Where do we go from here? Moving from systems-based practice process measures to true competency via developmental...

Area of Science:

• Medical Education
• Healthcare Administration

Background:

• Educators face challenges meeting Accreditation Council for Graduate Medical Education requirements for systems-based practice (SBP).
• Evaluating competency in SBP, despite milestones and entrustable professional activities (EPAs), adds complexity.
• Current SBP curricula often fail to address multiple core principles effectively.

Purpose of the Study:

• To review current teaching methods for systems-based practice (SBP) in graduate medical education.
• To provide recommendations for developing competency-based SBP curricula aligned with the Next Accreditation System (NAS).

Main Methods:

• A literature review of 29 articles on SBP education was conducted.
• Analysis focused on the core principles of SBP taught and the quality of educational approaches.
• Four guiding principles for curriculum development were synthesized.

Main Results:

• Only 28% of reviewed articles meaningfully taught more than one core SBP principle.
• A mere 7% of articles received the highest quality grade.
• Significant gaps exist in current SBP education, with limited focus on comprehensive coverage and quality.

Conclusions:

• Residency educators need to implement comprehensive, competency-based curricula for SBP.
• Four principles are proposed: include all core SBP principles, drive objectives by clinical outcomes, use interactive/relevant teaching, and ensure evaluations reflect milestones/EPAs.
• Adherence to these principles will help meet NAS standards for SBP competency.