Lessons on resilience: Learning to manage complexity

Complexity permeates every aspect of contemporary healthcare, challenging the delivery of medical education [1]. Gormley and Fenwick [2] invite us to reflect on how we can help individual learners to see what’s in front of them when they face complexity. Instead of saying, ‘well, everything is just so chaotic’, the authors offer a practical application of complexity theory that facilitates understanding of why things seem to be so chaotic. Gormley and Fenwick’s perspective on complexity, rooted in the field of education, provides the conceptual tools – emergence, self-organization, nested systems – to analyze how things are happening. Since studies on clinical complexity in medical education are growing, in this commentary I would like to offer a complementary perspective to the one put forward by Gormley and Fenwick. Two special reports published in the Lancet and JAMA have raised concerns about the disconnect between the traditional focus on training individuals as independent practitioners and the expectation that they will perform as collaborative members of healthcare systems [1, 3]. To begin addressing this disconnect, we must consider how we can cultivate a systems mindset [3]. While the notion of a systems mindset has been slow to take root in medical education, it is at the very heart of my home discipline of systems engineering. In systems engineering, the ‘big picture’ is everything. But to see the big picture, systems engineering teaches us that we must focus our attention on the different di-