Related Experiment Video
Updated: Jun 2, 2026
14:32
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Systems-based practice in graduate medical education: systems thinking as the missing foundational construct.
Colleen Y Colbert1, Paul E Ogden, Allison R Ownby
1Scott & White Healthcare and Internal Medicine, Texas A&M University System Health Science Center College of Medicine, Temple, Texas 76508, USA. cycolbert@swmail.sw.org
Teaching and Learning in Medicine
|April 26, 2011
Summary
Systems thinking, not just systems-based practice (SBP), is crucial for effective assessment in medical residencies. Incorporating systems thinking models into curricula can improve quality and patient safety initiatives.
Area of Science:
- Medical Education
- Healthcare Systems Analysis
- Psychometrics
Background:
- Residencies face persistent challenges in teaching and assessing systems-based practice (SBP) since 2001.
- Current assessment methods for SBP may be insufficient due to the lack of a foundational construct.
- Systems thinking is proposed as the underlying construct for SBP, currently missing from accreditation standards.
Purpose of the Study:
- To identify and describe psychometric challenges hindering the assessment of systems-based practice (SBP).
- To clarify the integral role of systems thinking in both the teaching and assessment of SBP.
- To advocate for the integration of systems thinking into graduate medical education.
Main Methods:
- Literature review and conceptual analysis of systems thinking and systems-based practice.
- Examination of psychometric principles relevant to competency assessment in medical education.
- Synthesis of existing models for skill development and application to healthcare systems.
Main Results:
- Psychometric limitations impede the accurate assessment of systems-based practice (SBP) when treated as a standalone competency.
- Systems thinking provides a robust framework for understanding and evaluating SBP.
- The absence of explicit systems thinking instruction hinders trainees' ability to analyze complex healthcare environments.
Conclusions:
- Medical residency programs must integrate systems thinking principles and models into their educational frameworks.
- Trainees require explicit instruction in systems thinking to analyze healthcare systems and engage in quality improvement.
- A developmental progression for systems thinking, akin to the Dreyfus model, should be established for medical trainees.
Related Concept Videos
01:30Theoretical Foundations of Nursing Practice
Theories play an essential role in organizing patient care. Theories refer to a proposed or followed belief, policy, or procedure that is the basis for action. Nursing theories are knowledge-based concepts that guide nurses' actions, influence nursing education and practice, and allow nurses to care for their patients.
Theories provide a perspective to assess patients' conditions and organize data and methods. They also assist in analyzing and interpreting information. They represent a...
Theories provide a perspective to assess patients' conditions and organize data and methods. They also assist in analyzing and interpreting information. They represent a...
01:25Critical Thinking II
Critical thinking is a cognitive process with several attributes. The attributes of critical thinking include the following:
01:13Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:24Critical Thinking I
Critical thinking helps decision-making and allows nurses to recognize barriers to success and find solutions to possible issues. It helps to brainstorm and implement ideas to achieve goals. Critical thinking helps acknowledge and state workflow inefficiencies while improving management techniques. Nurses understand the value of critical thinking and look for fellow nurses with critical thinking skills to upgrade their professional standards. Critical thinking can advance a nurse's career with...
01:18Introduction To Health Care Delivery System
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...