How Medical Schools Can Promote Community Collaboration Through Health Systems Science Education

Abstract

Traditional focus areas of medical education are insufficient for preparing future clinicians to function well in the rapidly evolving US health care system. In response, many medical schools and residency programs are integrating into their curricula health systems science (HSS), which includes health care policy, public and population health, interprofessional collaboration, value-based care, health system improvement, and systems thinking. To illustrate the value of HSS, the authors draw upon their experiences as a medical student immersed in HSS and as an educator facilitating students' cultivation of HSS skills. The Need for Health Systems Science US health care delivery systems are rapidly and extensively changing. A significant component of this change concerns organizational structures and processes, such as shifting reimbursement models towards value-based care, increasing the use of care coordinators, and implementing patient-centered medical homes. 1-3 Yet there has also been a concomitant transformation in the outlook of physicians, who are becoming increasingly aware, for instance, that what occurs outside of the clinic or hospital and in a patient's community has a significant impact on health. As these changes require physicians to view their role and contribution to patient care in a new and different way, medical schools and residencies are faced with the corresponding challenge of changing the way students and residents are educated. For nearly a century, medical education has focused on the basic and clinical sciences, 4 but this paradigm has been changing with the emergence of health systems science (HSS). This change started in the 1990s, when increasing evidence of the high incidence of medical errors catalyzed a movement to improve care delivery models. 5-7 In 1999, the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties adopted systems-based practice as one of the 6 core competencies in both undergraduate and graduate medical education. 8 Medical schools slowly began to integrate quality improvement, 9,10 interprofessional education and collaboration, and social determinants of health into curricula, while residency programs increased their focus on quality improvement and patient safety. 11,12 However, by 2012, these systems

The Impact of Community Service Experience on the Undergraduate Students’ Learning Curve and Subsequent Changes of the Curriculum- A Quality Improvement Project at a Caribbean Medical University

“…Various CSL models that researchers have proposed are targeted towards creating community-oriented healthcare professionals aligned with identification and addressing the health care needs of society. The true goal of medical education is to work in collaboration with society and strive to improve health systems and patient care (Davis and Gonzalo, 2019). This collaboration underpins the increasing need for medical students to learn the functioning of a physician in society (Asgary et al, 2016;Meili et al, 2011).…”

The triple helix of clinical, research, and education missions in academic health centers: A qualitative study of diverse stakeholder perspectives

“…These concepts (Figure 1 ) overlap with the HSS framework, which originated within medical education but has been proposed as a unifying framework for advancing research and clinical operations. 25 , 26 , 27 , 28 , 29 HSS has the depth and reach to support coproduction across missions. Some authors have suggested more limited applications, such as a recent insightful commentary suggesting AHCs consider adding a fourth mission to the tripartite model focusing on social accountability.…”

“…16 In addition, based upon our prior and current work, we were open to categorizing the results within the health systems science (HSS) framework (if applicable), which is defined as the “principles, methods, and practice of improving quality, outcomes, and costs of healthcare delivery for patients and populations within systems of medical care.” The HSS framework originated within education but has been advanced as critical for integrating research and operations. 25 , 26 , 27 , 28 , 29 We anticipated that several areas of synergy between the missions would be related to HSS concepts. Analysis was performed with data management support from the program Atlas.ti 6.0 (Scientific Software, Berlin, Germany).…”

How Academic Medical Centers Can Navigate the Pandemic and Its Aftermath: Solutions for 3 Major Issues

“…AMC relationships with their surrounding communities, including providing social work, drug rehabilitation, counseling, and a host of wellness/prevention services, can provide space for students to interact with and contribute to active public health systems. 12 Such service learning has been shown to help students and communities better understand and address social determinants of health. 13 …”