Curriculum and Evaluation Results of a Third-Year Medical Student Longitudinal Pathway on Underserved Care
ABSTRACT There is a need to train compassionate and competent physicians to care for the growing underserved population in this country.
The authors developed the third-year Longitudinal Ambulatory Care Experience (LACE) Underserved Care pathway at Baylor College of Medicine in 2003 to help interested students prepare to be clinicians who care for the underserved. The pathway curriculum included seminar/journal clubs on relevant underserved care topics, clinical time with an underserved care preceptor, visits to community organizations, an assignment to help an uninsured patient obtain health care funding, and a group project. The authors report on the student evaluations of the first 4 years of the pathway, 2003 to 2007. The Institutional Review Board of Baylor College of Medicine granted this educational study exempt status.
Students highly rated each pathway component in enhancing their knowledge, skills and attitudes. For 2005 to 2007, students rated most knowledge, skills, and attitudes items more highly at the conclusion of the pathway compared to the beginning (p <.05).
The pathway has been successful in enhancing knowledge, skills, and attitudes in underserved care for its participants. Further study is needed to evaluate long-term outcomes of participants in this pathway, including practice setting, knowledge, skills, attitudes, quality of care, and ability to help patients navigate through the health care system and overcome barriers.
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ABSTRACT: PURPOSE: The number of U.S. medical school graduates who choose to practice in health professional shortage areas (HPSAs) has not kept pace with the needs of society. The University of Wisconsin School of Medicine and Public Health has created a new program that prepares medical students to reduce health disparities for urban medically underserved populations in Milwaukee. The authors describe the Training in Urban Medicine and Public Health (TRIUMPH) program and provide early, short-term outcomes. METHOD: TRIUMPH integrates urban clinical training, community and public health curricula, longitudinal community and public health projects, mentoring, and peer support for select third- and fourth-year medical students. The authors tracked and held focus groups with program participants to assess their knowledge, skills, satisfaction, confidence, and residency matches. The authors surveyed community partners to assess their satisfaction with students and the program. RESULTS: From 2009 to 2012, 53 students enrolled in the program, and 45 have conducted projects with community organizations. Participants increased their knowledge, skills, confidence, and commitment to work with urban medically underserved populations. Compared with local peers, TRIUMPH graduates were more likely to select primary care specialties and residency programs serving urban underserved populations. Community leaders have reported high levels of satisfaction and benefits; their interest in hosting students exceeds program capacity. CONCLUSIONS: Early, short-term outcomes confirm that TRIUMPH is achieving its desired goals: attracting and preparing medical students to work with urban underserved communities. The program serves as a model to prepare physicians to meet the needs of urban HPSAs.Academic medicine: journal of the Association of American Medical Colleges 01/2013; DOI:10.1097/ACM.0b013e3182811a75 · 3.47 Impact Factor
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ABSTRACT: In 2006, the University of Washington School of Medicine (UWSOM) launched the Underserved Pathway (UP), an extracurricular longitudinal experience supporting student interest in caring for underserved populations. This study examined the association between UP participation and residency choice. The study population was 663 UWSOM graduates who matched to a residency from 2008 to 2011; 69 were UP participants. Outcomes included matching to primary care residencies (family medicine, internal medicine, pediatrics, or medicine-pediatrics). The authors calculated graduate rates and odds of UP participants versus nonparticipants matching to primary care residencies overall and to residencies in individual primary care specialties. This analysis included all graduates and 513 graduates who had dual interest in primary care and underserved care at matriculation. Of 336 graduates matching to primary care, the authors calculated rates of entering the individual specialties with respect to UP participation. UP participants matched at significantly higher rates than nonparticipants to primary care (72.5% versus 48.1%, adjusted odds ratio [OR] 2.2) and family medicine residencies (33.3% versus 15.0%, adjusted OR 2.9). Of graduates with dual matriculation interest in primary care and underserved care, 73.4% of participants versus 53.5% of nonparticipants matched to primary care (adjusted OR 1.9), and 31.2% of participants versus 18.0% of nonparticipants matched to family medicine (adjusted OR 2.1). Of primary care matched graduates, 46.0% of participants versus 31.1% of nonparticipants entered family medicine. Supporting student interest in underserved careers is associated with higher rates of graduates entering primary care residencies, specifically family medicine.Academic medicine: journal of the Association of American Medical Colleges 11/2013; DOI:10.1097/ACM.0000000000000075 · 3.47 Impact Factor
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ABSTRACT: Introduction Medically underserved populations experience a lower quality of health services and increased incidence of chronic disease. Identified strategies to reduce disparities in health care include educating health professional students on caring for medically underserved populations and integrating interprofessional education into health science curricula. The objective of this paper is to describe an interprofessional course designed for Doctor of Pharmacy and Master of Social Work students to enhance knowledge and identify barriers in providing care to medically underserved populations with an emphasis on homeless populations and examine students’ perceptions of interprofessional education. Challenges to course implementation are also described. Methods An elective course including didactic and experiential components was created with the goal of promoting awareness and self-reflection in providing care for medically underserved populations. Students participated in case-based discussions and wrote reflections about their experiences at a homeless clinic. Results Of 25 students, 18 participated in pre- and post-surveys. At the end of the course, students’ confidence in communicating with medically underserved populations increased, but interest in working with these patients declined. Conclusion The course enhanced collaboration and interprofessional communication between the Schools of Pharmacy and Social Work. Factors to consider for future courses include closer examination of the content level of introductory materials and differences in curriculum committee guidelines.Currents in Pharmacy Teaching and Learning 07/2014; DOI:10.1016/j.cptl.2014.04.004