Integrating occupational health into a third year medical clerkship in community medicine

BACKGROUND. Integration of occupational health into primary care education and practice has been much discussed but too often honored in the breach. EDUCATIONAL INTERVENTION. A case-based module to introduce third year medical students to occupational health during their community medicine clerkship has been developed. Learning objectives include taking an occupational history and rapid research on hazards. In an actual patient encounter, the students elicit an occupational history, using a modified version of the WHACS mnemonic or one of the available historical approaches. They perform a brief hazard evaluation of one of the jobs, culminating in work-site visits. Students document their findings in standard SOAP (subjective, objective assessment plan) note format with an addendum of their literature review summarized in two to three pages. METHODS. A medical educator specializing in qualitative evaluation methods held focus groups with medical students at the end of four six-week clerkships. Students' impressions of the occupational health module were elicited verbally and in writing on index cards. In addition, the SOAP notes and literature reviews were subjected to content analysis. RESULTS AND DISCUSSION. Evidence of attainment of learning objectives, along with the critical feedback received from students, will be presented. How these future primary care providers conceptualize of occupational health risks in domains beyond individual behaviors, such as social structural factors and disparities in income and education, is explored. Their ability to prescribe control strategies above the level of PPE in the hierarchy of controls is of special interest.