Deciding 'what to teach' health professionals: a human-centred systems engineering perspective.

Abstract

Recent calls propose the conceptualisation of medical education research as 'an improvement science for complex social interventions'. This involves developing principled, yet contextually grounded, descriptions of health care practice that increase the likelihood of successful intervention. Defining what health professionals should be taught using theoretical perspectives and analytical techniques borrowed from human-centred systems engineering (HCSE) may acknowledge this call by allowing learning objectives and performance assessment criteria to be aligned with the demands of actual work. Human-centred systems engineering is a multidisciplinary endeavour that seeks to promote the safe, efficient and productive performance of socio-technological systems. Systems theories in HCSE explain how environmental conditions constrain and afford human goal-directed behaviour and are modified by such. Many of the techniques used in HCSE research that are applicable to examining health care practice should be familiar to medical education researchers. This method differs from other empirical approaches that have been applied to the study of health care practice in its emphasis on practical problem solving via intervention design. Learning objectives and performance assessment criteria derived from an HCSE perspective target people's attunement to environmental conditions as they strive to enact goal-directed behaviour. Implementing educational interventions from an HCSE perspective should facilitate a sustained positive impact across contexts because theories of person-environment interaction enable principled adaptations of interventions to local circumstances.