Student-Faculty Co-Production of a Medical Education Design Challenge as a Tool for Teaching Health System Science

Posted 2021/04/08


AMA Accelerating Change in Education Innovation Grant program



What problem was addressed:

Medical schools prepare students to enter a complex health system with the knowledge to care for patients but provide little training on the health system they join. Health systems science (HSS) is an important topic that is starting to enter medical school curricula. The difficulty is how to teach this complex topic which is slow to gain traction with key stakeholders.1 We argue that HSS is not as difficult a concept to implement if presented in a familiar context that encourages active participation with the material. We present our educational innovation to teach HSS in an active learning setting that increased buy-in from medical students and faculty. 

What was tried:

We organized the Medical Education Design and Innovation Challenge (MEDIC), a competition that taught medical students HSS as they competed to design an educational innovation. We introduced 24 medical students from all years of training to HSS using the Shingo ModelTM 2 as a framework, the model successfully used by the University of Utah Health system. Students were divided into 6 teams and asked to identify an area for improvement and then design a program, course, or initiative utilizing this model. The Shingo ModelTM requires users to identify guiding principles, key stakeholders, and important outcomes as precursory steps to any innovative problem-solving design. This encouraged students to understand education system before proposing a solution to a perceived deficit. This event was divided over two days with a total of 8 hours of participation. Students were introduced to HSS and the Shingo ModelTM during an introductory dinner and then placed into teams. The following day teams had 4 hours to identify a deficit within their school system and design a solution (ex. Mentorship program for specialty exploration) using the Shingo ModelTM as a framework. Teams then pitched their proposals and were evaluated on their creativity, feasibility, and evidence of utilizing systems science in their design. Winners were determined based on majority vote from guest faculty judges, coordinators and participants.

What lessons were learned:

Two major challenges exist in teaching HSS to medical students: relevance to learners and incorporation into already full medical school curricula. Survey data from MEDIC suggest this project-focused approach to teaching HSS addressed both challenges. Participants (63% response rate) revealed that 100% of students felt that MEDIC was relevant to them. 93% of students thought the Shingo ModelTM was an appropriate framework for approaching medical education innovation and 73% were confident in their ability to apply the model after only four hours of team-based work. 80% of students found they developed new skills and had a change of perception of medical education design by participating in MEDIC. Additionally, 80% of students agreed or strongly agreed that all students would benefit from exposure to HSS in the core curriculum. This experience may be easily reproduced at other institutions. The positive response of the students and success in proposing innovative ideas for medical education encouraged us to continue to use this framework as we engage students and faculty in ongoing curricular reform.


  1. Gonzalo JD, Hawkins R, Lawson L, Wolpaw D, Chang A. Concerns and Responses for Integrating Health Systems Science Into Medical Education. Acad Med. 2018; 93(6):843–849

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Student-Faculty Co-Production of a Medical Education Design Challenge as a Tool for Teaching Health System Science by Sarah Nguyen, Paul Bluth, Spencer Lindsay, Tony Tsai, MBA, Candace Chow, PhD & Sara Lamb, MD