Working with health care delivery systems in novel ways

Consortium schools are creating new learning experiences embedded within health care systems that not only teach principles of health systems science, but also bring value to the health care system.

Training students to be patient navigators, to plan and execute quality improvement projects and to perform important functions that benefit patient-centered teams serve dual purposes. Students learn about health care delivery by working in authentic settings, and they are able to contribute to improving the health of patients in meaningful ways.

"The really innovative part is the authentic, in-depth clinical experience of students serving as patient navigators, both within our health system and also health systems in south-central Pennsylvania."

Jed Gonzalo, MD, MSc, senior associate dean for medical education, Virginia Tech Carilion School of Medicine

Value-Added Roles for Medical Students, published by Elsevier and written by experts from the Accelerating Change in Medical Education Consortium, is a first-of-its-kind, instructor-focused field book that inspires educators to transform the relationship between medical schools and health systems with authentic workplace roles for medical students, adding relevance to medical education and patient care. Providing real-life clinical experiences and context to medical students is an essential part of today’s medical education, and the partnerships between medical schools and health systems are an integral part of this approach.

This study by authors at Penn State College of Medicine investigates preceptor-role types, communication frequency, and importance of preceptors in value-added patient navigator roles (PN) and clinical preceptorships (CP). Comparing ratings for non-physicians to physician health care professionals in PN, communication frequency, importance to work, and education were higher for non-physician educators. Comparing ratings for non-physicians to physician health care professionals in CP, communication frequency, importance to work and education were higher for physician educators.

Qualitative analysis indicated that non-physician health care providers in PN focused on health systems science concepts, including social determinants of health and health care delivery. In PN, students observed collaboration from the perspective of multiple providers. In CP, health care professionals, mainly physicians, focused on physician-centric clinical skills and interprofessional collaboration from the physician’s perspective. Educational benefits of non-physician health care professionals related to health systems science in work-based clinical settings—or landscapes of practice—can help students understand systems-based concepts such as social determinants of health, health care delivery systems, and interprofessional collaboration.

This study by authors at the University of California, San Francisco, a member school of the Accelerating Change in Medical Education Consortium, proposes a framework for evaluating medical student health system improvement projects that incorporates the effects on health systems. This is so program design can optimize the experience for all involved, health systems as well as medical students.

This study by authors at the University of Chicago, a member school of the Accelerating Change in Medical Education Consortium, explores how medical students fulfilled a value-added role, gained knowledge of and hands-on experience with addiction medicine, discussed sensitive topics with patients and identified a high volume of patients eligible to receive naloxone.

This study by authors from Case Western Reserve University, School of Medicine, a member school of the Accelerating Change in Medical Education Consortium, explores how early meaningful experiential learning in community settings impacted medical students’ application of systems thinking, their perceptions of systems navigation, and their professional identity as health system change agents.

This paper, by authors from Penn State University College of Medicine and the AMA, identifies way that medical students in current clinical roles can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects.

This paper by researchers at Florida International University Herbert Wertheim College of Medicine, describes the approach, logistics, educational goals, structure and outcomes of the Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP).

This program provides a platform for the school's community-focused mission and emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care.

NeighborhoodHELP is a required, longitudinal service-learning outreach program in which each medical student is assigned a household in a medically underserved community. Students, teamed with learners from other professional schools, provide social and clinical services to their household for three years.

In this paper the authors describe principles and strategies for meaningful medical school-health system partnerships to engage students in value-added clinical systems learning roles.