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Chaos theory: lessons on educating equality and leadership
  1. Chris Bowman1,
  2. Katie Mellor1,2,
  3. Arfon Powell1,
  4. Wyn G Lewis1,3
  1. 1School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UK
  2. 2Department of Surgery, Ysbyty Gwynedd, Bangor, UK
  3. 3Department of Surgery, University Hospital of Wales, Cardiff, UK
  1. Correspondence to Chris Bowman, School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, Cardiff CF15 7QQ, UK; crb36cam{at}

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Chaos is a state of complete disorder and confusion. Chaos theory is an interdisciplinary branch of mathematics focusing on dynamic systems whose ostensible disorder is influenced by regulations extremely vulnerable to early conditions. Education embraces three principal elements: curriculum, teaching and assessment. Each is a hot political topic, they run deep, for four collective reasons: personal, social, cultural and economical. The quest for equality in education requires collective synchronisation from each perspective, but at present no such harmony exists, in large measure because of chaos.

Swift career progression and national training number promotion demands steep learning curve trajectories from early year (phase I) trainees. But despite apparent parity of esteem in training programme selection, faced with frequent curriculum upgrades, stiff examination hurdles and hidden curricular variation, differential attainment burgeons and malady lurks.1 Forecasting behaviour is the holy grail of social science, yet prognostic accuracy is volatile and discouragingly poor. Health is all about people and education about leadership, and consequently modern medical organisations are inherently disorganised. Individuals or organisations existing within similar environments reveal quite different behaviours, despite comparable performance governance. Moreover, the concept of chaos is distinct from other flaws in practical research, including chance, intangible extrinsic factors and the tyranny of metrics; yet given its importance, this theory has received little learnt analysis from a medical perspective. To paraphrase: some shared systems are characterised by chaotic behaviour, precluding the possibility of accurately predicting performance and research should focus on identifying high-risk scenarios, so that training environments may be optimised, trainee resilience improved and effective counter measures implemented.

In mathematics, physics and similar non-social scientific arenas, the existence of chaotic systems is well established. Evidence for chaotic behaviour in social science emerged in the late 1980s and there are at least two useful indicators of chaos.2 First, …

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  • CB and KM are joint first authors.

  • Twitter @PowArG07

  • Contributors WGL conceived the paper, refined the reporting of the work and is the guarantor of this work. CB, KM and AP contributed to reporting of the work and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.