Presented By: Jaya Yodh, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Co-Authors: Jenny Amos, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
JoAnn Archey, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Joe Bradley, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Kristine Carpenter, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Samar Hegazy, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Grace Park, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign

Purpose 
The current landscape of medical education is expanding to incorporate health systems science (HSS) content to address health care needs at the community level. At Carle Illinois College of Medicine, we are training Physician Innovators to generate relevant solutions to improve health care. We present an instructional intervention designed to facilitate student understanding of the community-based contexts of the patients they are serving, thus developing systems-thinking skills to allow for more meaningful clinical experiences and impactful innovations. 

Methods 
The longitudinal experience spans students' first five courses starting with Foundations where students are exposed to introductory concepts pertaining to social/structural determinants of health (SSDOH), HSS, and environmental health. In subsequent organ-system courses, students were divided into teams (3-5) based on their clinical site assignments. Teams were assigned a summative presentation across three courses, and individual reflections and peer responses for each course. Discussion prompts linked introductory concepts to course objectives covering health risk factors, patient experiences, and vulnerable populations. Student outcomes will be gleaned through mixed methods analysis of pre-/post-surveys of Jefferson Empathy Scale and Systems-Thinking Scales scores and qualitative thematic coding of student assignments. 

Results 
Initial qualitative observations from student reflections were primarily based on interactions with patients from surrounding rural communities. Examples included lack of transportation, grocery, and specialty care options, increased environmentally-based and smoking health risk in these populations. Students also noted the importance of the role of the physician for identifying solutions to help mitigate constraints on patients imposed by socioeconomic factors. 

Conclusions 
Although the project is ongoing, initial results based on student reflections demonstrate their ability to synthesize demographic, SSDOH, and environmental information into a health systems level analysis of their patient's communities. This project can serve as a model for an easily implementable early intervention to develop holistic and system level thinking skills during undergraduate medical education.