Who Learns from Disruption? Antifragility and Burden Transfer in Health Professions Education

Health professions education (HPE) increasingly operates amid recurrent disruption: technological change, resource constraint, accreditation reform and unstable clinical learning environments. Antifragility - the property of systems that improve because of stressors - offers a tempting vocabulary. This Monograph argues that its value depends on the level of analysis. Applied to individuals, antifragility risks becoming another attribute demanded of those already absorbing systemic strain. Applied to systems, it asks whether institutions learn from disruption or transfer its costs downwards. The article distinguishes antifragility from neighbouring concepts, proposes five conditions for ethically defensible design, and identifies indicators for detecting burden transfer.