Development of a health care systems curriculum

Abstract

BackgroundThere is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.MethodsThis case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created to assess student health system competence. Student evaluation of course curriculum design, delivery, and assessment was provided through web-based surveys.ResultsTo meet competency standards for system-based practice, a health systems curriculum was developed and delivered across 4 years of medical school training. Each of the health system lectures and problem-based learning activities are described herein. The majority of first and second year medical students stated they gained working knowledge of health systems by engaging in these sessions. The majority of the 2016 graduating students (88.24%) felt that the course content, overall, prepared them for their career.ConclusionA health systems curriculum in undergraduate medical education using a problem-based learning approach is feasible. The majority of students learning health systems curriculum through this format reported being prepared to improve individual patient care and optimize the health system’s value (better care and health for lower cost).

Building Health Systems Science Education from the Core Domain of Interprofessional Education at Virginia Tech Carilion School of Medicine

“…As healthcare delivery systems continue evolving the delivery of care to achieve the Quadruple Aim (i.e., improved patient experience of care, better care outcomes, lower costs, and clinician well-being), there is a corresponding need for medical education to develop and deliver content pertaining to how healthcare systems work and how the role of the clinical provider must include what has been described as systems citizenship. Currently, physicians may acquire skills in HSS during residency training as part of education pertaining to the general competency known as systems-based practice [ 4 ]. Subsequently, physicians may also encounter this content as part of ongoing professional development designed for career enhancement, with much of this learning taking place in their everyday workplace settings.…”

The need for health systems education during medical training in the UK

“…New curricula in the UK must make educated guesses regarding what type of instruction makes sense and/or use US medical school 4-year curricula as loose guides. One case study of a US medical school showed that over 85% of graduating students felt that the health systems curriculum had prepared them for their careers 22. This seemingly general metric is important to note, because it suggests that implementing such a programme in the UK could break down the greatest barrier to UK medical students engaging in health policy work: knowledge of the health system.…”

Problem-based learning in primary care at University of Ribeirão Preto (UNAERP) in Brazil

“…We read with great interest the excellent paper by Pruitt et al 1 who presented a problem-based learning (PBL) approach to system-based practice medical education. Because a PBL medical teaching approach in primary care is rare, we would like to report our experience on this strategy as well.…”

“…We are grateful to Romão et al for their comments about our recently published manuscript outlining the development of the health systems curriculum. 1 We read with interest that Romão et al have recently implemented problem-based learning (PBL) strategy in primary care clerkship (PCC). We have employed a similar approach at the PCC of our University of South Florida Lehigh Valley Health Network campus, which is also a longitudinal clerkship offered concurrently with other traditional clerkships in blocks.…”

“…As outlined in our recent manuscript, we have employed a PBL approach to teaching health systems curriculum incorporating health care system topics of the USA and around the globe. 1 We would encourage Romão et al if they have not already done so, to apply a PBL approach to health systems curriculum to evaluate the performance of Brazil’s Unified Health System, the need for improvement in cost, quality, safety, and access, and the role of the physician in health system transformation.…”