Health educators and learners face many challenges in obtaining, consolidating, and disseminating knowledge on a daily basis. The International Association of Medical-Scientific Educators has published an interesting article by Stewart Mennin, which looks at what the top 10 global challenges are:

1 – The pandemic has imposed changes that have been perpetuated, such as the replacement of face-to-face by online, in many instances. But in the case of medical education, this represented a fragmentation of content and reduced opportunities for clinical encounters.

2 – The quality of teaching remains a major challenge, even more so after Covid-19. Many evaluations are now online, provoking much discussion about their validity and effectiveness. The author assesses that even though online topic rooms exist; group discussions have been affected.

3 – While medical education has changed significantly in recent years, it still has a faculty resistant to change in many institutions.

4 – Health professionals are trained in a model that prioritizes independent practice and research training also directs them to be independent investigators. Thus, collaboration and sharing among peers become difficult.

5 – “There is too much to do, not enough time and not enough resources. This is a chronic problem that will not go away,” says the author. He further points out that this applies to patient care, research, teaching and administration.

6 – Prejudice continues to permeate environments, whether based on race, gender, age, religion, region of origin, among others. Gender equity is still far away, as men continue to dominate leadership roles in academia.

7 – The field of health education requires intensive dedication, which exhausts many professionals. Not to mention the need to perform multiple roles, such as teacher, researcher, clinician, and administrative manager, among others.

8 – An integrated curriculum, encompassing the various disciplines and departments of an educational institution, is also a goal that needs to be pursued. It is not enough to integrate more courses into the curriculum, making the transmission of knowledge overwhelming for students and teachers.

9 – Conflict between individuals and groups still occurs in professional health institutions. Learning needs to be increasingly based on the student’s ability to learn.

10 – Continuous training of teaching staff remains deficient.  Many educators do not engage in capacity building when it is voluntary.  Or recycling opportunities are isolated, without continuity over time.

Based on Rittel and Webber (1973), Mennin calls these challenges “wicked questions”, i.e., they do not close with simplistic measures, as they are sensitive to several conditions at the same time. He then suggests three approaches to making these issues manageable: investigation, standards, and adaptive action. In the investigative line, the author suggests, for example, transforming judgment into curiosity, after all, this leads to learning. “Perverse” patterns are not stable, he points out, as they involve human relationships. Thus, it is important to understand how the different parts interact in setting standards. Finally, he teaches that adaptive action helps us to inquire and perceive the pattern in a “perverse” problem situation in medical education.