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Practice-Based Systemic Learning
1995 - 2001
During 1995-2001, scholarship reframed health care as a learning system where education, clinical practice, and organizational structures co-evolve to improve outcomes. Education and training are treated as system-level levers for physician performance and care quality, with emphasis on evaluating educational quality, feedback, and alignment of continuing medical education with practice via effectiveness studies and problem-based and team-based learning guidance. Interprofessional and team-based learning in ambulatory care emphasizes collaborations among doctors and other professionals, while settings-based learning treats education institutions as learning ecosystems that govern and embed health learning within schools and universities. Information literacy and evidence-based practice increasingly define lifelong learning, leveraging clinical questions, digital databases, and critical appraisal to continuously update practice.
• Education and training are framed as system-level levers to improve physician performance and care outcomes, emphasizing evaluation of educational quality, feedback, and alignment with practice through CME effectiveness studies, Objectives of the Medical School Objectives Project, and PBL/TBL guidance [1], [15], [6], [13], [12], [7], [19].
• Interprofessional and team-based learning in ambulatory care is highlighted, with evaluation of collaborations between doctors and social workers and the social-contextual conditions shaping learning in clinics (team learning frameworks and programme evaluations) [2], [8], [17].
• Health promotion and settings-based learning treat institutions as learning ecosystems, exploring governance and implementation of health-promoting schools and university settings to embed health learning in education systems [3], [10].
• Information literacy and evidence-based practice emerge as lifelong learning patterns, using clinical questions, digital databases, and critical appraisal to continuously update practice [16], [18], [19].
Interprofessional Learning Health Systems
2002 - 2009
Learning Health System Integration
2010 - 2016
Real-Time Learning Health Systems
2017 - 2023