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Phenomenon: Systems thinking is the cornerstone of systems-based practice (SBP) and a core competency in medicine and health sciences. Literature regarding how to teach or apply systems thinking in practice is limited. This study aimed to understand how educators in medicine, physical therapy, physician assistant, nursing, and speech-language pathology education programs teach and assess systems thinking and SBP., Approach: Twenty-six educators from seven different degree programs across the five professions were interviewed and program descriptions and relevant course syllabi were reviewed. Qualitative analysis was iterative and incorporated inductive and deductive methods as well as a constant comparison of units of data to identify patterns and themes., Findings: Six themes were identified: 1) participants described systems thinking as ranging across four major levels of healthcare (i.e., patient, care team, organization, and external environment); 2) participants associated systems thinking with a wide range of activities across the curriculum including quality improvement, Inter-professional education (IPE), error mitigation, and advocacy; 3) the need for healthcare professionals to understand systems thinking was primarily externally driven; 4) participants perceived that learning systems thinking occurred mainly informally and experientially rather than through formal didactic instruction; 5) participants characterized systems thinking content as interspersed across the curriculum and described a variety of strategies for teaching and assessing it; 6) participants indicated a structured framework and inter-professional approach may enhance teaching and assessment of systems thinking. Insights: Systems thinking means different things to different health professionals. Teaching and assessing systems thinking across the health professions will require further training and practice. Tools, techniques, taxonomies and expertise outside of healthcare may be used to enhance the teaching, assessment, and application of systems thinking and SBP to clinical practice; however, these would need to be adapted and refined for use in healthcare.

Problem: Educators face many challenges in teaching professionalism. Despite attempts to define professionalism, it remains abstract for students and often not fully appreciated until they are in clinic. Without a way to make it personally relevant, students will likely be less motivated to learn., Intervention: We used student-generated word clouds to facilitate reflection and discussions, thereby helping students make their perceptions of professionalism more explicit. Group discussion was followed by a 5-minute written reflection. Word clouds created in Semesters 1 and 7 enabled students to compare perceptions at two points in the curriculum., Context: The George Washington University Doctor of Physical Therapy Program is a 3-year, 8-semester, 109-credit postgraduate program that includes 34 weeks of clinical practice. Reflection is foundational to the curriculum, and students reflect on their learning and professional growth each semester. Historically, students were introduced to professionalism in Semester 1 using explicit instructional strategies. Despite the wealth of resources, readings, and discussions, engagement remained challenging., Outcome: Student-generated word clouds created a personally relevant visual from which uniquely designed prompts were created to facilitate discussion. Having students compare word clouds across semesters enabled them to identify what, when, how, and where they learned about professionalism. Word clouds, categorized words, and 5-minute written reflections provided evidence of individual and collective changes in student perceptions., Lessons Learned: Students will engage in rich discussions on professionalism if it is personally relevant. Anonymity can foster discussion on personal characteristics and biases. Visualization of student-generated, narrative data enhanced reflection and discussion. Comparing word clouds from two points in time helped students articulate changes in their perceptions of professionalism. A 5-minute reflection can be a powerful learning tool for students and faculty. Outcomes demonstrated the value of designing interventions grounded in the educational principles.