Learning Social Determinants through Longitudinal Preclinical Patient Relationships
METHODS: Twenty-four students in pairs formed longitudinal partnerships with twelve patients living with chronic disease, and established and pursued patient health goals. Three faculty physicians mentored students, recruiting patients from 2 Montefiore health centers. Initial student training included phone patient introductions. Patient-student teams spoke weekly, with EMR documentation. Students met monthly in groups with physician mentors, alternating skills workshops and reflection. Participating students were surveyed before and after, and patients once, on attitudes, knowledge, and behavior. Anonymous bi-monthly student written reflections were analyzed thematically.
RESULTS: Students (n=17) joined PACt for various reasons; self-perceived knowledge of patient resources increased; and plans to pursue primary care increased; but unremarkable student empathy scores remained unchanged; and plans to care for the underserved declined. Challenges included time constraints, role confusion, frustration, and logistical issues. Patients (n=11) joined PACt for various reasons; reported poor or fair health; achieved goals with student help; and rated student communication highly.
DISCUSSION: Despite goal-oriented progress for patients, valuable learning opportunities for students, and a modest increase in students committed to primary care, the experience discouraged some students from working with the underserved.
Learning Areas:Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Public health or related education
Describe a longitudinal program involving medical students and patients with chronic illness. List elements of a program evaluation strategy that includes patients and students.
Keyword(s): Training, Underserved Populations
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Any relevant financial relationships? No
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