Josiah Macy, Jr. Foundation Faculty Scholar and 2018 Scholar Vineet Arora, M.D., recently accepted the new Associate Chief Medical Officer-Clinical Learning Environment role at the University of Chicago Medicine. Vineet previously worked in graduate medical education to improve the clinical learning environment for residents and fellows by aligning institutional priorities with the work that trainees do on a daily basis. She is expanding this work to the whole health system, in her role as a “bridging leader.” She recently completed the Program in Health Professions Educators with Nirvani Goolsarran, an Associate Internal Medicine Program Director at Stony Brook University Hospital who is also a bridging leader in quality and education and active in the growing bridging leader community. We thought it would be interesting to ask them some questions about bridging leaders and how they were able to apply their knowledge gained at the course to these new roles.

At the 2019 Central Group on Educational Affairs Conference in Grand Rapids, Michigan, Irina Overman and Brenda Roman from the Wright State University Boonshoft School of Medicine shared their experiences with Peer Instruction (PI). PI is a learner‐centered instructional approach developed at Harvard University by Eric Mazur and a straight forward method for encouraging active learning.

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

It is 5 pm on a Friday in the pre-doctoral dental clinic at your institution. A procedure has taken 5 hours, when it seemingly could have taken 90 minutes. Frustrated and exhausted, the student cannot seem to apply the content that they have learned in the classroom into real life. As an instructor you can’t help but think “What could we, as dental educators, have done to prevent this?”