Implementing systems engineering techniques into health care: An investigation into using problem based learning in medical schools to teach systems engineerin

Health care delivery in the United States needs improvement. Each year, between 44,000 and 98,000 people die as a result of medical errors and the United States is outranked by ¾ of developed countries in life expectancy and infant mortality. In a recent report, The National Academy of Engineering and the Institute of Medicine and Dr. Bin Wu's paper entitled "Healthcare Systems Engineering - An Interdisciplinary Approach to Achieving Continuous Improvement" recommend that implementing systems engineering and systems engineering tools should be used in health care to improve the industry. Systems thinking is a way to gain insight into an organization by looking at the interactions of the various processes within the whole, and systems tools are the means by which the organizations are constructed and analyzed. These tools have improved other complex industries, such as manufacturing.;A unique way to implement systems thinking in health care is to educate future caregivers in systems thinking so that they can recognize problems and make improvements from within. This method reduces the need for change management within established organizations and emphasizes the importance using systems tools early in the career of a caregiver.;The implementation of systems skills into medical school curriculum was tested at the University of Missouri-Columbia School of Medicine. The medical school uses Problem Based Learning (PBL) to teach its students. This approach is different from traditional medical school instruction because it does not rely as heavily on lectures, instead using small groups of student to solve clinical problems. This setting is ideal for introducing systems design because of its flexibility in being able to simulate the complexities of health care. The students were given a case that was modified in such a way that the students would hopefully create objectives about systems engineering and health care. The objectives were compared to those of a previous year for the same case. If the new objectives titles included systems engineering terms, than PBL could be seen as an effective way to teach systems engineering to first year medical students. The lack of a resource for medical students to research health care systems engineering prompted the creation of a handbook entitled "Handbook of Health Care Systems Engineering for Medical Students.".;There was not a major difference in the objectives with the addition to the case. The students were not familiar with the terms and did not place much importance on them. However, the addition did make a positive impact on the students and repeated exposure in future cases will hopefully result in the students leaning more about health care systems engineering. The research also identified key ideas that medical students should learn about systems concepts and a handbook for the students was created.