When the COVID-19 pandemic emerged and medical schools temporarily suspended clinical rotations for their students, it threw undergraduate medical education into limbo. Thousands of learners, though, seized the opportunity to pursue innovative projects in increasingly important areas of medical education.
Many of those areas were within health systems science (HSS)—the study 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 delivery.
“This crisis was an unmatched opportunity for exploring core HSS concepts, and medical students developed meaningful competencies by alternate means,” wrote the authors of a review published last fall in the journal Cureus.
“Although medical students in medical school in 2020 and 2021 may have gaps in some areas that need to be addressed, the authors posit that those who engaged in these projects gained strengths that they would not have otherwise acquired,” they wrote.
For the study, “Applying Health Systems Science Competencies to Contribute to the COVID-19 Pandemic Response,” the authors reviewed 55 abstracts focused on student-led pandemic-related projects entered into the 2020 AMA Accelerating Change in Medical Education Consortium Health Systems Science Student, Resident and Fellow Impact Challenge.
By looking for keywords relevant to the health systems science domains, they identified which HSS competencies students most likely acquired through their participation in the projects.
The domain of competency that showed up most often: teaming, followed by technology and leadership.
Direct application of concepts
“If you look at what the needs were in this moment of time, basically our entire country got a crash course in health systems science,” said Kimberly D. Lomis, MD, vice president of education initiatives at the AMA and senior author of the study. “Nothing could have illustrated more obviously how HSS competencies are critical to the function of a physician.”
Teaming, technology and leadership bubbled up most often in the projects “because those were the things that were so necessary in the pandemic to respond to patients’ needs,” Dr. Lomis noted.
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In the case of the teaming domain, a project was considered as potentially leading to competency if it required the project leader to collaborate with medical or other health professions students or health professionals. The study found that 54 of the 55 projects, 98%, would likely contribute to developing competency in teaming, and 38 of the 55—more than two-thirds—were explicitly interprofessional.
One project, at New York University Grossman School of Medicine, paired 115 medical students with physicians who trained them to remotely gather clinical information from patient charts, participate in virtual rounds and provide daily clinical updates to patients’ family members, then document their interactions.
"Something we all heard at the time was how cut off patients felt from their families while they were hospitalized,” Dr. Lomis said. “In this case, students were able to acquire skills that they would have learned in the clinical workplace, but through a different modality—one that was very familiar to them.”
Dive deeper:
- Why teaching health systems science is a continuous commitment
- Health systems science skills must survive transition to residency
- How health systems science transforms future-physician training
- Before implementing health systems science, do these 3 things
Lessons for system leaders
The study had several limitations, the authors noted, including that reported data varied widely and that none of the abstracts included an assessment of whether an HSS-related competency had been achieved.
Nevertheless, the authors believe their review “reflects positive professional identity formation among students who took the initiative to contribute to the response in a way that was appropriate to their skill level and available information and resources.”
Moreover, it demonstrates that the student-led projects delivered numerous positive results for their academic medical centers, including financial savings and quality improvement.
“In some clinical contexts, because of the busy pace of the workflow, students can be perceived as a burden,” Dr. Lomis said. “It's our pitch that these are incredibly brilliant, talented, dedicated young people who have a lot to contribute.”
Learn more about the AMA ChangeMedEd® initiative, a collaborative effort to transform medical education across the continuum.
