Research, kindness and the antifragility of emergency medicine.

Antifragility is a property of things that benefit from shocks, randomness and uncertainty and love adventure and risk. This describes emergency medicine. Improving evidence-based medicine requires a learning health system, where the whole system is constructed to advance patient care via research driven excellence. So we need to develop our own evidence base by embedding research into everyday practice. Clinical research is messy but the repeated stress testing of clinical practice via research enhances our antifragility. This is even more important because our world is complex, as are humans. Unfortunately, the human brain is hard wired for simplicity, making us disinclined to challenge the status quo. Yet probably <10% of our practice is supported by high-level evidence. Research is altruistic and a form of kindness for our patients, which includes having a culture of research within a learning health system, so that we can be thoughtful!