Interview with Rosalyn Maben-Feaster, MD, MPH; Jeffrey Borkan, MD, MBA; Ami Dewaters, MD, MSc; and Stephanie Starr, MD 

Why did you feel it was important to write a book on Health Systems Science Education: Development and Implementation, 1st Edition? What does your book add to the field? 

Dr. Maben-Feaster: The AMA’s health systems science (HSS) textbooks (Health Systems Science and Health Systems Science Review) have done a great job of defining HSS and its domains as well as making the case for why it is so important for medical education and health care reform. However, given the broad nature of the content, it can be challenging to consider how you might implement this practically. This book is designed to build on the HSS textbooks and provide practical advice and examples to help educators incorporate HSS into their curricula. 

Dr. Borkan: Health systems science is critical to successful functioning in the health care system and all students and trainees should be engaged in its domains. This book fills a gap by providing the “how to develop and implement” at your institution or program.  

Dr. DeWaters: A lot of educators are recognizing the importance of including health systems science (HSS) in the training of health care professionals. However, adding a new field of education like HSS is a heavy lift at any institution. It was important to write this book so that we could help guide fellow educators on how best to implement this critical work in their local environments.  

Dr. Starr: We have had many medical educators/faculty asking us to share our approach to and experience regarding HSS education. Before this book, there was no single resource which pulled together the components and considerations faculty must reflect upon and plan for to build and/or modify a successful HSS program. While we will continue to learn over time how to improve our shared work, this is a singular reference for all faculty to start with and for us collectively to build upon. 

What is the most exciting aspect of your book Health Systems Science Education: Development and Implementation, 1st Edition? What chapter or topic covered in this book are you most excited about? 

Dr. Maben-Feaster: I am really excited that we were able to include health systems science competencies that were developed by the AMA Health Systems Science Competency Taskforce in chapter 2. There has been a great need for this in the field, and this will serve as a great foundation for anyone looking to implement HSS into their curricula.  

Dr. Borkan: I like it all—but am inspired by the first chapters that provide the framework—we have come so far in a short time in developing it.  

Dr. DeWaters: I’m personally very excited about the information in the book that relates to the graduate medical education (GME) space. There has been so much incredible work related to HSS that has happened at the medical school level. As national focus shifts toward improving the UME-GME transition, the HSS work that has been occurring at the GME level is becoming even more relevant. I’m so glad that we can present what HSS innovations are already happening in residency programs as it can serve as a foundation for upcoming HSS UME-GME transition work. 

Dr. Starr: It’s hard to choose one chapter – I’ll highlight two that I am most excited about and I think will have significant impact. 

• Many faculty have been waiting for a parsimonious set of HSS competencies, which are listed in Chapter 2. Importantly, these competencies were created after a gap analysis of existing related competencies (e.g., in Liaison Committee on Medical Education [LCME] requirements and GME core competencies). These fundamental units, which enable us to decide what we want our learners to achieve, are needed for programs to be planned, implemented, and evaluated. 
• I wish I’d had Chapter 7 (Sustainability in an HSS Program) when our school’s team was planning our HSS curriculum—the authors have summarized a comprehensive approach to ensuring the good intentions and hard work by medical educators translate into meaningful change over time. This includes common structural challenges (e.g., ensuring buy-in by multiple stakeholders) and use of logic models to evaluate, improve, and sustain HSS programs (example included). 

Who will find the greatest value from Health Systems Science Education: Development and Implementation, 1st Edition and why?  

Dr. Maben-Feaster: Educators in the UME and GME space will find the greatest value from this book because it provides practical considerations for designing, implementing, and evaluating curriculum for those who are doing it in their day-to-day work.  

Dr. Borkan: Educators at all stages of medical training—medical schools, residencies, fellowships, CME. Also, I would like to see it expand to pre-medical studies and other health professions.  

Dr. DeWaters: I think there are many interested parties who could benefit from this book. Certainly, we hope our medical educators find this book practical and useful as they look to implement HSS in their own programs/schools. However, I think leaders and learners alike may find this book very useful as it clearly outlines the rationale behind HSS as an education pillar and the benefits from implementing HSS in medical education institutions and health systems.  

Dr. Starr: Indirectly, patients and learners. Directly, any medical educator or team of medical educators seeking to build or modify existing HSS programs with the goal of helping physician trainees learn to integrate HSS into their knowledge and skills in the basic and clinical sciences toward improving the health of individuals. 

What new ideas, practices, or procedures do you hope your readers take away from Health Systems Science Education: Development and Implementation, 1st Edition? 

Dr. Maben-Feaster: I hope that readers will take away that HSS education development and implementation is about more than just creating the content but also about integrating change management/leadership principles to help reshape the professional identify of current and future clinicians. 

Dr. DeWaters: There are some critical descriptions in this book about the importance of utilizing change management skills and curriculum development skills to successfully build HSS educational work. While those may not be new practices or ideas, I do think that their application to this content is new and cannot be overemphasized in terms of their importance.  

How would you like to see this book used? 

Dr. Maben-Feaster: I hope that this book will serve as a reference to help those who are just starting out on their HSS educational journey but also as an inspiration to those who have been working hard in this space already and seeking fresh ideas.  

Dr. DeWaters: Ideally, educators would be able to use this book as a pragmatic roadmap for building their own health systems science curricula at their local institutions. Hopefully laying out common challenges and tips and tricks for successful implementation of health systems science helps other educators do this work with ease! 

Dr. Starr: I’d like to see this book be used by educators in schools and GME programs to help them maximize their time and effort to have the greatest impact on learners and patients. I also hope those who use the book build on our shared HSS experience to date, prompting discussion and innovation so we can improve our shared efforts toward successful HSS education as part of physician training.  

Is there anything else about Health Systems Science Education: Development and Implementation, 1st Edition you’d like to say?  

Dr. Maben-Feaster: I am really proud of the diversity of experience that was represented via the authors throughout the book and hope this will help other HSS educators in their future endeavors. 

Dr. Borkan: All other health professions need HSS—I hope that other fields and disciplines take it to heart.  

Dr. DeWaters: Putting in place any new curricula is a lot of work, but the importance of HSS makes it worth it! 

About the editors and authors: 

Rosalyn Maben-Feaster, MD, MPH is an associate professor of obstetrics and gynecology at the University of Michigan Medical School where she serves as the health systems science curricular thread director and the associate director of the Women’s Health Division. She has also served as a faculty for the American Medical Association’s Health Systems Science Scholars Program since 2021. She completed undergraduate school, medical school, school of public health, and her obstetrics and gynecology residency at the University of Michigan.  

Jeffrey Borkan, MD, Ph.D. is a family physician educator, researcher, clinician, and advocate whose career has bridged two fields (family medicine and medical anthropology), both in the US and abroad. He is a professor and assistant dean for primary care-population health at the Warren Alpert Medical School of Brown University in Rhode Island. 

Ami Dewaters, MD, MSc, is the interim director of health systems science at the Penn State College of Medicine. She is an associate professor of medicine and works clinically as a general internist. She is also leading the Penn State College of Medicine strategic plan focused on improving the implementation of health systems science in the clinical learning environment. She completed her medical degree at the Medical College of Georgia and earned her master’s degree at UT Southwestern Medical Center. Her research focus is primarily on curriculum development within medical education. 

At the time this book was written, Stephanie Starr, MD, was director of science of health care delivery education at Mayo Clinic Alix School of Medicine and vice-chair for quality and safety, community pediatric and adolescent medicine at Mayo Clinic in Rochester, Minnesota. She completed her education at Saint Louis University School of Medicine and training in the National Capital Area Uniformed Services Pediatric Residency Program before serving overseas in the U.S. Navy. At Mayo Clinic she served in many education leadership roles, including vice-chair for education (Department of Pediatric and Adolescent Medicine) and assistant medical director, Quality Academy. Her scholarship has primarily focused on health systems science, quality improvement, and pediatric education. She is currently a community pediatrician teaching the University of Washington WWAMI students in Bozeman, Montana. 

Purchase your copy of Health Systems Science Education: Development and Implementation, 1st Edition here!