title: Complexity theory and the "puzzling" competencies: Systems-based Practice And Practice-based Learning explored.
abstract: Of all the clinical competencies, the least understood are Systems-Based Practice and Practice-Based Learning and Improvement. With a shift to competency-based education and evaluation across the spectrum of surgical education and practice, a clear understanding of the power and utility of each competency is paramount. Health care operates as a complex adaptive system, with dynamics foreign to many health care professionals and educators. The adaptation and evolution of such a system is related directly to both the individual and the organizational learning of the agents within the system and knowledge management strategies. Far from being "difficult," Systems-Based Practice and Practice-Based Learning form the heart of quality improvement initiatives and future productivity advances in health care.
authors.affiliation: Department of Ophthalmology, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA. rsgonnering@hotmail.com
authors.forename: Russell S
authors.initials: RS
authors.lastname: Gonnering
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education; D013502:General Surgery / Q000193:education*; D006801:Humans; D017145:Models, Educational; D018794:Problem-Based Learning