Until recently, medical education had changed little for over a century. But then a breakthrough change began in US medical schools. They started teaching Health Systems Science (HSS) – the understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care – as the third pillar of medical education alongside the basic and clinical sciences.
And now, students at dozens of medical schools are putting what they learned about health systems science into practice.
The authors of a current one items in the Academic medicine reviewed more than 40 abstracts on projects using one or more HSS domains submitted to the AMA Accelerating Change in Medical Education 2018 Health Systems Science Student Impact Competition. They identified three persistent shortcomings in medicine and medical training that were frequently addressed: care for patients with mental illness, diversity in medicine, and teamwork and interprofessional training.
The AMA is accelerating change in the medical education consortium, which was launched in 2013, is one of the most prominent voices for integrating health systems science into medical education.
The consortium launched the Student Impact Competition Health Systems Science – now known as the Health Systems Science Student, Resident and Fellow Impact Challenge – 2018 to identify medical students who have used their knowledge of health systems science to improve the lives of patients, physicians, and other health professionals.
“These projects and their subsequent analysis show that medical students not only have a significant impact on the health system, patients and other health professionals when they are armed with HSS skills, work in health teams and are mentored, but that they may also be in the Are able to address some of the long-standing challenges of medicine and medical education, “write the authors, which include doctors and other staff at the AMA, Boston Children’s Hospital, Boston Medical Center, University of Michigan Medical School, and Virginia Commonwealth University School of Medicine belong.
Three teams from the University of California, San Francisco (UCSF) School of Medicine and two from the University of North Carolina (UNC) School of Medicine ran pilot projects to address the reduced life expectancy, stigma, and inequalities in care associated with mental illness go hand in hand, tackle. Starting from the HSS areas of population health, public health, and quality improvement, they sought to better connect patients with preventive medicine, outpatient mental health services, and general practitioners.
To improve the connection between paediatricians and counselors, a team from the UNC School of Medicine has developed a one-page summary report that is faxed to counselors after each referral so that paediatricians can learn from counselors whether their patients’ first appointments have been met. if diagnoses are available, appointments for follow-up appointments, any concerns and treatment recommendations have been agreed.
After the one-page summary reports were implemented, referrals increased from 18% to 66%.
Teams from Harvard Medical School, the University of California, Davis School of Medicine, the University of Michigan Medical School, and Brown University’s Warren Alpert Medical School wanted to help create a more diverse workforce for doctors to address health disparities between demographic groups to tackle. With what they learned about the HSS area of leadership, the students sought to strengthen the medical school pipeline for students who are underrepresented in medicine.
For example, the Brown team launched Health Career Opportunities Reimagined (HealthCORE), a longitudinal counseling and mentoring program for high school students from ethnic and ethnic groups who are underrepresented in medicine. They recruited 23 students for a two-week summer intensive program that focused on topics not normally included in pipeline programs, including global health, medical design, and narrative medicine. The students then spent a year volunteering in the community, accompanying doctors and taking part in research internships.
In conclusion, high school students reported an increased interest in a health career from 4.36 to 4.59 on a five-point Likert scale and a greater ability to pursue a career from 4 to 4.23.
Medical students at Emory University School of Medicine, Harvard Medical School, Rutgers Robert Wood Johnson Medical School, and UCSF School of Medicine wanted to improve interprofessional education. Starting from the HSS domain of “teaming” or focusing on how individuals work together on specific tasks to achieve common goals, they sought to overcome problems with information sharing, professional silos, and organizational factors.
The UCSF team worked on communicating doctors and other health professionals to reduce the time from decision to incision (DTI) on unplanned Caesarean sections at a county teaching hospital. They created a grading system to standardize the urgency of unplanned Caesarean sections and implemented a team huddle that included the chief obstetrician, bedside nurse, nurse, and anesthetist.
The first intervention reduced the DTI time from 97 to 93 minutes; later interventions reduced it to 82 minutes.
In 2020, the AMA Health Systems Science Student, Resident and Fellow Impact Challenge focused on Projects to fight the COVID-19 pandemic. The challenge continues this month.