Educating Physicians for the 21st Century: Learning from the Experiences of ‘Systems Citizens’
Open Access
- Author:
- Louw, Byron
- Graduate Program:
- Lifelong Learning and Adult Education
- Degree:
- Doctor of Education
- Document Type:
- Dissertation
- Date of Defense:
- September 24, 2020
- Committee Members:
- Elizabeth Jean Tisdell, Dissertation Advisor/Co-Advisor
Elizabeth Jean Tisdell, Committee Chair/Co-Chair
Robin Redmon Wright, Committee Member
Britta May Thompson, Committee Member
Sharilee Myer Hrabovsky, Outside Member
Elizabeth Jean Tisdell, Program Head/Chair - Keywords:
- Medical Education
Health Systems Science
Transformative Learning Theory
Perspective Transformation
Quality Improvement
Medical Students
Identity Formation
Physician
Role of Physician
Systems-Conscious
Systems
Population Health
QI
Social Determinants of Health
SDoH
Quality
Value-Based Care
UME
Undergraduate Medical Education
COVID
Systems Citizen
Qualitative
4th-Year Medical Student
HSS
Systems-Based Practice
SBP
Interprofessional
Interprofessionalism
Wellness
Quadruple Aim
Near-Peer
Global Health
Humanities - Abstract:
- The purpose of this study was to explore why some fourth-year medical students exemplify the principles of Health Systems Science (HSS), and how they came to incorporate these principles into their perspectives on the role of a physician. This study was grounded in the theoretical frameworks of transformative learning theory in adult education and diffusion of innovations theory. Data were primarily collected through qualitative interviews with 12 fourth-year medical students. Eligible participants were fourth-year medical students who were enrolled in either a year-long longitudinal HSS elective and/or in a voluntary COVID-19 elective course. Data were analyzed using the constant comparative method. There were four main sets of findings relating to how participants came to exemplify the principles of HSS, namely through: engaging in experiences first hand; interacting with formal curricula; engaging in social networks; and implementing system change. They engaged with experiences first hand, through participating in the health journey of a family member or by overcoming a significant health problem of their own. Students learned from their formal HSS curriculum and through clinical experiences, and through global trips that formed part of formal education in the humanities. Students’ social networks formed HSS perspectives through effective physician role models, and support networks in sub-communities that also highlighted the political environment, the presence of political issues in the media, and in popular culture. Students described how physicians could advocate for patients, as a way of implementing system change by advocating through policy, taking up issues that are important to the health and wellness of patients, educating patients and others as a form of advocacy, and leveraging the skills of all members of the health care team as a means to advocating for patients. The study concludes with a consideration of the findings for theory and practice, and suggestions for further research.