Systems-Based Practice in Graduate Medical Education: Evolving Toward an Ideal Future State

Area of Science:

• Medical Education
• Health Systems Science
• Graduate Medical Education (GME)

Background:

• Systems-based practice (SBP) was established as a core competency in GME in 2002.
• Challenges include perceived curricular time erosion, context irrelevance, and late introduction.
• SBP experiences are often disconnected from trainees' practical realities.

Purpose of the Study:

• Provide guidance for evolving SBP to a future state.
• Enable graduates to apply a systems science mindset in practice.
• Address challenges hindering effective SBP integration in GME.

Main Methods:

• Commentary offering suggestions for SBP transformation.
• Focus on adapting SBP to current health system needs and educational realities.
• Proposing changes at learner, faculty, program, and clinical environment levels.

Main Results:

• Recommends expanding the SBP toolbox for contemporary health systems.
• Advocates for evolving teaching methodologies in SBP.
• Suggests broadening SBP content areas and emphasizing it as a team responsibility.

Conclusions:

• GME must adapt to train effective systems thinkers.
• Physicians need to understand how health system levers impact patient outcomes.
• SBP should be integrated holistically into GME curricula.