The Learning Sciences Meet the Learning Health System

Abstract

Lifelong learning is central to the identity of a physician. Yet rarely in medical education do we emphasize how to learn. Instead, we generally work under the assumption that physicians, who were proficient enough to succeed in their premedical years, are optimally skilled at learning during medical school, postgraduate training, and throughout their careers. This assumption goes untested, but when the desired outcome of education initiatives is enacting evidence-based practices, it is crucial that health systems use methods of learning that are the most effective, efficient, and durable.McEvoy et al 1 report the results of a single-center randomized cluster crossover trial using spaced education and retrieval practice with feedback to disseminate knowledge to clinicians at scale and measure the effect on prescribing patterns. After completing an app-based educational module with daily multiple-choice quiz questions over 4 weeks, clinicians were more likely to follow the evidence-based practice of prescribing balanced crystalloids rather than normal saline. This approach exemplifies how learning health systems can use evidence-based learning to improve clinical practice.

Harmonizing the Tripartite Mission in Academic Family Medicine: A Longitudinal Case Example

“…education. 18 A framework of specific organizational and relational features to build within academic centers to achieve those virtuous circles in the context of learning health systems was recently proposed. 19 Much of this same literature also points at significant challenges in achieving such virtuous circles.…”