and discussion among a diverse group of learners, practitioners, educators, policy makers, scientists, and consumers.
To provide structure for the digital and physical meeting spaces, Minnesotafutura established a Knowledge, Agents and Networks (KAN) framework to inform the interactions among participants and the products the collaboration would create. Knowledge, visualized as a pyramid, served as a model to describe the transformation continuum of data to information to knowledge to wisdom. In mHPE, knowledge and wisdom are the assets negotiated by agents. Agents include teachers, learners, allied health professionals, patients, agencies, employers and societies, all potential stakeholders that participate in learning networks. A Network is formed by nodes and links, where information is distributed and both the nodes and links transfer information. The Minnesotafutura network is a hybrid of scale-free networks with rhizomatic features.
Minnesotafutura has held three meetings. The first meeting created a social network and was organized to expand awareness of digital scholarship and connectivist educational theory. The second meeting focused on an environmental scan of current mHPE. The third meeting created a colliding space to craft a foresight vision of HPE. Each meeting had over 100 attendees representing a variety of institutions including university systems and colleges, healthcare systems, and state agencies. From these institutions a multidisciplinary group of clinician educators, education scientists, administrators, medical residents, graduate students, regional policy makers, academic authorities, quality specialists, collectively engaged.
Through these gatherings, MinnesotaFutura identified three hard trends defining the future of mHPE:
- Management of Knowledge: The gravitational point for knowledge will shift away from the clinician. Most data, information, and knowledge will live in digital networks informed by artificial intelligence. Clinicians will move their core focus away from analysis and towards synthesis. This synthetic mindset will co-create wisdom with others to help guide the final clinical decision: patients, families, members of the health care team, communities, and the public at large.
- Professional Identity: There will be a shift from a binary to a non-binary professional identity. Rather than physician or not physician, nurse or not nurse, clinicians will be identified by their roles (e.g. emergency perfusionist, teleclinician). It will become more common to develop transdisciplinary identities where a provider can have a role for a specific issue and change to a different role depending on the circumstance. As a result, credentialing and certification organizations will need to adapt.
- Organizations & Systems: The structure of mHPE will change from a centralized, unidirectional, hierarchical organization (a “complicated system’, where the value of the system is the sum of the value of the parts) to a decentralized, multidirectional, networked system (a “complex” system, where the value of the system is the sum of the value of the connections between the parts)
Whether a post-graduate dean or other professional role facing similar questions and challenges, we are hopeful the grass roots efforts and energy of MinnesotaFutura described in this case study provides a foundational framework, a common language, and hard trends to facilitate transformation in education.
Joynes, V. C. (2018). Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students. Advances in Health Sciences Education, 23(1), 133-149.
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