Journal article
Exploring clinician perspectives of systems-based practice: A physician training challenge
The clinical teacher, v 22(1), e13840
Feb 2025
PMID: 39505364
Abstract
IntroductionSystems-based practice (SBP) has been a competency in US graduate medical education for over 20 years, but it is not well implemented. SBP is loosely defined as physician's responsiveness to the larger system of healthcare. The aim of this study was to describe healthcare professionals' perspectives regarding: (1) their knowledge and beliefs about SBP and (2) their beliefs regarding factors in clinical learning environments (CLE) that facilitate or hinder operationalisation and learning of SBP.MethodsSemi-structured interviews were conducted between November 2020 and April 2021 with 42 individuals from four health systems. Participants were healthcare professionals involved in graduate medical education, including physicians and interprofessional clinicians (e.g., nursing staff). Interviews were transcribed and coded using a social constructivist, codebook thematic analysis approach and themes were agreed upon through discussion amongst the research team.ResultsFive themes were constructed: (1) SBP remains a challenge to define, (2) SBP may be intuitively understood, particularly when framed at the microsystem level, (3) SBP aligns with the Health Systems Science framework, (4) SBP learning must be intentionally integrated into the CLE, through training such as onboarding and (5) multidisciplinary settings and work processes are critical to engage in SBP. Workload compression is a barrier to SBP implementation.ConclusionsHealthcare professionals highlighted that current CLEs are not designed to prioritise SBP. Graduate medical education programmes may benefit from focusing systems content at the microsystem level and purposefully integrating onboarding procedures, clinical settings and rotations specifically designed to teach SBP into their residencies.
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Details
- Title
- Exploring clinician perspectives of systems-based practice: A physician training challenge
- Creators
- Ami L. DeWaters - Penn State Milton S. Hershey Medical CenterSomalee Banerjee - Kaiser PermanenteJames Bruce - Allegheny Health NetworkRob Cooney - Geisinger Hlth Syst, Fac Dev, Danville, PA USAHalle B. Ellison - Geisinger Commonwealth School of MedicinePaul Haidet - Penn State Milton S. Hershey Medical CenterLindsay Mazotti - Kaiser PermanenteJames B. Reilly - Drexel UniversityJed D. Gonzalo - Carilion Clinic
- Publication Details
- The clinical teacher, v 22(1), e13840
- Publisher
- Wiley
- Grant note
- American Medical Association (AMA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001354296900001
- Scopus ID
- 2-s2.0-85208420732
- Other Identifier
- 991022197413304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Medicine, Research & Experimental