Perspectives on Cancer Screening Among Latino Community Members and Internal Medicine Residents

Abstract Background The current system of residency training focuses on the hospital setting, and resident exposure to the surrounding community is often limited. However, community interaction can play an important role in ambulatory training and in learning systems-based practice, a residency core competency. The goal of the Neighborhood Health Exchange was to develop a community partnership to provide internal medicine residents with an opportunity to interface with community members through a mutually beneficial educational experience. Methods Internal medicine residents received training during their ambulatory block and participated in a voluntary field practicum designed to engage community members in discussions about their health. Community members participated in education sessions led by resident volunteers. Results Resident volunteers completed a survey on their experiences. All residents stated that the opportunity to lead an exchange was very useful to their overall residency training. Eight exchanges were held with a total of 61 community participants, who completed a 3-question survey following the session. This survey asked about the level of material, the helpfulness of the exchanges, and opportunities for improvement. We received 46 completed surveys from community members: 91% stated that the material was presented “at the right level” and 93% stated that the presentations were somewhat or very helpful. Eighty percent gave positive and encouraging comments about the exchange. Conclusion Effective community partnerships involve assessing needs of the stakeholders, anticipating leadership turnover, and adapting the Neighborhood Health Exchange model to different groups. Community outreach can also enhance internal medicine ambulatory training experience, provide residents with patient counseling opportunities, and offer a novel method to enhance resident understanding of systems-based practice, especially within the larger community in which their patients live.

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Review of annual compliance of low-dose CT for lung cancer screening among internal medicine resident physicians in a university teaching program.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19187 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19187-e19187

Author(s):

Nerea Lopetegui-Lia ◽

Dimitrios Drekolias ◽

Syed Imran Mustafa Jafri ◽

James Vredenburgh

Keyword(s):

Internal Medicine ◽

Lung Cancer ◽

Cancer Screening ◽

Low Dose ◽

Lung Cancer Screening ◽

Smoking History ◽

Definitive Treatment ◽

Internal Medicine Residents ◽

Annual Screening

e19187 Background: Lung cancer remains the leading cause of morbidity and mortality, with an estimated 2.1 million newly diagnosed cases each year. A large percentage of cases are detected at an advanced stage, making treatment recalcitrant. Only about 15% are diagnosed at an early stage, highlighting the significance of timely screening. USPSTF recommends annual screening with low-dose computed tomography (LDCT) in adults aged 55-80, who have a 30 pack-year smoking history and are current smokers, or former smokers who have quit within the last 15 years. The National Comprehensive Cancer Network (NCCN) guidelines, as well as the National Lung Screening Trial (NLST), recommend annual screening with LDCT until a person is no longer a candidate for definitive treatment. This study aimed to evaluate the compliance with annual LDCT based on USPSTF guidelines among internal medicine residents from the University of Connecticut residency program at a Clinic in Hartford, Connecticut, USA. Methods: Patients who were under the care of internal medicine residents and who had undergone an initial LDCT for lung cancer screening were included. A total of 61 medical charts were reviewed. Three patients were diagnosed with lung cancer and nineteen patients had their initial LDCT in 2019, and therefore excluded. Results: Out of the 39 patients, 10 patients (25.64%) had a follow-up annual LDCT performed, 2 patients before the annual mark due to various clinical concerns, and 9 patients (23%) in the following 24-48 months. 6 patients (15.38%) had a repeat LDCT ordered but was not done or it was canceled. 12 patients (30.77%) had no repeat LDCT ordered at 12 months. Overall, 69.23% had no follow-up CT at 12 months, and 46.15% with no follow up CT at all at the time of chart review. Conclusions: Based on our analysis, follow-up annual LDCT scans for lung cancer screening on patients under the care of residents-in-training are not being ordered frequently enough. The failure to order annual LDCT could be due to a false sense of relief with a normal initial LDCT, the lack of provider’s awareness of USPSTF guidelines, or insurance issues. Educating primary care providers on the importance of follow-up annual LDCT will ensure early detection and decrease mortality from lung cancer in high risk patient population.

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