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Health Systems Science: The future of medical education and the solution to improving health care

This is an exciting time in medical education – as educators we have realized the importance of medical education reform and are in the process of rethinking how we educate our learners. There are many exciting innovators and innovations – but none with more potential and direct applicability than the implementation of Health Systems Science into medical education curricula.

What is Health Systems Science? Also known as the Science of Health Care Delivery, it refers to the critical competencies that are necessary for us to deliver the highest quality value-based health care in a manner that is both patient and population centered. It is how we can operationalize the education necessary to meet the Triple Aim of health care. Many of the hot topics currently being addressed in both the undergraduate medical education and graduate medical education spheres already encompass some Health Systems Science competencies. These competencies include population health (social determinants and healthcare equity), value-based care, health care policy and economics, interprofessional skills, informatics, and health system improvement. 

Why is Health Systems Science so important? In order to move beyond Flexner and truly embrace the continuum of medical education, we need to start thinking about foundational knowledge and clinical knowledge in a synthetic fashion and move away from the traditional 2+2 medical education model.  We have an opportunity to truly integrate the foundational sciences and clinical knowledge that our learners need, to use pedagogical approaches that will facilitate the integration of their foundational and clinical learning, and to ensure our students acquire the knowledge and skills necessary to be excellent physicians. Threads now incorporated into many curricula such as clinical reasoning, leadership, professionalism, and reflection are all critical subcompetencies of each of the Health Systems Science competency domains. Health Systems Science is the scaffolding upon which competency based medical education will thrive and ensure that our future physicians have the knowledge and skills to meet the needs of their patients. 

What are some early outcomes of Health Systems Science? As with any change in approach to medical education, innovative change without program evaluation impedes meaningful dissemination. Some of the early outcomes that speak to the importance and value of Health Systems Science have been the adaptation and implementation of the components of Health Systems Science into Undergraduate Medical Education programs. Some examples include:

1) Design of curricular frameworks for Health Systems Science

2) Early integration of medical students into the health care delivery system by incorporating medical students into the health care team as part of their educational experience

3) Students with longitudinal exposure to curricula that include competencies of health systems science will be better prepared to take on the challenges of residency and functioning in complex health care systems 

What are the next steps? Much of the curricular reform centered on Health Systems Sciences is fairly recent. Next steps include a thoughtful approach to defining specific competencies associated with the application of Health Systems Science knowledge, assessing short term and long-term educational outcomes, and most importantly determining the impact on patient care associated with incorporation of Health Systems Science into the undergraduate medical education sphere.

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Friday, 23 August 2019