title: From problem solving to problem definition: scrutinizing the complex nature of clinical practice.
abstract: In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations. As such we need to shift the conversation from (1) problem solving to problem definition, and (2) from a problem definition derived exclusively at the level of the individual to a definition derived at the level of the situation in which the problem is manifested. Embracing such a focus on problem definition will enable us to advocate for novel educational practices that will equip trainees to effectively manage the problems they will encounter in complex, team-based healthcare.
authors.affiliation: Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Sayra.Cristancho@schulich.uwo.ca.
authors.forename: Sayra
authors.initials: S
authors.lastname: Cristancho
authors.affiliation: Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Lorelei
authors.initials: L
authors.lastname: Lingard
authors.affiliation: Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Glenn
authors.initials: G
authors.lastname: Regehr
keywords: Interactions; Perspectives; Systems Engineering