Bridging early medical education and health systems improvement: a multi-faceted faculty development program to enhance engagement and impact.

Background: Despite calls to further incorporate health systems science in undergraduate medical education, the ability for early medical learners to participate in authentic, project-based learning in health systems science and improvement has been limited by the knowledge, skills, and competency of teaching faculty. This study explores the impact and outcomes of a comprehensive, longitudinal faculty development program for physician educators in health systems improvement (HSI).

Methods: The University of California, San Francisco HSI faculty development program began with a medical school curricular redesign to include a 14-month weekly course that integrates HSI experiential learning with clinical skills training for early medical students in small groups led by physician coaches. Most physician educators began the role with no formal training in HSI - a gap this program addresses through a multi-faceted approach with standardized and individualized components. We studied the efficacy of the HSI faculty development program and report outcomes using the Kirkpatrick Model, focusing on impact on physicians, students, and health systems.

Results: From 2016 to 2023, the HSI faculty development program reached 119 faculty across 15 departments and three health systems. For Kirkpatrick level one (satisfaction), faculty participated in at least three workshops per year, with an average rating of 4.7 (scale 1-5). Faculty satisfaction in the teaching role is 4.5 and student rating of faculty is 4.8. Each year, faculty demonstrated Kirkpatrick level two (knowledge) by designing up to 60 HSI projects for the class of incoming first year medical students (n = 165). Faculty assessed other students' projects with high concordance with curricular leader grading (> 90%). All students met expectations by course conclusion. For level three (behavior), faculty independently led 35 three-hour small group sessions yearly for a total of 1,281 early medical students over 8 years, and all student project teams completed at least one full Plan-Do-Study-Act cycle. For level four (impact), faculty and students have completed 242 HSI projects to date, each aligned with health system priority areas.

Conclusions: Our study demonstrates that a longitudinal, multi-component HSI faculty development program provides physician faculty sufficient competence to effectively engage medical student-led teams in systems improvement in the clinical learning environment.