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Breaking Down Silos Between Medical Education and Health Systems: Creating an Integrated Multilevel Data Model to Advance the Systems-Based Practice Competency.

Authors
  • Reilly, James B
  • Kim, Jung G
  • Cooney, Robert
  • DeWaters, Ami L
  • Holmboe, Eric S
  • Mazotti, Lindsay
  • Gonzalo, Jed D
Type
Published Article
Journal
Academic medicine : journal of the Association of American Medical Colleges
Publication Date
Feb 01, 2024
Volume
99
Issue
2
Pages
146–152
Identifiers
DOI: 10.1097/ACM.0000000000005294
PMID: 37289829
Source
Medline
Language
English
License
Unknown

Abstract

The complexity of improving health in the United States and the rising call for outcomes-based physician training present unique challenges and opportunities for both graduate medical education (GME) and health systems. GME programs have been particularly challenged to implement systems-based practice (SBP) as a core physician competency and educational outcome. Disparate definitions and educational approaches to SBP, as well as limited understanding of the complex interactions between GME trainees, programs, and their health system settings, contribute to current suboptimal educational outcomes elated to SBP. To advance SBP competence at individual, program, and institutional levels, the authors present the rationale for an integrated multilevel systems approach to assess and evaluate SBP, propose a conceptual multilevel data model that integrates health system and educational SBP performance, and explore the opportunities and challenges of using multilevel data to promote an empirically driven approach to residency education. The development, study, and adoption of multilevel analytic approaches to GME are imperative to the successful operationalization of SBP and thereby imperative to GME's social accountability in meeting societal needs for improved health. The authors call for the continued collaboration of national leaders toward producing integrated and multilevel datasets that link health systems and their GME-sponsoring institutions to evolve SBP. Copyright © 2023 the Association of American Medical Colleges.

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