As health care increasingly requires physicians to function as part of a system, medical schools are incorporating more hands-on, team-based experiences for students to learn the skills they need. Find out how students, clinics and patients alike may benefit from this emerging educational component.
How is med ed changing?
Medical students soon are likely to spend time in clinics doing more than simply observing physicians taking care of patients. They increasingly may take part in more aspects of the health system, for example, helping patients navigate the health care system, helping physicians who run clinics identify areas for quality improvement or coordinating different aspects of a patient’s care.
As accountable care organizations and patient-centered medical homes become a larger part of the health care system, health systems science (HSS) is becoming the third pillar of undergraduate medical education. That means professional teamwork and collaboration, population health, quality improvement, clinical informatics and high-value care all are skills that new physicians need to function in the 21st-century health care system, leaders in the HSS field say.
Medical schools are incorporating HSS into classroom curriculums, but a new study points out that more needs to be done to provide students with hands-on experience. The study grew out of HSS work that Penn State University College of Medicine is doing after becoming a founding member of the AMA’s Accelerating Change in Medical Education Consortium in 2013.
Study authors talked with leaders at 30 clinical sites and programs—a wide range of settings from primary care clinics to an inpatient discharge program—to find out what experiences would be useful to students and the professionals helping train the next generation of physicians.
“This study’s results highlight the potential for integrating students into interprofessional care teams in a wide range of clinical sites to simultaneously add value to the health care system and enhance education,” study authors concluded.
How can students help patients, clinics?
Clinicians who participated in the study said students could work directly with patients to improve their health. Examples of these kinds of activities include:
- Monitoring care plans via face-to-face meetings
- Facilitating patient access to services and resources, for example medical assistance or exercise programs
- Assessing patients to identify social or systems barriers that may impact the care plan
- Assisting patients to overcome challenges and motivating them to attain their goals by serving as a patient “coach”
Participants in the study said that patients benefit from having another set of eyes on them and another contact for them.
Students also would be able to help the clinic by serving as a link between patients and the clinic. For example, students could arrange appointments, communicate updates to specialist care teams or assist patients through the hospital discharge transition period.
As part of hands-on HSS, students also could explore areas at a clinic where quality improvement initiatives would help advance patient care, or students could expand the educational library available for patients, the study said.
What do students gain?
Professionals in the clinical setting told researchers that students would graduate from medical school with a better understanding of the health care delivery system and a better appreciation for the patient experience.
“In identifying and addressing barriers to care, students would have the opportunity to appreciate firsthand the fragmentation of the health care system and participate in efforts to overcome those gaps to improve outcomes,” study authors wrote. Among the skills that leaders at the clinics and programs told researchers that medical students would gain:
- “It will improve their ability to provide care to patients as they move on in their training. Sometimes people finish their medical training and don’t understand how you arrange visiting nurses or what community services are available for patients who may have a limited social network.”
- “It’s really crucial to help students have a better understanding of all the barriers a person might face to get where they are when they show up in their exam room."
- “Students need to be aware of the patient’s situation in life and how that is impacting their ability to either follow your recommendations or not, get the medications that they need or not, go to the referral that they need or not.”
