Public Health 785 teaches MPH students to “think in systems”

In a new course designed by CPP co-director Sarah Davis and CPP health systems instructor Mary Michaud, students in MPH and health professional programs learn how to “think in systems.” 

Medical Care and Public Health Systems 785, a core course in the UW School of Medicine and Public Health Master’s of Public Health program, helps students understand the organization, finance, and delivery of health care and public health services. The course offers critical insights into the unique evolution of the U.S. health sector, paying close attention to the reasons racial and social inequities have persisted over time.

In the future I will constantly have a piece of systems thinking running in my head as I make decisions, and I will pull it to the forefront and help others understand it when wise to do so…The class has impacted me at a level that is hard to describe, and I hope to weave into my mental framework the insights and skills I have learned permanently.”

–MPH pre-medicine Student, Systems 785

“We use case studies, interactive activities, and multimedia to dive deeply into the history and assumptions driving our health care system,” says Michaud, who taught the course in Spring 2020. “In January, on the first day of class, small groups of students had to come up with a plan, on the spot: A passenger on a jet, symptomatic with what was suspected to be the novel coronavirus, would land in Madison in two hours. What were the critical questions they needed to ask?”

Part of “thinking in systems” requires students to become more comfortable seeking out multiple perspectives and dealing with ambiguity. To do this, Michaud taught students to use visual methods, “mapping” complex concepts and systems in ways that garnered a more nuanced view of the forces at play. “I loved the content of this course and the ways that it was made relevant to all students regardless of their focus on a clinical path, [or] a pure public health path,” said one student in her evaluation. “Being a very strict science person and not at all artistic, I was skeptical about the effectiveness of visuals. By the end, I developed a deep appreciation for the power of visuals.”

Students also locate and examine their own health insurance coverage policies in great detail. “The insurance policy review, although time-consuming, helped me to understand the complexities of the healthcare system,” one student remarked. “I now think more broadly about the underlying causes of the disparities and public health challenges our society faces.” 

Davis says that every year, simply obtaining copies of the policies is a learning opportunity. “Many students learn just how difficult it is to obtain a copy of one of the most important–and expensive–contracts they or their parents own,” she says. Ultimately, students discover a lot about their coverage, liability, and “what’s hidden in the fine print.” And it confounds them.

The Center’s interdisciplinary approach informs course design. Michaud encouraged students with expertise to contribute it to the learning, and a group of students in the MS in Pharmacy Administration program stepped up to deliver timely, relevant content on drug pricing. “This course more than others fostered interdisciplinary studies,” one student wrote in their evaluation. “The lectures from the pharmacy administration students were a highlight of the semester.”