The Systems SOAP Note: A Systems Learning Tool.
OBJECTIVE
Systems-based practice (SBP) is the only Accreditation Council for Graduate Medical Education (ACGME) competency concerned with public health and is relatively neglected in residency curricula. A tool was developed and pilot-tested to improve SBP learning on inpatient psychiatry rotations.


METHODS
A four-step approach was used: (1) literature review, (2) expert consultation, (3) tool development, and (4) pilot testing on four cases and evaluation for completion time and preliminary efficacy.


RESULTS
Out of 51 SBP articles, six (12%) focused on psychiatric residency programs, and none had a practical SBP learning tool. The "systems SOAP (subjective, objective, assessment, plan) note" (S-SOAP) was structured after a clinical SOAP note and was easy to use (mean completion time = 60 min), and residents self-reported more insight into systems issues.


CONCLUSIONS
The S-SOAP tool was effectively integrated into clinical experience and provided insight into systemic complexities. Future research should assess SBP knowledge acquisition after the use of such tools.
University of California, San Francisco, San Francisco, CA, USA. fumi.mitsuishi@ucsf.edu.
Fumi
F
Mitsuishi
Hofstra North Shore LIJ School of Medicine, Glen Oaks, NY, USA.
John Q
JQ
Young
University of California, San Francisco, San Francisco, CA, USA.
Mark
M
Leary
University of California, San Francisco, San Francisco, CA, USA.
James
J
Dilley
University of California, San Francisco, San Francisco, CA, USA.
Christina
C
Mangurian
D000068:Accreditation; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D017145:Models, Educational; D011570:Psychiatry / Q000193:education*; D011634:Public Health
Educational tools; Systems learning; Systems-based practice