title: Systems survivor: a program for house staff in systems-based practice.
abstract: BACKGROUND
  The Systems-Based Practice competency expanded the scope of graduate medical education. Innovative approaches are needed to teach this material.
  
  
  OBJECTIVE
  We have designed and implemented a rotation in Systems-Based Practice focused on the interrelationships of patient care, clinical revenue, and the physician's role within health care systems.
  
  
  METHODS
  Experiential learning occurs during a 5-day rotation through 26 areas encompassing the clinical revenue cycle, guided by "expert" staff. Using a reversal of the TV show Survivor, house staff begin conceptually "alone" and discover they are members of a large, dedicated team. Assessment results, including a system knowledge test and course evaluations, are presented.
  
  
  RESULTS
  Twenty-five residents from four clinical departments participated in Year 1. An increase in pretest to posttest knowledge scores of 14.8% (p <or= 0.001) was observed, with high program evaluations.
  
  
  CONCLUSIONS
  "Systems Survivor" is successful in providing an innovative opportunity to explore complex health care systems and is an effective curriculum.
authors.affiliation: Department of Pediatrics, University of Texas Medical Branch, Galveston, TX 77555-0351, USA. cbturley@utmb.edu
authors.forename: Christine B
authors.initials: CB
authors.lastname: Turley
authors.forename: Richard
authors.initials: R
authors.lastname: Roach
authors.forename: Marilyn
authors.initials: M
authors.lastname: Marx
mesh_terms: D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D005791:Patient Care; D011216:Practice Management, Medical / Q000191:economics* / Q000458:organization & administration; D015397:Program Evaluation; D013663:Teaching / Q000379:methods*; D013781:Texas