Outcomes of a Health Systems Advocacy, Leadership, and Management Curriculum in a Family Medicine Residency Program

Introduction: Healthcare Administration, Leadership, and Management (HALM) offers a broad area of expertise that is key to health care delivery and health services research. The Accreditation Council for Graduate Medical Education (ACGME) established a Review Committee (RC) specific to the HALM fellowship to enhance the agenda further. Some of the core health systems competencies are already common program requirements. Although most residency programs offer a curriculum in health systems to fulfill these requirements, a dearth of data exists on the outcomes of these curricula. Methods: We implemented a HALM curriculum in a family medicine residency program featuring competencies in patient safety, health care quality, care management, and systems of care. This study compares pre-HALM and post-HALM groups by measuring the achievement of the Kirkpatrick Level 2, 3, and 4 outcomes in a quasi-experimental pre- and postdesign. The levels were ranked as a demonstration of interdisciplinary leadership within the program (Kirkpatrick Level 2), demonstration of a significant leadership role outside of the program (Kirkpatrick Level 3), or attainment of a physician leadership role or significant entrepreneurship postgraduation (Kirkpatrick Level 4). Results: The results showed increased achievement of Kirkpatrick Level 2, 3, and 4 outcomes in the post-HALM group compared to the preimplementation of the HALM curriculum. The average number of demonstrated Kirkpatrick Level 4 behaviors, leadership role postgraduation, increased significantly from pre- to postimplementation of the HALM curriculum. This difference was statistically significant with a P value <.05. Conclusions: Overall, implementing the HALM curriculum was associated with an increase in both physician leadership during residency training and after graduation.