Mega-evolutions in medical education: Helpful or harmful to higher cognitive skill development?

Medicine is practiced in environments of volatility, uncertainty, complexity, ambiguity, and disruption (VUCAD). Medical educators are tasked with providing an education that prepares graduates to successfully practice medicine in those types of environments. While medical education is continually evolving to incorporate new content and educational approaches, there are two mega-evolutions that have permeated medical education: increased curricular structure and content integration. Structure and integration are assumed to be positive changes; however, they may alter the development of higher cognitive skills such as information management, planning, breadth of approach, strategy, and initiative. As new graduates will practice in VUCAD environments, it seems prudent to consider the effects of medical education’s mega-evolutions on the development of higher cognitive skills critical to those types of environments. This paper explores the potential consequences of the increased curricular structure and content integration in medical education for learners who will practice in VUCAD environments and proposes a research agenda to better understand the relationship between curricular structure and integration and higher cognitive skill development.