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Individual differences in the timing of developmental processes are often of interest in longitudinal studies, yet common statistical approaches to modeling change cannot directly estimate the timing of when change occurs. The time-to-criterion framework was recently developed to incorporate the timing of a prespecified criterion value; however, this framework has difficulty accommodating contexts where the criterion value differs across people or when the criterion value is not known a priori, such as when the interest is in individual differences in when change starts or stops. This article combines aspects of reparameterized quadratic models and multiphase models to provide information on the timing of change. We first consider the more common situation of modeling decelerating change to an offset point, defined as the point in time at which change ceases. For increasing trajectories, the offset occurs when the criterion attains its maximum ("inverted J-shaped" trajectories). For decreasing trajectories, offset instead occurs at the minimum. Our model allows for individual differences in both the timing of offset and ultimate level of the outcome. The same model, reparameterized slightly, captures accelerating change from a point of onset ("J-shaped" trajectories). We then extend the framework to accommodate "S-shaped" curves where both the onset and offset of change are within the observation window. We provide demonstrations that span neuroscience, educational psychology, developmental psychology, and cognitive science, illustrating the applicability of the modeling framework to a variety of research questions about individual differences in the timing of change. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The American Medical Association formed the Accelerating Change in Medical Education Consortium through grants to effect change in medical education. The dissemination of educational innovations through scholarship was a priority. The objective of this study was to explore the patterns of collaboration of educational innovation through the consortium’s publications. Publications were identified from grantee schools’ semi-annual reports. Each publication was coded for the number of citations, Altmetric score, domain of scholarship, and collaboration with other institutions. Social network analysis explored relationships at the midpoint and end of the grant. Over five years, the 32 Consortium institutions produced 168 publications, ranging from 38 papers from one institution to no manuscripts from another. The two most common domains focused on health system science (92 papers) and competency-based medical education (30 papers). Articles were published in 54 different journals. Forty percent of publications involved more than one institution. Social network analysis demonstrated rich publishing relationships within the Consortium members as well as beyond the Consortium schools. In addition, there was growth of the network connections and density over time. The Consortium fostered a scholarship network disseminating a broad range of educational innovations through publications of individual school projects and collaborations.

In Future Studies and the History of Technology accelerating change is a perceived increase in the rate of technological change throughout history. This may suggest faster and more profound change in the future and may or may not be accompanied by equally profound social and cultural change. Responding to the accelerating technological landscape and contemporary life, this paper researches how the concept of ‘time’ plays a significant role. The author, an experimental filmmaker, charts an experiential journey within several pivotal ‘dream films’, along with relevant artists’ moving images in relation to time and slowness in the moving image as critical media. As contemporary life has become more and more fast paced, and one year on the impact of COVID-19 is still being felt, the idea of stillness is beginning to become a more desirable commodity. The author explores ‘slow cinema’, acknowledging seminal directors Andrei Tarkovsky and Claire Denis, as well as art films which frequently emphasise long takes, offering minimalist aesthetics with little or no narrative. In an endeavour to portray different temporalities and reveal and allude to the invisibility of time, the author relates to Julia Kristeva’s notions of intertextuality, transposition and time, and Lutz Koepnik’s concept of slowness as a strategy of the contemporary. The author discusses four ‘dream films’, where painterly, poetic, non-linear narratives, and ‘in-between’ spaces are played out: FRIDA Travels to Ibiza, Cycle, Llafarganu Papagei and Frock.

Despite the accelerating change at all levels of life, demanding a plethora of new intelligent systems, formal education continues to resemble a box, created during Industrial Revolution and only modestly changed since. The technicist curriculum and the public school remain a modernist project, boxing in students and constraining their imaginations. It is not worth investing in intelligent technologies if education is not taken into account, creating new flexibilities for people’s behaviours and attitudes. A paradigm shift in the area of education and teacher education is a must. The aim of this presentation is to share my concern about the inadequacy of the “black-and-white” mental organisation caused by the knowledge boundaries of various disciplines in hierarchical order, characteristic of the modernist curriculum implemented at schools, and the real need for a global and interdisciplinary methodological approach focused on the greatest problems of humanity.

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed. Education programs must shift focus from content delivery to providing students explicit scaffolding for future learning, such as the Master Adaptive Learner model. Additionally, educators should leverage informatics to improve the process of education and foster individualized, precision education. Finally, attributes of the successful physician of the future should inform adjustments in recruitment and admissions processes. This paper explores how member schools of the American Medical Association Accelerating Change in Medical Education Consortium adjusted all aspects of educational programming in acknowledgment of the rapid expansion of information.

In the last two decades, prompted by the anticipated arrival of the 21st Century and on the centenary of the publication of the Flexner Report, many in medical education called for change to address the expanding chasm between the requirements of the health care system and the educational systems producing the health care workforce. Calls were uniform. Curricular content was missing. There was a mismatch in where people trained and where they were needed to practice, legacy approaches to pedagogical methods that needed to be challenged, an imbalance in diversity of trainees, and a lack of research on educational outcomes, resulting in a workforce that was described as ill-equipped to provide health care in the current and future environment. The Lancet Commission on Education of Health Professionals for the 21st Century published a widely acclaimed report in 2010 that called for a complete and authoritative re-examination of health professional education. This paper describes the innovations of the American Medical Association Accelerating Change in Medical Education Consortium schools as they relate to the recommendations of the Lancet Commission. We outline the successes, challenges, and lessons learned in working to deeply reform medical education.

In 2010, several key works in medical education predicted the changes necessary to train modern physicians to meet current and future challenges in health care, including the standardization of learning outcomes paired with individualized learning processes. The reframing of a medical expert as a flexible, adaptive team member and change agent, effective within a larger system and responsive to the community's needs, requires a new approach to education: competency-based medical education (CBME). CBME is an outcomes-based developmental approach to ensuring each trainee's readiness to advance through stages of training and continue to grow in unsupervised practice. Implementation of CBME with fidelity is a complex and challenging endeavor, demanding a fundamental shift in organizational culture and investment in appropriate infrastructure. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium developed and implemented CBME, including common challenges and successes. Critical supporting factors include adoption of the master adaptive learner construct, longitudinal views of learner development, coaching, and a supportive learning environment.

The American Medical Association's (AMA's) Accelerating Change in Medical Education (ACE) initiative, launched in 2013 to foster advancements in undergraduate medical education, has led to the development and scaling of innovations influencing the full continuum of medical training. Initial grants of $1 million were awarded to 11 U.S. medical schools, with 21 schools joining the consortium in 2016 at a lower funding level. Almost one-fifth of all U.S. MD- and DO-granting medical schools are represented in the 32-member consortium. In the first 5 years, the consortium medical schools have delivered innovative educational experiences to approximately 19,000 medical students, who will provide a potential 33 million patient care visits annually. The core initiative objectives focus on competency-based approaches to medical education and individualized pathways for students, training in health systems science, and enhancing the learning environment. At the close of the initial 5-year grant period, AMA leadership sought to catalogue outputs and understand how the structure of the consortium may have influenced its outcomes. Themes from qualitative analysis of stakeholder interviews as well as other sources of evidence aligned with the 4 elements of the transformational leadership model (inspirational motivation, intellectual stimulation, individualized consideration, and idealized influence) and can be used to inform future innovation interventions. For example, the ACE initiative has been successful in stimulating change at the consortium schools and propagating those innovations broadly, with outputs involving medical students, faculty, medical schools, affiliated health systems, and the broader educational landscape. In summary, the ACE initiative has fostered a far-reaching community of innovation that will continue to drive change across the continuum of medical education.

Aim Simulation models are important tools for quantifying the resilience (i.e., persistence under changed environmental conditions) of forest ecosystems to global change. We synthesized the modelling literature on forest resilience, summarizing common models and applications in resilience research, and scrutinizing the implementation of important resilience mechanisms in these models. Models applied to assess resilience are highly diverse, and our goal was to assess how well they account for important resilience mechanisms identified in experimental and empirical research. Location Global. Time period 1994 to 2019. Major taxa studied Trees. Methods We reviewed the forest resilience literature using online databases, selecting 119 simulation modelling studies for further analysis. We identified a set of resilience mechanisms from the general resilience literature and analysed models for their representation of these mechanisms. Analyses were grouped by investigated drivers (resilience to what) and responses (resilience of what), as well as by the type of model being used. Results Models used to study forest resilience varied widely, from analytical approaches to complex landscape simulators. The most commonly addressed questions were associated with resilience of forest cover to fire. Important resilience mechanisms pertaining to regeneration, soil processes, and disturbance legacies were explicitly simulated in only 34 to 46% of the model applications. Main conclusions We found a large gap between processes identified as underpinning forest resilience in the theoretical and empirical literature, and those represented in models used to assess forest resilience. Contemporary forest models developed for other goals may be poorly suited for studying forest resilience during an era of accelerating change. Our results highlight the need for a new wave of model development to enhance understanding of and management for resilient forests.

Purpose Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH. Methods A team from the American Medical Association's Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate. Results Twenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations. Conclusion Despite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multitude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional "preclinical" years, indicates curricular areas in need of attention.

An important tenet of competency-based medical education is that the educational continuum should be seamless. The transition from undergraduate medical education (UME) to graduate medical education (GME) is far from seamless, however. Current practices around this transition drive students to focus on appearing to be competitively prepared for residency. A communication at the completion of UME-an educational handover-would encourage students to focus on actually preparing for the care of patients. In April 2018, the American Medical Association's Accelerating Change in Medical Education consortium meeting included a debate and discussion on providing learner performance measures as part of a responsible educational handover from UME to GME. In this Perspective, the authors describe the resulting 5 recommendations for developing such a handover: (1) The purpose of the educational handover should be to provide medical school performance data to guide continued improvement in learner ability and performance, (2) the process used to create an educational handover should be philosophically and practically aligned with the learner's continuous quality improvement, (3) the educational handover should be learner driven with a focus on individualized learning plans that are coproduced by the learner and a coach or advisor, (4) the transfer of information within an educational handover should be done in a standardized format, and (5) together, medical schools and residency programs must invest in adequate infrastructure to support learner improvement. These recommendations are shared to encourage implementation of the educational handover and to generate a potential research agenda that can inform policy and best practices.

Rapid developments in technology as well as permanent changes in audience behaviour and media consumption have led to accelerating change, continuous transformation and disruption of business model...

Many challenges could occur that result in the need to handle an increase in the number of medical student clinical placements, such as curricular transformations or viral pandemics, such as COVID 19. Here, we describe four different institutions’ approaches to addressing the impact of curricular transformation on clerkships using an implementation science lens. Specifically, we explore four different approaches to managing the ‘bulge’ as classes overlap in clerkships Curriculum leaders at four medical schools report on managing the bulge of core clinical placements resulting from reducing the duration of the foundational sciences curriculum and calendar shifts for the respective clerkship curriculum. These changes, which occurred between 2014 and 2018, led to more students being enrolled in core clinical rotations at the same time than occurred previously. Schools provided respective metrics used to evaluate the effectiveness of their bulge management technique. These data typically included number of students affected in each phase of their curricular transformation, performance on standardized examinations, and student and faculty feedback. Not all data were available from all schools, as some schools are still working through their ‘bulge’ or are affected by COVID-19. There is much to be learned about managing curricular transformations. Working on such endeavors in a learning collaborative such as the AMA Accelerating Change in Medical Education Initiative provided support and insights about how to survive, thrive and identifying lessons learned during curricular transformation.

In the modern technological world, the concept of creativity is associated with a timeline and a focus on the future. The accelerating change of life under the influence of high-tech changes requires new approaches to the discourse about the future. Creativity as the most “lively” and unpredictable component of technological development is difficult to define, measure, and evaluate. The rapid development of technologies has brought the creation of ideas and their implementation much closer. The most popular issue is becoming the discourse about the future in the format of foresights, which represent the programming of the future. In this study, the authors propose a direction for generating ideas other than tasks for evaluating individual divergent thinking and the foresight format. The assumption of the absence of one of the basic foundations of the existence of modern humanity was used as an incentive to generate ideas about the fate of our civilization, its problems, and opportunities. Understanding the impact of technology development on society, the ability to assess the consequences of technological decisions is an important competence of a modern engineer. The article presents a general picture of the student's answers to the question about the consequences of the absence of gravity (N = 100) and electricity (N = 150). Along with disaster scenarios, students present the solutions for adaptation, positive consequences, and options for using new opportunities. The answers trace the influence of mass culture, popular media discourse, scientific facts related to the topic, and everyday experience, which in some cases are evaluated and revised in a new context.

Disease presentations can vary between different skin phototypes, at times requiring distinct management and therapies. Medical education curricula have yet to be updated to better reflect and address the dermatologic needs of an increasingly diverse population. The objective of this study was to determine if the preclinical dermatology curriculum at 3 US medical schools provided adequate representation of skin of color patients in their didactic presentation slides. Three US medical schools-all members of the American Medical Association (AMA) Accelerating Change in Medical Education consortium-were included in the study. The institutions were a blend of private and public schools located across different geographic boundaries. The main outcome measures included the proportion of total skin of color photographs for each institution, the number of priority conditions for skin of color patients, and the discussion of differences between skin types. The results strongly suggested that skin of color is underrepresented in the preclinical dermatology curriculum at all 3 institutions. Efforts should be made to increase images and discussion of skin of color in preclinical didactics.

The speed and uncertainty of environmental change in the Anthropocene challenge the capacity of coevolving social–ecological–technological systems (SETs) to adapt or transform to these changes. Formal government and legal structures further constrain the adaptive capacity of our SETs. However, new, self-organized forms of adaptive governance are emerging at multiple scales in natural resource-based SETs. Adaptive governance involves the private and public sectors as well as formal and informal institutions, self-organized to fill governance gaps in the traditional roles of states. While new governance forms are emerging, they are not yet doing so rapidly enough to match the pace of environmental change. Furthermore, they do not yet possess the legitimacy or capacity needed to address disparities between the winners and losers from change. These emergent forms of adaptive governance appear to be particularly effective in managing complexity. We explore governance and SETs as coevolving complex systems, focusing on legal systems to understand the potential pathways and obstacles to equitable adaptation. We explore how governments may facilitate the emergence of adaptive governance and promote legitimacy in both the process of governance despite the involvement of nonstate actors, and its adherence to democratic values of equity and justice. To manage the contextual nature of the results of change in complex systems, we propose the establishment of long-term study initiatives for the coproduction of knowledge, to accelerate learning and synergize interactions between science and governance and to foster public science and epistemic communities dedicated to navigating transitions to more just, sustainable, and resilient futures.

A hundred years after the Flexner report laid the foundation for modern medical education, a number of authors commemorated the occasion by commenting on how the medical education system had to change once more to serve 21st century patients. Experts called for standardized outcomes and individualized learner pathways, integration of material across traditional areas, attention to an environment of inquiry, and professional identity formation. The medical education community responded and much has been achieved in the last decade, but much work remains to be done. In this paper we outline how the American Medical Association Accelerating Change in Medical Education Consortium, launched in 2013 through significant funding of transformation projects in undergraduate medical education, expanded its work into graduate medical education, and we look to the future of innovation in medical education.

Promoting optimal health outcomes for diverse patients and populations requires the acknowledgement and strengthening of interdependent relationships between health professions education programs, health systems, and the communities they serve. Educational programs must recognize their role as integral components of a larger system. Educators must strive to break down silos and synergize efforts to foster a health care workforce positioned for collaborative, equitable, community-oriented practice. Sharing interprofessional and interinstitutional strategies can foster wide propagation of educational innovation while accommodating local contexts. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium leveraged interdependence to accomplish transformative innovations catalyzed by systems thinking and a community of innovation.

The National Collaborating Centre for Methods and Tools (NCCMT) is part of a network of six National Collaborating Centres for Public Health (NCC) created in 2005 by the federal government following the severe acute respiratory syndrome (SARS) epidemic to strengthen public health infrastructure in Canada. The work of the NCCMT, to support evidence-informed decision-making (EIDM) in public health in Canada, is accomplished by curating trustworthy evidence, building competence to use evidence and accelerating change in EIDM. Ongoing engagement with its target audiences ensures NCCMT’s relevance and ability to respond to evolving public health needs. This has been particularly critical during the coronavirus disease 2019 (COVID-19) pandemic, which saw NCCMT pivot its activities to support the public health response by conducting rapid reviews on priority questions identified by decision-makers from federal to local levels as well as create and maintain a national repository of in-progress or completed syntheses. These efforts, along with partnering with the COVID-19 Evidence Network to support Decision-Making (COVID-END), sought to reduce duplication, increase coordination of synthesis efforts and support decision-makers to use the best available evidence in decision-making. Data from website statistics illustrate the successful uptake of these initiatives across Canada and internationally.

Faculty play an important role in attracting students to the geosciences, helping them to thrive in geoscience programs, and preparing them for careers. Thus, faculty have the responsibility to wor...

In the context of sustainability and devising win-win solutions to socio-environmental challenges, this paper discusses various aspects of the fundamental role narratives play in grounding our values and institutions, impacting on our decisions and actions, and slowing down or accelerating change. Narratives are created to integrate particular events or trends in the worldview of the societies experiencing them. They anchor a linear story or timeline to underlying multidimensional “Gestalts” that characterize the society involved. Depending on the particular context involved, narratives can therefore “fix” existing assumptions, attitudes, and opinions, or they can open the way for change. When different narratives are conflated, results may emerge that have not been expected—as in the case of different perspectives on the relationship between humans and their environment. Narratives and the values they represent are articulated in the networks that each individual or group is part of. As such, they are at the root of the “imagined futures” that, according to Beckert, drive our societies’ economies. Changing narratives and thus changing imagined futures can transform ideas, attitudes, and institutions and are thus essential to effectuate societal change.

Defining entrepreneurship within healthcare Accelerating change, increasing complexity and the need to control costs are the operative terms driving the healthcare environment today, with the goals of improving metrics in both healthcare and patient health. Yet, physicians are not educated to understand the concepts nor trained to practice the necessary skills to carry out activities directed towards these goals.1 Thus, Myers and Pronovost have proposed making management skills core components of medical education.2 These include the management domain skill sets that concern individual and interpersonal dynamics, team and unit dynamics, and organisational dynamics that would have the potential to enhance interactions at all management levels, not only senior management. These ‘soft’ skills can contribute to quality improvement, that is, incremental improvements in the effectiveness and efficiency of processes throughout healthcare. However, these skills alone do not address the further critical need for innovation in those processes. The discipline of entrepreneurship, as it bridges the broad complementary disciplines of management and leadership, can make a meaningful contribution to this discussion. In the first landscape review and thematic analysis of innovation and entrepreneurship programmes in medical education in the USA, Niccum and colleagues identified 13 programmes that provide training in these disciplines.3 They identify seven educational themes, the top two of which, innovation (92%) and entrepreneurship (85%), show the gaining relevance of these disciplines to medical education and to the future careers of medical professionals who will benefit from skill sets that address complex problem solving and solution design. Defined broadly, entrepreneurship is the ‘pursuit of opportunity beyond resources controlled’,4 (box 1) embodying a singular focus to bring forth innovation5 (box 1) in any form, for example, in pioneering new technology that improves an existing process while counteracting resource constraints. Within the healthcare sector, entrepreneurship has taken the form of design …

Medical education and the health system must address challenges that, despite significant effort, seem unsolvable. Health systems science (HSS)-the fundamental understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care delivery-is increasingly being recognized as a potential source of solutions to these challenges. In this article, the authors review the 43 abstracts submitted to the American Medical Association Accelerating Change in Medical Education 2018 Health Systems Science Student Impact Competition that aligned with the goals of HSS. Their qualitative review identified 3 long-standing problems in medicine and medical education that were frequently addressed by the submissions: improving care for those with mental illness (5 submissions), improving diversity in medicine (4 submissions), and improving teamwork and interprofessional education (4 submissions). The authors extracted lessons learned from these abstracts. Many of the projects detailed in this article continue to make an impact at multiple levels. While not all projects were scientifically rigorous enough to be published on their own and the quality of the data presented in the abstracts varied widely, many provide innovative ideas for potentially solving long-standing problems that may have been overlooked or not considered sufficiently. These projects and their subsequent analysis demonstrate that, not only do medical students make significant impacts on the health system, patients, and other health professionals when equipped with HSS skills, working in health care teams, and advised by mentors, but they also may be able to address some of medicine's and medical education's long-standing challenges. The fresh perspective and high energy of medical students is valuable and should be nurtured and encouraged.

EXECUTIVE SUMMARY The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists’ and physicians’ practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.

In an era marked by accelerating change and destabilisation of many structures and regularities in almost all domains, it becomes crucial to understand the source and nature of the unfolding crises and their relation to social dynamics. In this paper the evolution of social dynamics is investigated not on the basis of observable structures, but the mental model of human agents, that is, how they both perceive and conceive of the world and their relation to it. For this purpose, the paper reaches out to Ancient Mesopotamia, where the oldest written documents provide evidence about the evolution of the mental model as it has been preserved in the form of myths. Some key notions filtered out from some important myths are used to analyse the interaction between the mental model and social dynamics. Finally, some criteria and directions are suggested for the present-day crises.

Issue: Despite clear relevance, need, descriptive literature, and student interest, few schools offer required curriculum to develop leadership skills. This paper outlines a proposed shared vision for leadership development drawn from a coalition of diverse medical schools. We advocate that leadership development is about self (looking inward), teams (not hierarchy), and change (looking outward). We propose that leadership development is for all medical students, not for a subset, and we believe that leadership curricula and programs must be experiential and applied. Evidence: This paper also draws on the current literature and the experience of medical schools participating in the American Medical Association's (AMA) Accelerating Change in Medical Education Consortium, confronts the common arguments against leadership training in medical education, and provides three cross-cutting principles that we believe must each be incorporated in all medical student-centered leadership development programs as they emerge and evolve at medical schools. Implications: By confronting common arguments against leadership training and providing a framework for such training, we give medical educators important tools and insights into developing leadership training for all students at their institutions.

Introduction: The role of medical students in catalyzing and leading curricular change in US medical schools is not well described. Here, American Medical Association student and physician leaders in the Accelerating Change in Medical Education initiative use qualitative methods to better define student leadership in curricular change. Methods: The authors developed case studies describing student leadership in curricular change efforts. Case studies were presented at a national medical education workshop; participants provided worksheet reflections and were surveyed, and responses were transcribed. Kotter’s change management framework was used to categorize reported student roles in curricular change. Thematic analysis was used to identify barriers to student engagement and activators to overcome these barriers. Results: Student roles spanned all eight steps of Kotter’s change management framework. Barriers to student engagement were related to faculty (e.g. view student roles narrowly), students (e.g. fear change or expect faculty-led curricula), or both (e.g. lack leadership training). Activators were: (1) recruiting collaborative faculty, staff, and students; (2) broadening student leadership roles; (3) empowering student leaders; and (4) recognizing student successes. Conclusions: By applying these activators, medical schools can build robust student–faculty partnerships that maximize collaboration, moving students beyond passive educational consumption to change agency and curricular co-creation.

It is a strange and fascinating time to be alive. Modern societies and lifeways are changing faster than ever as new technologies rapidly reshape the nature of modern institutions, modes of communication, healthcare, education, relationships, and our views of what it means to be human and to live a good life. Masses of humans across the globe are at risk of succumbing to what the futurist Alvin Toffler called “future shock,” i.e., “the shattering stress and disorientation that we induce in individuals by subjecting them to too much change in too short a time.” With such rapid change in play, humanity badly needs a global roadmap for the future. Besides the issues of climate change, population growth, declining biodiversity, and sustainability, we must also think seriously about the rise of artificial intelligence, exponential growth trends in technological evolution, and the impacts of rapidly developing information technologies. In this chapter, Bohan develops a conceptual scaffold for a Threshold 9 story, focusing on the next hundred years. She proposes using the key concepts of the Great Acceleration and Kurzweil’s Law of Accelerating Returns to contextualize the immediate future as a transhuman era of accelerating social, technological and planetary change, and human-machine convergence. In addition, a provisional list of twelve major topics is presented that Bohan believes we should explore in this context of accelerating change. Even if a technological singularity never occurs, there will be enough social disruption in the immediate future to necessitate a common framework that can help us understand why the world is changing so fast today and help us imagine potential scenarios.

How can organizations cope with accelerating change in more complex worlds? The growth of capabilities produces expanded scales of operation, extensive interdependencies, new vulnerabilities, and puzzling failures. The result is the strategic agility gap where organizations are slow and stale in recognizing changing risks and fall behind the pace of change. The chapter addresses what factors drive the gap and what adaptive capabilities allow organizations to flourish in the gap. The result is a new paradigm for continuous adaptability illustrated in web-powered enterprises.

As globalization and increasing societal demands create urgent agendas for school improvement, educational leaders are left searching for effective strategies to make gains, and to do so quickly. I...

On large time scales the progress of human technology follows an exponential growth trend that is termed accelerating change. The exponential growth trend is commonly considered to be the amalgamated effect of consecutive technology revolutions – where the progress carried in by each technology revolution follows an S-curve, and where the aging of each technology revolution drives humanity to push for the next technology revolution. Thus, as a collective, mankind is the ‘intelligent designer’ of accelerating change. In this paper we establish that the exponential growth trend – and only this trend – emerges universally, on large time scales, from systems that combine together two elements: randomness and amalgamation. Hence, the universal generation of accelerating change can be attained by systems with no ‘intelligent designer’.

The number of global tobacco-related deaths is projected to increase from about 6 million to 8 million annually by 2030, with more than 80% of these occurring in low- and middle-income countries (LMICs). The World Health Organization Framework Convention on Tobacco Control (FCTC) came into force in 2005 and Article 14 relates specifically to the treatment of tobacco dependence. However, LMICs, in particular, face several barriers to implementing tobacco dependence treatment. This paper is a descriptive evaluation of a novel grant funding mechanism that was initiated in 2014 to address these barriers. Global Bridges. Healthcare Alliance for Tobacco Dependence Treatment aims to create and mobilize a global network of healthcare professionals and organizations dedicated to advancing evidence-based tobacco dependence treatment and advocating for effective tobacco control policy. A 2014 request for proposals (RFP) focused on these goals, particularly in LMICs, where funding for this work had been previously unavailable. 19 grants were awarded by Global Bridges to organizations in low- and middle-income countries across all six WHO regions. Virtually all focused on developing a tobacco dependence treatment curriculum for healthcare providers, while also influencing the political environment for Article 14 implementation. As a direct result of these projects, close to 9,000 healthcare providers have been trained in tobacco dependence treatment and an estimated 150,000 patients have been offered treatment. Because most of these projects are designed with a “train-the-trainer” component, two years of grant funding has been a tremendous catalyst for accelerating change in tobacco dependence treatment practices throughout the world. In order to foster such exponential growth and continue to maintain the impact of these projects, ongoing financial, educational, and professional commitments are required.

Volatility, uncertainty, ambiguity, and complexity (VUCA) are drivers in today’s business world. Therefore, an increasing number of organizations implement agility (agile methods) to cope with the rapid and accelerating change. However, these agile transformations do not succeed unhindered, and some fail. One reason for that is the employees lacking an agile mindset and they do not support or participate in the transformation. So far, knowledge of the agile mindset is in its infancy. A conceptualization for developing a measuring instrument on the individual level is lacking. Furthermore, the relevance of the agile mindset regarding organizational performance in a VUCA world is still unclear. Our study aims to close this gap. To do so, we examine the agile mindset with 15 qualitative interviews and conduct an online survey (N=449) to predict organizational agility and organizational performance based on the agile mindset. As for results, we conceptualize the agile mindset as an attitude that comprises four dimensions: ’learning spirit’, ‘collaborative exchange’, ‘empowered self-guiding’, and ‘iterative value creation’. We have found an indirect effect of the agile mindset affecting organizational performance towards organizational agility. These findings contribute to the agility and management research by providing both a conceptualization and a measuring instrument for the agile mindset. Furthermore, the agile mindset´s relevance in agile transformation is explained and its relation to organizational performance outlined. For successful agile transformation, executives must focus on the agile mindset of their employees and foster this by e.g. being a role model.

The Sustainable Development Goals (SDGs) and the Agenda 2063 chart a new development pathway for Africa. ‘Leaving no one behind’, or full social inclusion, is central to this effort. What will this mean for lesbian, gay, bisexual, transgender, or intersex (LGBTI) people in Africa who are among the most socially excluded members of the population? This article explores this through a discussion framed by the concept of social inclusion and the commitments regarding it that appear in the SDGs and the Agenda 2063. Although LGBTI inclusion across Africa is not explicit in either document, there are nevertheless important opportunities for linking continental LGBTI advocacy to the sustainable development enterprise.

The continued exponential growth of the price-performance of computing is likely to effectuate technologies that radically transform both the global economy and the human condition over the course of this century. Conventional visions of the next 50 years fail to realistically account for the full implications of accelerating technological change driven by the exponential growth of computing, and as a result are deeply flawed. These flawed visions are, in part, a consequence of three interrelated errors in reasoning: 1) the linear projection fallacy, 2) the ceteris paribus fallacy, and 3) the arrival fallacy. Each of these informal fallacies is likely a manifestation of shortcomings in our intuitions about complex dynamic systems. Recognizing these errors and identifying when and where they affect our own reasoning is an important first step toward thinking more realistically about the future.

The current social reality is characterized by all-encompassing change, which disrupts existing social structures at all levels. Yet the prevailing view of society is based on the ontological primacy of stable hierarchical structures, which is no longer adequate. We propose a conceptual framework for thinking about a dynamically changing social system: the Living Cognitive Society. Importantly, we show how it follows from a much broader philosophical framework, guided by the theory of individuation, which emphasizes the importance of relationships and interactive processes in the evolution of a system. The framework addresses society as a living cognitive system -- an ecology of interacting social subsystems -- each of which is also a living cognitive system. We argue that this approach can help us to conceive sustainable social systems that will thrive in the circumstances of accelerating change. The Living Cognitive Society is explained in terms of its fluid structure, dynamics and the mechanisms at work. We then discuss the disruptive effects of Information and Communication Technologies on the mechanisms at work. We conclude by delineating a major topic for future research -- distributed social governance -- which focuses on processes of coordination rather than on stable structures within global society., Comment: Preprint: 29 pages, 5 figures

The authors performed a review of 30 Accelerating Change in Medical Education full grant submissions and an analysis of the health systems science (HSS)-related curricula at the 11 grant recipient schools to develop a potential comprehensive HSS curricular framework with domains and subcategories.In phase 1, to identify domains, grant submissions were analyzed and coded using constant comparative analysis. In phase 2, a detailed review of all existing and planned syllabi and curriculum documents at the grantee schools was performed, and content in the core curricular domains was coded into subcategories. The lead investigators reviewed and discussed drafts of the categorization scheme, collapsed and combined domains and subcategories, and resolved disagreements via group discussion.Analysis yielded three types of domains: core, cross-cutting, and linking. Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking.This broad framework aims to build on the traditional definition of systems-based practice and highlight the need for medical and other health professions schools to better align education programs with the anticipated needs of the systems in which students will practice. HSS will require a critical investigation into existing curricula to determine the most efficient methods for integration with the basic and clinical sciences.

Health system leaders are calling for reform of medical education programs to meet evolving needs of health systems. U.S. medical schools have initiated innovative curricula related to health systems science (HSS), which includes competencies in value-based care, population health, system improvement, interprofessional collaboration, and systems thinking. Successful implementation of HSS curricula is challenging because of the necessity for new curricular methods, assessments, and educators and for resource allocation. Perhaps most notable of these challenges, however, is students' mixed receptivity. Although many students are fully engaged, others are dissatisfied with curricular time dedicated to competencies not perceived as high yield. HSS learning can be viewed as "broccoli"-students may realize it is good for them in the long term, but it may not be palatable in the moment. Further analysis is necessary for accelerating change both locally and nationally.With over 11 years of experience in global HSS curricular reform in 2 medical schools and informed by the curricular implementation "performance gap," the authors explore student receptivity challenges, including marginalization of HSS coursework, infancy of the HSS field, relative nascence of curricula and educators, heterogeneity of pedagogies, tensions in students' perceptions of their professional role, and culture of HSS integration. The authors call for the reexamination of 5 issues influencing HSS receptivity: student recruitment processes, faculty development, building an HSS academic "home," evaluation metrics, and transparent collaboration between medical schools. To fulfill the social obligation of meeting patients' needs, educators must seek a shared understanding of underlying challenges of HSS innovations.

The environment in which a company or organization operates today can be characterized by accelerating change, the globalization of markets, the emergence of new technologies and competitors, new regulatory requirements and ever more demanding users and citizens. In this environment, the ability to innovate becomes a key success factor for most organizations. They seek to continuously create and realize value by introducing new or changed products, services, processes, models, methods, etc.

This paper offers a general systems definition of the phrase “evolutionary development” and an introduction to its application to autopoetic (self-reproducing) complex systems, including the universe as a system. Evolutionary development, evo devo or ED, is a term that can be used by philosophers, scientists, historians, and others as a replacement for the more general term “evolution,” whenever a scholar thinks experimental, selectionist, stochastic, and contingent or “evolutionary” processes, and also convergent, statistically deterministic (probabilistically predictable), or “developmental” processes, including replication, may be simultaneously contributing to selection and adaptation in any complex system, including the universe as a system.

The Thames is an iconic river of cultural and historical importance. A cyclical process of deterioration during the last two centuries, followed by technology-driven restorations, including two major sanitation projects with a third currently underway, has produced detrimental effects on the Thames ecosystem. This paper overviews the river ecology, pollution and other anthropogenic pressures, which lead to biodiversity loss and the proliferation of non-native, pollution-tolerant species. This article further reviews past and current management, sampling and assessments trends and provides an objective overview of remediation, restoration and monitoring needs, practices and research gaps. Here, we argue that restoration work, if maladapted, can be ineffective in improving resilience or have unexpected side effects that make matters worse rather than better. We explain the need for a broader view of river restoration and management including consideration of species transplants in achieving overall sustainability against a backdrop of accelerating change in the Anthropocene.

Purpose The impact of changing roles, skill mix and a shortage of consultant radiologists on the profession of diagnostic radiography is not clearly understood in Scotland although the anecdotal perspective suggests the situation in many areas does not equate to that of England. Method A questionnaire survey was administered to ‘lead diagnostic radiographers' across all Health Boards in Scotland and this was supplemented with telephone interviews. Results The implementation of skill mix initiatives and particularly advanced/extended scope practice was found to be geographically variable with limited evidence of change in some areas. Lack of effective funding and backfill for training was found to be a major barrier to change, although it was also acknowledged that opposition from some professional groups could be a major factor. Conclusion Although there is some optimism and evidence of accelerating change, development of the radiographic workforce in Scotland does not in general compare favourably to the findings of Price et al., in 2007. The reasons are multi-factorial including fiscal, professional and geographical elements.

NCS are the contents such as knowledge, technology, and culture demanded for performing the duties in the industrial field systemized by a nation classified with industrial divisions and levels. It is an ability standardized in the national level necessary for performing duties of industrial field successfully. Now, the society structure, due to abrupt change and development, has to secure core ability demanded to human resources in common, irrespective of kinds and positions, and lays an emphasis on vocational basis ability to softly cope with the accelerating change of labor market. This dissertation, on the basis of NCS-based vocational education curriculum, focuses on information ability, computer use ability(information management ability), one of vocational core competency used for the duties related at the department of video & broadcasting to develop learning module. In addition, this dissertation researches learning results such as satisfaction and accomplishment over learning on the object of the students who took the education.

Considering a stochastic clock – a chronograph that ticks randomly according to an underpinning ticking rate – we address the durations between its successive ticking epochs and ask: when are the inter-ticking durations independent of each other? We establish that this question has two answers: equilibrium and non-equilibrium. The equilibrium answer is termed Benchmark Clock, it is characterized by a constant ticking rate, and it corresponds to the time-flow of a “steady-state universe” model. The non-equilibrium answer is termed Moore’s Clock, it is characterized by an exponential ticking rate, and it corresponds to the time-flow of a “big-bang universe” model. In the context of stochastic clocks, Moore’s Clock is the manifestation of Moore’s Law of accelerating change . This paper explores the rich statistical structure of Moore’s Clock, and pinpoints the dramatic differences between the stationary Benchmark Clock and the non-stationary Moore’s Clock.

Despite the accelerating change at all levels of life, demanding a plethora of new intelligent systems, formal education continues to resemble a box, created during Industrial Revolution and only modestly changed since. The technicist curriculum and the public school remain a modernist project, boxing in students and constraining their imaginations. So, it is not worth investing in intelligent technologies if education is not considered, creating new flexibilities for people’s behaviours and attitudes. A paradigm shift in the area of education and teacher education will advance the fruition of the Universal Village more than any specific invention or system. The aim of this presentation is to share my concern about the inadequacy of the “black-and-white” mental organisation caused by the knowledge boundaries of various disciplines in hierarchical order, characteristic of the modernist curriculum implemented at schools, and the real need for a global and interdisciplinary methodological approach focused on the greatest problems of humanity.