Presented By: Michael Haight, AlohaCare
Co-Authors: Michele Favreau, JABSOM

Purpose 
Health Systems Science (HSS)  has been identified as the third pillar of medical education. However, there are limited undergraduate medical education (UME) curricula which demonstrate how health plans impact physicians' ability to provide patient care. Many medical school graduates enter residency without an understanding of how health care is structured and funded in the US.  The John A. Burns School of Medicine (JABSOM) partnered with the not-for-profit AlohaCare health plan to pilot an immersive HSS curriculum for rising second year medical students. This curriculum provided a platform for early learners to participate in HSS learning experiences from the health plan perspective. 

Methods 
Two 4-week, 16-hour electives were conducted during July and August 2022. Each elective enrolled two rising second year medical students for a total of 4. Learning activities involved in-person sessions conducted at the Alohacare offices and hands on sessions at community health centers. Students also completed virtual, asynchronous HSS modules. Coursework was co-developed with JABSOM faculty and taught by AlohaCare leadership and staff, who volunteered their time and efforts. Students learned about the core domains of HSS through the lens of managed care by participating in authentic health plan experiences. 

Results 
100% of the students participated in pre-post, electronic surveys and a final debriefing session. The Chief Medical Officer and Senior Medical Director for AlohaCare participated in debriefing sessions at the end of each elective. Although limited by the small sample size, 100% of the student survey results and the qualitative debriefing data demonstrated increased levels of confidence working with health plans. Debriefing data also indicated an increased understanding of how health plans inform physicians' provision of patient care. 

Conclusion 
Early medical student participation in authentic HSS experiences can increase students' HSS knowledge and confidence and facilitate their abilities to provide equitable and inclusive health care.