Although health systems science (HSS) has become increasingly included as requisite curricular content in undergraduate medical education (UME), educators have many implementation options. Learning from medical schools’ authentic experiences and lessons learned for the successful and sustainable implementation of HSS would be valuable. In this submission, we share our journey with the longitudinal and vertical integration of HSS at the Sidney Kimmel Medical College (SKMC) at Thomas Jefferson University in Philadelphia during the past six years. We discuss how this approach has afforded us the “curricular elasticity” needed to keep our educational program current and flexible in the rapidly-changing healthcare and geopolitical landscape.

1. The Longitudinal & Vertical Integration of Health Systems
Science in Undergraduate Medical Education:
A Vehicle for Sustainable ”Curricular Elasticity”

2. Dimitri
Papanagnou
MD, MPH, EdD(c)
Sr. Associate Dean, Faculty Development
Thread Director: Health Systems Science
Professor
Department of Emergency Medicine
Sidney Kimmel Medical College at
Thomas Jefferson University
@dmitripapa

3. Deborah Ziring, MD
Sr. Associate Dean
Undergraduate Medical Education and
Academic Affairs
Professor
Department of Medicine
Sidney Kimmel Medical College at
Thomas Jefferson University

4. Objectives
1. Describe the concept of curricular elasticity and its role in medical
education.
2. Share curricular design decisions and examples that support curricular
elasticity in a UME program.

5. Definition
Elasticity is a measure of the degree of
sensitivity (or responsiveness) of one
variable to changes in another variable

6. JeffMD

7. HSS
Domains

8. The context in which
healthcare is delivered
is dynamic.

9. The Challenge
•The world is a dynamic place
•Geopolitical forces are dynamic,
impacting policies and health
•These conversations need to be
housed in formal curriculum for
all students (not relegated to
extracurricular/elective topics)

10. A Solution
•Dynamic > Static
•Keeping the curriculum
relevant, timely, and engaging
•This can be accomplished by:
• Designing a curriculum that
responds to unpredictable
forces in real time
• Intentionally linking these
conversations to specific HSS
domains

11. The Value of
Contextual
Relevance
• Avoids “stand-alone” sessions
• Explicitly links emerging
knowledge and concepts (i.e.,
current events) to the curriculum
• Provides a critical lens to
examine issues objectively and
their impact on care delivery
• While HSS LOs may remain
constant from year to year, the
conversations scaffolding these
LOs remain contextually relevant

12. Topics and Examples

13. Public Health
LO: Educate patients on vaccines to empower
them to participate in their care and support
shared decision-making (Block 1)

14. Population Health
Healthcare Delivery Systems (Block 1)
COPD / Asthma (Block 3B)
Diarrheal Illnesses (Block 4B)
Nutrition and Food (Block 4B)
Climate Change

15. Political Determinants of Health

16. Review the Supreme Court holdings in Roe v. Wade, Planned
Parenthood v. Casey, and Dobbs v. Jackson
Discuss the impact legislation has on patient autonomy and
physical/emotional wellbeing
Describe the impact legislation has on clinicians’ ability to
provide medical services
Highlight the potential impact of legislation on training future
clinicians
HSS Panel
Block 5
August 2022
HSS Domains: Access to Care. Disparities. Policy. Determinants of Health.
Patient, Provider, and Trainee Implications of
Dobbs v. Jackson Decision

17. Access To Care:
Family Planning and Reproductive Technologies
Identify challenges
that individuals
and/or families may
encounter when
planning a family
01
Describe several
examples of how to
build a family
02
Explain the financial
barriers and
disparities in access
to care when
planning a family
03
HSS Panel
Block 5
August 2023

18. What have we learned
in the last 5 years?
In today’s climate,
a curriculum requires elasticity.

19. Definition
Elasticity is a measure of the degree of
sensitivity (or responsiveness) of one
variable to changes in another variable

20. Definition
Curricular Elasticity is a measure of a
curriculum’s responsiveness to how
contextual forces impact curricular
relevance and learner/educator
engagement

21. How did we achieve “Curricular Elasticity?”
1. Anchoring learning objectives to core HSS
domains
2. Intentionally integrating content into the
curriculum for contextual relevance
3. Designing a longitudinal approach to
ensure conversations include all students
4. Co-creating knowledge and fostering
engagement with students and faculty

22. * Developed with our JeffLGBTQ interest group for students and faculty.

23. Questions? Thoughts? Contact us!
dimitrios.papanagnou@jefferson.edu
deborah.ziring@jefferson.edu