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The Action Research Program: Experiential Learning in Systems-Based Practice for First-Year Medical Students.

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Summary

This pilot program integrated systems-based practice (SBP) training into medical education, enhancing students' understanding of healthcare delivery and clinical skills. Future initiatives require dedicated time for quality improvement projects to ensure successful implementation.

Keywords:
clinical educationimplementation sciencequality improvementsystems-based practice

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Area of Science:

  • Medical Education
  • Healthcare Systems
  • Quality Improvement

Background:

  • The American Association of Medical Colleges recommends incorporating systems-based practice (SBP) into medical curricula.
  • Experiential learning in SBP, crucial for improving clinical care quality and efficiency, is often lacking in medical education.

Purpose of the Study:

  • To design and evaluate a 9-month clerkship for first-year medical students focused on systems-based practice.
  • To enhance students' understanding of clinical operations and strategies for improving healthcare quality and efficiency.

Main Methods:

  • A multidisciplinary team developed the "Action Research Program" in partnership with a cardiology outpatient clinic.
  • Eight trainees participated in educational seminars, research, and 9-week clinic rotations.
  • A qualitative evaluation used interviews and student field notes to assess process and outcomes.

Main Results:

  • Students demonstrated improved understanding of care delivery systems, enhanced clinical skills, and greater confidence.
  • Clinicians reported increased clinic efficiency and improved medical assistant performance due to mentoring.
  • Some clinicians experienced burden from student shadowing; most student-led improvement projects were not fully implemented.

Conclusions:

  • The Action Research Program successfully paired experiential and didactic training in systems-based practice.
  • Dedicated faculty support and protected time are essential for the success of student-led quality improvement projects.
  • Key features of the program were integrated into the University of California, San Francisco School of Medicine's curriculum.