Teaching and evaluating group competency in systems-based practice in anesthesiology

BACKGROUND: Teaching and assessment of the systems-based practice competency has been problematic in hospital-based specialties such as anesthesiology. We developed a method to teach systems-based practice with collaborative team projects. The outcome was assessed with a tool that focused on group attributes. METHODS: Resident teams chose projects that focused on the health care system. Projects included economic analyses, safety initiatives, process analyses, and policy revisions. Projects were presented by groups in poster discussion sessions. The educational program was evaluated using five criteria: implementation, awareness and acceptance in the organization, utility, sustainability, and diffusion to other programs. RESULTS: The plan was implemented in 2005 and remains a required part of the resident curriculum. Key hospital and medical school leaders in our health care system participated in projects. Interdisciplinary collaboration occurred with multiple clinical departments. Nine projects performed economic analysis, 5 involved safety initiatives, 10 performed process analysis and recommended change, and 4 affected policy change in the institution. The program has been sustainable and has been effective in creating multidisciplinary institutional policy. CONCLUSIONS: We developed an innovative method to teach systems-based practice through a team-based project initiative. The projects appear to have had a positive impact on our health care organization. Our assessment tool for the project evaluated team, rather than individual, performance, which is crucial in this competency.