Strategies to Integrate Population Health and Health Policy into Medical Education

Purpose: Improving public health in health reform will require more education for future physicians in population health. We developed and tested a 50-question survey assessing public health knowledge and attitudes. Methods: Data were collected electronically for three cohorts: entering medical school (Class of 2013; N=86), beginning of second year (Class of 2012; N=81), and clinical clerkship (Class of 2011; N=69). Item scales were created reflecting 4 domains of public health knowledge: Evidence Base of Practice (EBP), Clinical Preventive Services and Health Promotion (CPSHP), Health Systems and Health Policy (HP) and Community Aspects of Practice (CAP). ANOVA in SPSS v18 and X2 tests were used (alpha =.05). Results: Cohorts differed in the mean number of items correct in the EBOP domain (2013 = 4.8, 2012 = 5.49 and 2011 = 6.65; p < .01) but not on the CPSHP, HP or CAP domains. Across all domains, cohorts differed on mean number of correctly answered items: 2013 = 14.2, 2012 = 14.9 and 2011 = 16.3. Cohorts differed in their agreement about technology as the most effective public health approach to address growing numbers of individuals with chronic conditions; agree + strongly agreed = 42% for the 2013 cohort, 44% for 2012 and 23% for 2011, respectively (X2=8.41, p=.02). Conclusion: Findings highlight needs for additional education in specific public health domains (including prevention of chronic conditions) throughout medical curricula, and further suggest integration strategies. These methods could be applied elsewhere, to improve education of future physicians in public health during health reform.