Understanding the Role of Health Professionals in Health System Transformation

Context: Policy makers are calling on health professionals to be accountable for health system transformation (HST) however, it is unknown if health professions education prepares them for this call.

Objective: We aimed to understand the current state of HST in health professions education and how to better prepare health professionals for HST.

Study Design/Analysis: We conducted a two-phase sequential, exploratory mixed methods study. Phase I is a scoping review on the current state of HST in health professions education. In Phase II we examined stakeholders’ concerns on the topic through a mixed-methods stakeholder consultation comprised of a quantitative survey and qualitative interviews. We analyzed quantitative survey data using SPSS and qualitative interviews following reflexive thematic analysis.

Dataset: We surveyed 72 stakeholders representing those who have stake in health systems and health professions education globally (28% response rate) and analyzed 23 interview transcripts.

Population: Participants comprised of stakeholders representing those with expertise in either HST or health professions education globally.

Instruments: We piloted and administered a 20-item survey (May-July 2022) and then used an interview guide (Sept-Nov 2022) to understand stakeholders’ perspectives on the topic.

Outcomes: We specifically measured the level of agreement on challenges, relevance of themes in the literature, level of preparedness of health professionals, level of familiarity with current curricula, and ranking of future programs of research.

Results: We described the current state of HST in health professions education according to five key themes: perspectives on the role of health professionals, the historical influence of clinical and basic sciences, bridging the context in which health professionals work, descriptions of recent progress and challenges, and mechanisms of HST in health professions education. We described areas important to consider for curriculum development and future research under two themes: the need for comprehensive education and measuring complexity.

Conclusion: This research discusses the current state of health system transformation in health professions education and describes key areas for future curriculum development and programs of research. This research provides direction to stakeholders on the resources and activities needed to ensure that informed health system transformation training decisions are made.