For years, medical students have sat in lecture halls during their first and second years of medical school learning about human anatomy, physiology, pharmacology, molecular biology, etc. — the so-called basic medical sciences. After two years of in-class learning, medical students enter their clinical years to learn about providing clinical care. This traditional model no longer meets current healthcare needs, that is why many are looking at redesigning residency and fellowship to better prepared students.
Starting with the Trainees
Traditionally, medical education has focused on two pillars: basic (medical) science and clinical care. Future physicians learned basic medical science in the first two years of school and then were forwarded onto the wards to learn how to provide care to patients. Long before that was the apprenticeship model, where physicians in training would learn directly from physicians in practice. Today, health professional education leaders have advocated for the two pillars to be transformed to four — clinical science, humanities, medical science, and systems science — in an effort to better prepare physicians in training. Our healthcare system is more than ever focused on yielding high-value care, improved patient experiences, and better population health while reducing costs. Interprofessional collaboration and care is essential to achieve the kind of care we want for our patients. It is imperative that future physicians be familiar with health systems including population health, health care policy, and interprofessional teamwork. Further, physicians need to be well-versed in-patient safety, health care quality, care transitions, supervision, well-being, and professionalism to provide safe, high-value patient care. Achieving this vision requires understanding of health systems so that future physicians enter the workforce ready to practice effective teamwork and team-based care in an effort to provide high-value care. However, finding the time to embed this training into medical programs has been challenging due to an already tight curriculum. Perhaps more importantly is how to incorporate these important health topics for residents and fellows from various specialty programs of different sizes, at different levels of training, and in a variety of learning environments (outpatient, inpatient, surgical, etc.) in a meaningful and standardized manner.
As the Director of Interprofessional Education and Collaborative Practice for the Johns Hopkins School of Medicine and through the guidance and mentorship of the AMA HSS Scholars Academy, I have teamed up with educational leaders to develop and offer two new curriculum tracks to better prepare future health professionals. I, along with an interprofessional team, am developing two programs for residents and fellows to introduce them to health systems science so that they can better adapt to the ever-changing healthcare system. First, the Health Systems Science Distinction Track pararells their current specialty program and is composed of modules about health systems science, high-value care, quality and safety, and interprofessional collaborative practice to introduce them to these topics. The residents and fellows are paired with health systems science leaders throughout the institution to attend events or meetings regarding decision making so that they get an “insider look” on the various roles physicians and other healthcare professionals have in a health system, whether it be as an education dean, chief medical officer, or director of quality and safety for a medical unit. Additionally, they will witness the importance of interprofessional collaboration outside direct patient care by having the opportunity to engage with other health professional leaders such as pharmacists, nurses, public health leaders, and administrators to see how decisions and solutions are made in a health system enterprise. This distinction track will allow residents and fellows the opportunity to speak directly with health systems leaders to hear their perspectives and learn about their journeys as physicians through the lens of health systems science. While health systems science encompasses a wide range of topics, this distinction track is designed to inspire and educate trainees in these areas of Health Systems Science (HSS): leadership and change agency, teamwork and interprofessional education (IPE), professionalism, and scholarship. Created for trainees (e.g., medical and pharmacy residents, fellows, DNP students) with aspirations to become leaders and role models in healthcare, this program is designed to help turn those aspirations into reality through coaching, mentorship, and a fully customized leadership development training program.
The second, the Johns Hopkins Health Humanities Track, is designed to inspire and educate trainees in the field of the health humanities. The health humanities (HH) comprise an interdisciplinary field that weaves humanistic principles, the arts, and social justice to broaden the scope of medical discourse from patient to people, from disease to health, from hospitals to communities, and from physicians to healthcare teams and caregivers. Trainees explore how the HH are applicable to their personal growth and professional development, and the roles of the HH in advancing patient care and in effective patient and community engagement. This tailored expertise will be of value to future educators in undergraduate, graduate, continuing, or interprofessional medical education, and to those with interests including, but not limited to, art, ethics, palliative medicine, social medicine, narrative medicine, law, and genetics. Created for trainees with aspirations to become leaders in healthcare, this program offers curated and customizable opportunities for experiential learning and mentorship.
While these new curriculum tracks are crucial in helping to prepare the health professionals of the future, we also need to be mindful of the faculty. Health humanities and health systems science were not necessarily an intentional part of the traditional medical school curriculums in the last few decades; thus, faculty educators, teachers, and clinicians may not be necessarily role modeling and teaching in the areas of interprofessional collaborative practice, health systems science, and so on. Further, it is well understood that trainees see faculty as role models, teachers, and mentors and model after them in professionalism, leadership, practice strategies, and so forth. Recent literature focused on burnout mitigation strategies has identified efforts to highlight the “meaningful aspects of our profession” as an effective approach to well-being and burnout mitigation. A faculty recognition program for stellar teachers and mentors cultivates an environment that fosters professional identity, satisfaction, pride, and priority in both teaching and mentoring our future leaders in healthcare. Such an approach is crucial to establish a viable and sustainable future for the interprofessional collaborative practice (IPCP) mentor and teaching pool. The Johns Hopkins IPCP Exemplars Program is both innovative and forward thinking as it focuses on multidisciplinary (a concept critical to modern healthcare delivery) faculty development and IPCP faculty recognition as a means to improve the “joy of medicine,” thus allowing faculty to feel more engaged in their teaching and become more proficient in IPCP. The hope is that this program will foster a sense of community that encourages career support, teaching, and recognition of accomplishments from an educational perspective. The program will allow faculty from the schools of medicine and nursing, public health, and pharmacy to develop their teaching skills in a collegial and supportive environment in the spirit of IPCP.
As a Macy Faculty Scholar, I am working with the support of my mentor Dr. Toni Ungaretti to create and implement The Interprofessional Exemplar Program through (or as part of) the Johns Hopkins School of Education. The program aims to recognize, develop, and nurture faculty as IPCP role models to serve and lead the next generation of healthcare professionals and to support pre- and post-healthcare learners across disciplines in various programs and courses (such as those mentioned above) at my institution and beyond.