In April 2018, the Macy Foundation hosted a conference to identify the elements of optimal health professions learning environments and recommend actions needed to better align them with patient needs and societal goals for better health.
Over the past decade, significant strides have been made in the United States toward reforming and aligning health professions education and the health care delivery system with the ultimate goal of improving the health of the public. During the same period of time, however, the challenges facing those engaged in these enterprises have been largely overlooked. These challenges, among many others, include: revolutionary changes in the health care industry; increasing demands on practitioners to increase clinical productivity and improve patient safety and quality of care; structural systems of inequities and exclusion; and health disparities. Among health professions learners, educators, and practitioners, these trends are producing increasing rates of burnout, distress, and depression. Even those not experiencing these things will have their learning adversely affected by negative environmental factors. As a nation, we have reached a critical moment and are now faced with an urgent need to dramatically improve the environments in which current and future health professionals learn and work and we all receive care.
Learning environments (LEs) are created when people come together to share knowledge, skills, and information to improve the performance of all involved. These environments can be formal or informal and occur within a particular social, organizational, physical, and/or virtual setting. Learning environments comprise a wide array of structures and formats within organizations that vary by purpose, scope, size, location, availability of resources, leadership, and infrastructure.
Health professionals want their learning and work to be meaningful, stimulating, empowering, collaborative, and respectful. Yet too many experience the opposite: high levels of depression and burnout as well as distress and marginalization and/or exclusion. The national initiatives designed to create optimal learning and work environments for health professions learners, educators, and practitioners, and ultimately contribute to better outcomes for patients, have not yet achieved the necessary results. They require more meaningful attention, including identifying and broadly disseminating best practices.
This conviction motivated the Josiah Macy Jr. Foundation to host a conference on Improving Environments for Learning in the Health Professions. Held in Atlanta in April 2018, the two-and-a-half-day meeting brought together a group of 44 invited experts to identify the elements of optimal health professions LEs and recommend actions needed to better align them with patient needs and societal goals for better health.
“This is possibly the most important conference we’ve ever had,” said George Thibault, MD, president of the Macy Foundation, during his opening remarks. “It certainly represents the culmination of our previous conferences. Actionable recommendations to improve health professions learning environments will be the great enabler or facilitator of many of our previous sets of conference recommendations—all of which have been directed toward reforming, aligning, and integrating health professions education and clinical practice to improve the health of the public.”