Presented By: Samantha Olson, Pennsylvania State College of Medicine
Co-Authors: Gitanjali Bhushan, Pennsylvania State College of Medicine
Hailey Kindt, Pennsylvania State College of Medicine
Brian McGillen, Pennsylvania State Hershey Medical Center
Jill Stachowski, Pennsylvania State College of Medicine

Purpose
Despite strong efforts to instill health systems science (HSS) principles in medical students through institutional curricula, barriers to engaging with systems science include the vast amounts of new terminology medical students encounter as they enter medical school and the limited time they have to devote to HSS. Medical students at the Penn State College of Medicine (PSCOM) created and implemented a HSS reference guide which was provided to first and second-year medical students during their preclinical HSS course. 

Methods
The reference guide followed the flow of the PSCOM HSS curricula and contained eight domains such as health care structures and processes; social determinants of health; population and public health; clinical informatics and health information technology; healthcare economics; evidence-based medicine; value-based care; and health care policy and advocacy. Information was presented in various formats which included definitions, tables, and conceptual diagrams. To align with the concepts of adult learning theory, individual guides were uploaded to Canvas after class, allowing students to critically think about the material before being presented with answers. 

Results 
The reference guide has been successfully implemented in two medical student classes with the goal of providing easily accessible and digestible information that supplements classroom learning. It is designed to be used 1) after class to better understand that day's learning objectives, 2) while working on class posters and projects and 3) by clerkships students, allowing them to identify health systems issues in the wards and helping them create solutions in real-time. 

Conclusion 
This quick reference guide increases accessibility to new HSS concepts and mitigates the "time burden" students feel when taking HSS courses in addition to basic and clinical sciences courses. Removing these barriers promotes engagement with HSS and therefore understanding of these critical concepts, providing a foundation for creating HSS-conscious physicians to ultimately improve healthcare quality and cost.