Optimizing health systems science at University of Nebraska College of Medicine

Each month, the AMA highlights institutions that are part of the AMA Accelerating Change in Medical Education Consortium to showcase their work with the consortium and innovations in medical education.

Kelly Caverzagie, MD

Kelly Caverzagie, MD

Associate dean for learning environment and educational strategy; Vice president for education

University of Nebraska College of Medicine; Nebraska Medicine

Number of years in the consortium: 5 years

Our ChangeMedEd projects have evolved quite significantly over the course of time. Originally, our focus was to partner with the Office of Health Professions Education at Nebraska Medicine (our integrated clinical partner) to measure and improve the learning environment within the clinical space. This was done through purposeful alignment of educational and clinical needs in addition to dedicated attention to collaboration and cross-pollination, not only with the medical school but for all health professions education. While that work is ongoing, our current focus is to optimize the health systems science (HSS) curriculum in a longitudinal fashion to improve student learning and engagement in these key concepts. One way in which we do that is to purposefully teach about Nebraska Medicine itself using “real-life” quality and safety strategies used by the health system, approaches to community engagement and the use of the actual electronic health record to facilitate student learning. We are also exploring the use of design thinking principles to facilitate student learning of HSS principles in a longitudinal fashion during the last phase of their training. 

Our first-year medical students recently participated in a Community Engagement Day that served as a capstone to our HSS unit focusing on socio-economic determinants of health, population health, health equity and community engagement among other related topics. In this half-day session, student small groups traveled to community sites to engage leaders from a diverse list of community partners who focus on health advocacy for our local population. This event, which was placed on hold in 2020 due to the COVID-19 pandemic, was once again extremely well received by the students as well as the community leaders who enriched student learning by providing vital context to the topics learned and explored previously in the semester. 

The consortium has been a vital resource for UNMC and our approach to managing the pandemic. It is exceptionally helpful to have a community of friends and colleagues from across the nation to provide ideas, innovations and, quite frankly, moral support, to help us navigate these uncertain times. I can’t wait to see everyone in person (hopefully) very soon!

Medical education is rapidly changing, and I believe that pace will only accelerate over the next five years. In my view, the most prominent changes will stem from an extreme focus on the UME to GME transition in the wake of USMLE Step 1 turning to pass/fail scoring and, more importantly, the ongoing maturation of competency-based medical education (CBME). Less prominent at present, but I believe is a critical issue that will lead to change in medical education, is the role that private equity and for-profit health systems will play in medical education and specifically in GME. 

Trust, patience and understanding are critical to maintaining an engaged and thriving team. This is true at any time but especially during these most challenging of times. Grace should be a word that all of us add to our daily vocabulary! I think it also important to remember our collective history and that we have been through tough times before and have always ended up better on the other side. I believe that will be the case as we look toward the future as well.