Experiential learning of systems-based practice: a hands-on experience for first-year medical residents

Systems-based practice, a domain of expertise mandated for all residencies by the Accreditation Council for Graduate Medical Education, requires an interdisciplinary approach that involves communicating with the other members of the health care team as well as utilizing the many components of health care delivery. The Mercy Catholic Medical Center internal medicine residency leadership developed a two-week supervised experience in systems-based practice for first-year medical residents to give them firsthand experience with nonphysician providers' delivery of health care. The disciplines in the experience were home care services, hospice care, pharmacy services, laboratory services, utilization services, and nutrition services. Nonphysician health care providers willingly made themselves available for this educational activity because they felt that such face-to-face interaction fosters an improved understanding of their discipline and its services in the participating physicians. Surveys of resident knowledge pre- and postworkshop suggested that the residents' rudimentary understanding of these disciplines developed into both a deeper theoretical understanding and a greater knowledge of specific policies regarding these health care services. This type of experience is likely a necessary first step toward developing physicians who can provide interdisciplinary medical care that integrates the many other health care disciplines into a comprehensive plan to maximize health outcomes. As physicians become leaders of multidisciplinary teams in the 21st century, firsthand knowledge of the other health services enhances their capacity to maximize the services of these other disciplines for the benefit of patient care.