Reviewer: Nehal Khamis, MD, PhD, MHPE, MAMSE (affil.)(Johns Hopkins University)
Description: In today's rapidly evolving complex healthcare systems and dynamic learning environments, the integration of Health Systems Science (HSS) into undergraduate and graduate medical education programs is essential. Although such integration of HSS into the curricula can prepare future physicians to be more "system-ready" and better equipped to meet societal expectations and address healthcare inequalities and disparities, challenges to such integration have persisted for years. This book presents a comprehensive evidence-based, stepwise, change management approach to the development, implementation, evaluation, and overcoming of challenges of HSS integration across the medical education spectrum.
Purpose: Written by national experts who have implemented HSS at various levels of the medical education journey, this book serves well its purpose of providing a systematic guide that combines theory and applications for the challenging mission of development, pre-implementation, implementation, and sustainability of HSS programs across the continuum of medical education (pre-clerkship, undergraduate, then graduate clinical learning environments). It answers many questions and provides a lot of tools and resources that would assist educators in HSS curriculum design and mapping, faculty development, building of dedicated teams, and thorough planning for long-term sustainability of HSS educational interventions.
Audience: This book represents a valuable resource for beginner and expert individuals responsible for the development, mapping, implementation, and evaluation of undergraduate and graduate curricula. Health profession education undergraduate students, trainees, and practitioners can also grasp the concepts of HSS and its applications by selection of the relevant topics without getting into the details that experts would go for; an option facilitated by the book's structure and the 'chapter outline' provided at the beginning of each chapter. The fact that the authors are nationally recognized interdisciplinary group of experts with real life relevant HSS experience shows itself in their presentation of practical approaches, educational interventions at both the classroom and clinical settings, and in the successful stories and best practices they discuss.
Features: The book starts with the pre-implementation stage, where the authors set a strong, evidence-based argument for the importance of and challenges in developing and integrating sustainable Health Systems Science (HSS) into curricula. It discusses analyzing the organization's current situation and readiness of its stakeholders for curricular transformation, establishing a sense of urgency for the change, and creating effective teams with a shared mental model for the integration of core functional, foundational, and linking domains of HSS into the broader curriculum. The authors then lay the ground for an outcome-driven HSS curriculum design, presenting a validated framework of HSS competencies and informative schemas that map UME and GME recommendations, accreditation standards, and systems-related national and local curricula to the HSS domains and subdomains. The book provides comprehensive strategies for the development, implementation, and evaluation of Health Systems Science (HSS) curricula across different stages of medical education. In the UGME pre-clerkship phase, it emphasizes the importance of professional identity and systems citizenship development, offering a six-step approach for curriculum design and implementation. For the clinical learning environments, the book offers guidance on practical considerations, transition of care, and advanced clinical integration of HSS, addressing potential challenges educators may face. In the GME context, the book discusses strategies to overcome anticipated barriers, focusing on faculty development and infrastructure needs for successful HSS integration. The importance of interprofessional (IP) teaming as a component of HSS is emphasized, proposing a template and structured recommendations for implementing IP and collaborative practice in HSS curricula. The concluding chapter provides a practical application of the fundamental theories of sustainability to the evaluation and continuous improvement of HSS programs. Each chapter is structured to start with learning objectives followed by a chapter outline that starts with chapter summary, the topics that the chapter focus on, followed by "Take home Points", "Questions for further Thought", and concludes with a "vignette" that ends with "thoughtful questions" on the scenario.
Assessment: This is a well-organized, well written comprehensive reference that provides a structured, systematic change management approach to integration of HSS into the medical education continuum. In my opinion, the main points of strength of the book over other available resources are the holistic approach where the reader feels that there is no need to visit many additional references because the book defines and explains even the very basic concepts like competency up to the more HSS specific concepts like systems thinking and systems citizenship. The number of robust tools is phenomenal, with a tool or a resource for nearly every step. Examples include templates for stakeholders' analysis and engagement, Current State Inventory of HSS Core Domain Content, a basic template for a longitudinally progressive IPE curriculum, example logic models for Health Systems Science Curriculum Component, integrating health systems science into a 4-year undergraduate medical education curriculum, health systems science-prepared entering residents logic models. The synthesized Kotter and Kern models describing the change management and curriculum development process represented the backbone for all discussions. I agree with the description on the back cover that it is to our knowledge, the first of its kind, instructor focused field book as contains a clear detailed road map that faculty can follow with all the details that a beginner can use and the applications that an expert can reflect on and correlate.