Beyond the Literature Search: Medical Librarians as Partners in Health Systems Science Education
Submitted by: Nadine Dexter
Health Systems Science (HSS) has emerged as the third pillar of medical education, complementing the traditional basic and clinical sciences. HSS prepares future physicians to understand not only the science and practice of medicine, but also the complex systems in which health care is delivered. The HSS framework brings together areas that historically may have been taught separately and emphasizes their relationships within the larger health care system [1, 2].
At our institution, this broad framework is translated into curricular disciplines that include Clinical Informatics, Population Health, Social and Structural Determinants of Health (SSDOH), Value-Based Care (VBC), Quality Improvement (QI), Patient Safety (PS), Interprofessional Education (IPE), Professionalism, Medical Ethics, the U.S. Health Care System, Systems Thinking, and the Quintuple Aim. The Quintuple Aim emphasizes patient experience, population health, health care costs, care-team well-being, and health equity.
For medical librarians, HSS presents an exciting opportunity. Many of us have contributed to these areas for years—sometimes without recognizing that our expertise fits naturally within what is now called Health Systems Science.
My own journey into HSS began long before the term became part of our curriculum.
From 1994 to 2008, while working at Florida State University, I participated in Longitudinal Curriculum Themes (LCTs), beginning with the Program in Medical Sciences (PIMS), a predecessor to the FSU College of Medicine. My longitudinal curriculum area was Medical Informatics and the integration of emerging technologies into medical education—from handheld Palm Pilots to increasingly sophisticated electronic clinical information resources.
When I joined the University of Central Florida College of Medicine in 2008 as founding director of its born-digital health sciences library, I brought that experience with me. As UCF prepared to welcome its inaugural medical school class in 2009, I was appointed to the LCT committee and became Co-Director of Medical Informatics. As our new medical school developed, the library’s role expanded into technology integration, evidence-based information skills, scholarly activities, and programs designed to embed librarians directly into students’ educational experiences [3, 4].
Years later, as UCF undertook a major curriculum reform, our longitudinal themes evolved into a more comprehensive HSS curriculum. My initial involvement seemed familiar to a medical librarian: helping HSS leadership identify digital textbooks, readings, educational resources, and reliable links for faculty and students. Gradually, however, that role expanded.
When our HSS director retired in 2025, I helped provide continuity during the transition to new leadership. I attended curriculum planning meetings, helped place HSS sessions throughout the new curriculum, and drew upon my experience as a founding faculty member to provide institutional and curricular history. After a new physician director was appointed, I continued supporting the HSS curriculum. In August 2026, I was formally appointed Assistant Director of Health Systems Science by the Senior Associate Dean for Medical Education (SADME).
Today, each HSS discipline at our institution has a faculty lead formally appointed by the SADME. My role is not to be the content expert for every discipline. Instead, I help support and coordinate these components as part of an integrated HSS curriculum across the first two years of medical education.
My responsibilities include supporting HSS leadership, participating in curriculum planning, identifying appropriate literature and educational resources, and ensuring that readings, PowerPoint presentations, and links are accurate and accessible in Webcourses, UCF’s learning management system. I also edit narrative essay questions and instructions, grade student essays, teach in Making of a Physician (MOP) sessions, and serve as a faculty resource for students. I also represent HSS as a voting member of our M.D. Curriculum Committee through a three-year appointment.
One particularly valuable connection is our Personal Librarian Program (PLP), through which every medical student is assigned a librarian.⁴ When HSS students need medical literature to support their individual narrative essays, I can direct them to a librarian who already has an established relationship with them and can assist in locating and evaluating appropriate evidence. The library becomes part of the educational experience rather than a service students encounter only when they need a literature search.
My experience has reinforced that librarians do not need to become experts in every HSS discipline to make meaningful contributions. We already bring important expertise to the table: evidence retrieval and evaluation, informatics, educational resources, information organization, technology, and connecting learners with reliable knowledge. Because medical librarians work across departments and disciplines, we may also recognize connections that are less visible from within a single specialty.
Librarians can provide something else particularly valuable during curriculum reform: continuity and institutional knowledge. We often know how subjects have been taught, how resources have evolved, and how students and faculty interact with information across the curriculum.
This opportunity may be especially important as medical libraries navigate changing organizational structures, financial pressures, and rapidly evolving technologies, including artificial intelligence. As access to information changes, the value of the medical librarian extends beyond providing resources. By becoming integrated into HSS and other areas of the medical curriculum, librarians can make their contributions more visible to institutional leadership and demonstrate their value as educators, collaborators, and curriculum partners.
For medical librarians wondering where they fit within HSS, I suggest beginning with a simple step: look at your institution’s HSS curriculum. Identify who leads it. Examine its disciplines and consider where your existing expertise intersects with them. You may discover that you are already supporting HSS without calling it HSS.
Then ask for a seat at the table.
Health Systems Science offers medical librarians an opportunity to move beyond the literature search and become active partners in the design, delivery, and continuous improvement of medical education.
References
- Skochelak SE, Hammoud M, Lomis KD, Lawson LE, Starr SR, Borkan JM, Gonzalo JD. Health Systems Science. 2nd ed. Philadelphia (PA): Elsevier; 2020.
- Borkan JM, Hammoud MM, Nelson E, Oyler J, Lawson L, Starr SR, Gonzalo JD. Health systems science education: The new post-Flexner professionalism for the 21st century. Medical Teacher. 2021;43(sup2)–S31. doi:10.1080/0142159X.2021.1924366.
- Dexter N, et al. Building new twenty-first century medical school libraries from the ground up: challenges, experiences, and lessons learned. Journal of the Medical Library Association. 2019;107(1):6–15. doi:10.5195/jmla.2019.493.
- Gillum S, Williams N, Herring P, Walton D, Dexter N. Encouraging engagement with students and integrating librarians into the curriculum through a Personal Librarian Program. Medical Reference Services Quarterly. 2018;37(3):266–275. doi:10.1080/02763869.2018.1477710.