AN ANALYSIS OF MEDICAL STUDENT ATTITUDES TOWARD THE INCLUSION OF HEALTH SYSTEMS SCIENCE IN MEDICAL EDUCATION

Abstract

ABSTRACT Despite changing demographics, policy, technology, and economics; medical education curriculum has changed very little from its inception over 100 years ago. The United States medical system has been under scrutiny for delivery of affordable, quality and accessible care for years. In order to address these challenges, we need to train physicians to consider these criteria when treating patients. A way to do this is through a curriculum that includes Health Systems Science (HSS). The challenge of HSS is that it adds additional topics and competencies to an already full medical education curriculum. In order to move forward in medical school, students are tested on their knowledge of basic science. Because HSS topics are not included in the required testing, students who have not been exposed to an HSS curriculum perceive HSS topics as less valuable than traditional medical school topics. This research sought to understand if students changed their perception of the value of HSS after exposure to an HSS curriculum. First-year medical students from a large, urban medical school were surveyed using a pre-test and post-test survey before and after exposure to an HSS curriculum. This study was conducted with two cohorts over two years to see if there was a change in student perceptions of HSS. An Institutional Cycle design was applied to compare the post-test from the students in cycle 1 to the pre-test of students in cycle 2. This approach was deployed for two reasons. The first because of restrictions placed on the data collection; the pre-test for each person could not be directly linked to the post-test. The second, because there was no way to create a control group. These cohorts could not be randomly assigned to another curriculum. Comparing the post-test of Cohort 1 to the pre-test of Cohort 2 allows for the analysis of change between the two cohorts. Student perceptions did not change significantly between the pre-test in cycle 2 and the post-test in cycle 1. More research is needed to provide guidance for the development of an HSS curriculum that aligns with traditional medical education components.