Designing for Adaptive Expertise: Deliberately Developmental Organizations and Continuing Professional Development

Abstract: Adaptive expertise, which combines the efficiency of routine expertise with the adaptability required for innovation, has increasingly been recognized as essential for health care practice. Although health professions’ education has made substantial progress in preparing learners for adaptive practice, the development of adaptive expertise extends well beyond formal training. Workplace-based learning and continuing professional development (CPD) play critical roles in supporting a professional's ability to learn, adapt, and innovate throughout their careers. However, many CPD approaches remain focused on knowledge acquisition and maintenance of competence with limited attention to the organizational conditions that support adaptive expertise development. This article proposes the use of the Deliberately Developmental Organization (DDO) model as a conceptual framework for cultivating adaptive expertise in health care organizations. Drawing on the literature from adaptive expertise, workplace learning, and organizational development, we describe how DDO principles could be applied to create workplace environments that embed learning into everyday practice. Specifically, we highlight the role of developmental learning communities, learning-oriented operational design, and expanded professional roles as possible mechanisms for fostering adaptive expertise. By reframing adaptive expertise as a shared responsibility between health care professionals and the environments in which they practice, the DDO model offers a conceptual framework for integrating adaptive expertise into CPD and workplace learning systems.