Curricular Transformation in Health Systems Science: The Need for Global Change.

In this Invited Commentary, the authors propose a counterperspective to the article by Borkan and colleagues, who advocate for a circumscribed, piloted, choice-focused approach to introducing curricular redesign options in undergraduate medical education, particularly in the area of health systems science. In making this case, Borkan and colleagues cluster several kinds of innovative curricular changes that the authors of this commentary believe are best separated by the scope of change and associated educational strategy: (1) innovations customized to student interest and motivation, which are best served by focused programmatic interventions; (2) innovations such as longitudinal integrated clerkships that represent creative and needed educational strategies but may be difficult to expand because of complex barriers; and (3) innovations that are truly transformational, with critical connections far beyond the boundaries of the medical school curriculum, which must be addressed in a comprehensive approach-despite the challenges, frustrations, and difficulties. The authors situate health systems science squarely into the third category, and address three important questions addressing the nature and demands of this change.

A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews.

Initial evaluation of a computer-based medication management tool in a geriatric clinic.

Background: Optimal management of medication regimens remains a challenge for elderly patients and their providers. Tools that aid communication and adherence can be valuable but often do not meet expectations.

Objective: The purpose of this article was to describe the development and preliminary evaluation of a computer-based medication management tool, the Visual Medication Profile (VMP), and to report initial feedback from geriatric patient and provider focus groups.