Effect of early clinical exposure based health systems science course in the Korean medical education: a prospective observational study

早期临床实践与卫生系统科学课程对韩国医学教育的影响:一项前瞻性观察研究

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Abstract

BACKGROUND: Health professions are required to understand social structures and systems, as well as basic and clinical medical knowledge. Accordingly, Health Systems Science (HSS) is recognized as a third party of medical education. The curriculum for HSS is currently being developed and implemented in Korea. This study aimed to evaluate the effectiveness of HSS in Korean medical education. METHODS: The HSS course using early clinical exposure (ECE) was implemented in Korean medical education and comprised lectures, four ECEs, and group activities. Students and clinical directors evaluated the course using questionnaires focused on systems thinking, productivity of group activities, and satisfaction. RESULTS: The study showed significant improvements in systems thinking, especially in team learning (p = .028) and overall systems thinking (p = .017). Key habits related to systems thinking also improved significantly over 15 weeks. ECE reports highlighted student engagement with various HSS domains, focusing on patient care, healthcare structure, and policy. Per the clinical directors' evaluations, "healthcare structure and process" was the most effective domain among the core domains of HSS. Per the students' evaluations, the overall satisfaction was higher than the college's average score, and especially "course structure" and "instructional expertise" domains were rated most effective. CONCLUSION: The HSS course with ECE is an effective method for fostering students' systems thinking habits and enhancing their understanding of healthcare systems and patient-centered care. Verifying whether students' interest in various domains and their systems thinking abilities are sustained over time is necessary, and further research is required to design a longitudinal course with continuity.

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