Research report: Cultivating physician change agents by foregrounding systems: experiential learning in health systems science

A three-year evaluation of an experiential Health Systems Science curriculum found that medical students valued applying systems concepts to real-world problems and reported strong support for their learning. Across 26 required selectives from 2022 through 2025, 128 students worked on system-level challenges in healthcare settings or the broader health ecosystem. Most survey respondents said that teaching and instructional materials supported their learning, while 96% of students who completed projects said the projects supported learning and 88% said they made a valuable contribution to their host organizations.

Students use Health Systems Science concepts to address actual system-level problems and submit project-based deliverables and other assignments. The study describes the design as an authentic-learning approach, with the reported aim of preparing physicians to contribute to and lead efforts aimed at transforming complex health systems. Its focus is therefore on physician preparation through practical engagement with health-system problems, not on measuring changes in clinical outcomes.

Researchers evaluated the selectives using evidence routinely collected by the school: end-of-course surveys, transcripts from curricular feedback sessions, project-based deliverables and other student assignments. They generated descriptive statistics from survey ratings and thematically analyzed feedback transcripts, using authentic learning theory as a sensitizing concept for the analysis. Among survey respondents, 93.6% agreed that teaching supported their learning and 88.6% agreed that instructional materials did so.

The results are based on students’ evaluations and their submitted work at a single medical school, rather than on a controlled comparison with another curriculum or measurements of improvements in patient care, institutional performance or population health. Students particularly valued opportunities to apply Health Systems Science concepts to real-world issues that had seemed vague or abstract in didactic or classroom-based learning. The analysis identified four elements that students described as influential: the authenticity of the health-system context, the authenticity of the problem-solving activities, access to system experts, and exposure to different system roles and perspectives.

These observations show that students associated the learning experience with genuine problems, expert involvement and multiple viewpoints. The reported findings do not separately quantify the contribution of each element or establish that one feature was more important than the others. The authors conclude that authentic, system-foregrounded experiential curricula can foster system-thinking skills and promote roles for physicians as contributors to and leaders of system transformation.

The evidence supports that conclusion as the program authors’ interpretation of the students’ experiences and assessments, while the study’s design does not determine the size of any effect or establish long-term changes in professional behavior. The curriculum offers a tested model for exposing future physicians to complex systems and engaging them in system-change efforts, and the authors suggest that other medical schools may develop comparable learning experiences.

Subject of Research: Evaluation of an experiential Health Systems Science curriculum for medical students at one school

Article Title: Cultivating physician change agents by foregrounding systems: experiential learning in health systems science

Article References: Solomon, L. S., Kanter, M. H., Chung, P. J., Robbins, C. W., Schmittdiel, J. A., Chen, I. L., Ryan, G. W., Perlman, S. M., & Chen, H. C. (2026). Cultivating physician change agents by foregrounding systems: experiential learning in health systems science. BMC Medical Education. https://doi.org/10.1186/s12909-026-10457-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10457-7

Keywords: medical education, Health Systems Science, experiential learning, medical students, authentic learning, system thinking, physician leadership, curriculum evaluation, health systems, Cultivating, physician, change