Resident education in the systems-based practice competency.

More than 10 years after the establishment of the six core competencies by the Accreditation Council for Graduate Medical Education, systems-based practice remains an elusive subject to teach, measure, and document. A wide variety of methods have been reported that address teaching and assessing performance for the discrete parts of systems-based practice; however, no single approach has been described that encompasses the competency in its entirety. To better understand the current state of this competency, orthopaedic residents and educators from around the country were surveyed to determine which systems-based practice topics were being taught at their institutions, how these topics were being taught, and how resident performance was assessed.