Harvard Macy Community Blog

Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education.

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

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F.O.C.U.S.E.D on Improving on the Dental Education

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?”

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Pedagogy and Discharge Instructions: Do We Practice What We Preach?

“OK, so we think you have pleurisy. Your D-dimer was negative. You should take ibuprofen, rest and stay hydrated, then follow-up with your primary care physician. Any questions?”

My daughter reached for her discharge papers as she slid off the exam table and we thanked the staff as we made our way out of the urgent care part of a local emergency department.

She was eighteen at the time, a college freshman studying sociology. She called me to tell me she had been experiencing two days of pleuritic chest pain and felt a little short of breath. Because our logical, medical brains turn into parent brains when our child is sick, I dropped everything I was doing to go and see her. She looked fine, the pain was probably just musculoskeletal; she is a ballet dancer and these minor aches and pains are common. But, I thought, “What about a pulmonary embolism?” “Not likely” I thought, “but I’m here so let’s go get it checked out”.

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Technology in education: Transforming how we connect and build our learning communities

Working through the online pre-course materials for the Harvard Macy course “Health Care Education 2.0 – Transforming your Teaching for the Digital Age” we could not help but wonder if technology has evolved to the point that courses such as this might soon be delivered in an entirely online format. As a busy health professions educator, perhaps this thought has occurred to you as well, as you pack your suitcase for yet another flight, set your away message again, and put your projects, clinics, patients or meetings on a temporary hold to attend professional conferences or courses. If you teach in the classroom, then you may have received similar feedback from your own students such as our favorite, “Next time, can this session just be available online? I prefer to watch lectures at night on 2x speed.”

Recent Comments
Amanda Brooke Hooper MD, FACP

Thank YOU!

Thank you for encouraging me to attend this Harvard Macy course. It is a privilege and a joy to work with you Dr. Bridges!
Wednesday, 03 April 2019 4:04 PM
Julie A. Bridges

Thank You!

The Healthcare Education 2.0 course was rocket fuel motivation for us at Eastern Virginia Medical School because Dr. Hooper came b... Read More
Thursday, 28 March 2019 2:02 PM
Amanda Brooke Hooper MD, FACP

Thank YOU!

One of the best parts of this course was connecting with colleagues like you BA! Thanks for being a fantastic sounding board and f... Read More
Wednesday, 03 April 2019 4:04 PM
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The Role of Emotionality in Teaching and Learning

Emotion and learning have been viewed largely as separate entities, often with the role of emotions in learning (e.g. anxiety) as hindering. However, recent research has pointed to the interdependence between emotions and learning, suggesting that emotions are important, and perhaps even central to the cognitive learning process. Biologically, emotions are powerful motivators of learning because they activate brain mechanisms (e.g amygdala) that originally evolved to manage our basic survival. When reflecting on past educational experiences, the best teacher most quickly recalled is usually one with whom an emotional bond existed. To maximize student understanding and transfer of educational experiences into real-world skills and careers, medical educators must find ways to leverage the emotional aspects of learning by:

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