scholarly journals Students of Change: Health Policy in Action

2022 ◽  
Vol 54 (1) ◽  
pp. 38-43
Author(s):  
Amy Clithero-Eridon ◽  
Danielle Albright ◽  
Clint Brayfield ◽  
Nicole Abeyta ◽  
Karen Armitage

Background and Objectives: Health policy is more impactful for public health than many other strategies as it can improve health outcomes for an entire population. Yet in the “see one, do one, teach one” environment of medical school, most students never get past the “see one” stage in learning about the powerful tools of health policy and advocacy. The University of New Mexico School of Medicine mandates health policy and advocacy education for all medical students during their family medicine clerkship rotation. The aim of this project is to describe a unique health policy and advocacy course within a family medicine clerkship. Methods: We analyzed policy briefs from 265 third-year medical students from April 2016 through April 2019. Each brief is categorized by the level of change targeted for policy reform: national, state, city, or university/school. Implemented policies are described. Results: Slightly less than one-third of the policies (30%) relate to education, 36% advocate for health system change by addressing cost, access, or quality issues, and 34% focus on public health issues. Fourteen policies have been initiated or successfully enacted. Conclusions: This curriculum gives each medical student a health policy tool kit with immediate opportunities to test their skills, learn from health policy and advocacy experts, and in some cases, implement health policies while still in medical school. A 1-week family medicine policy course can have impact beyond the classroom even during medical school, and other schools should consider this as a tool to increase the impact of their graduates.

2018 ◽  
Vol 50 (5) ◽  
pp. 369-371
Author(s):  
Arch G. Mainous ◽  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Alexander W. Chessman

Background and Objectives: The United States suffers from a low proportion of medical students pursuing family medicine (FM). Our objective was to examine institutional characteristics consistent with a focus on National Institutes of Health (NIH) research, institutional support for FM education, and the proportion of medical students choosing FM. Methods: The 2015 CERA Survey of Family Medicine Clerkship Directors was merged with institutional NIH funding data from 2014 and medical student specialty choice in 2015. Institutional educational support was operationalized as (1) clerkship director’s perception of medical school environment toward FM, and (2) amount of negative comments about FM made by faculty in other departments. The outcome was the percentage of students selecting FM. Bivariate statistics were computed. Results: As NIH funding increases, the proportion of students entering FM decreases (r=-.22). Institutions with higher NIH funding had lower clerkship director perceptions of medical school support toward FM (r=-.38). Among private institutions, the negative correlation between NIH funding and the proportion of students entering FM strengthens to r=-.48, P=.001. As perceptions of support for FM increase, the proportion of students entering FM increase (r=.47). Among private schools, perceptions of support toward family medicine was strongly positively correlated with the proportion of students entering FM (r=.72, P=.001). Conclusions: Higher institutional NIH funding is associated with less support for FM and lower proportions of students choosing FM. These issues appear to be even more influential in private medical schools. Understanding how to integrate the goals of NIH-level research and increasing primary care workforce so that both can be achieved is the next challenge.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin Kligler ◽  
Genevieve Pinto Zipp ◽  
Carmela Rocchetti ◽  
Michelle Secic ◽  
Erin Speiser Ihde

Abstract Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients’ environmental illnesses, nor speak to prevention. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students’ attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students’ perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives. Results 36 year 1 students completed both the pre and post EHMS surveys. McNemar’s test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling. When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted. Conclusions Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.


2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
A Soualhi ◽  
MSA Amin ◽  
A Aydin ◽  
MS Khan ◽  
P Dasgupta ◽  
...  

Abstract Introduction Early exposure of medical students to surgical skills has been associated with an increased interest in pursuing a career in surgery. This study aimed to investigate the impact of student background on basic laparoscopic skills acquisition and perceived stress to workload during simulation. Method Students were recruited to a course modelled on the European Basic Laparoscopic Urological Skills (E-BLUS) programme. Students filled out a pre-course demographic survey, and a post-course survey that evaluated perceived stress to workload (SURG-TLX). Pre- and post-course confidence in laparoscopic skills, performance in the course, as well as SURG-TLX parameters were statistically compared for all demographic factors. Result Twenty-three participants completed the course, fifteen (65%) of which were female. Ten students were junior (first and second year), and thirteen were senior (third year and above). Hobbies were grouped into either requiring hand-eye coordination (n=9), manual dexterity (n=9), or no relevance to surgery (n=5). No significant differences were found in demographic factors for course performance or pre- and post-course confidence. No significant differences were found between male and female students, and between different hobby groups, in all SURG-TLX parameters. Senior students reported a significantly higher Physical Demand of the SURG-TLX compared to juniors (p=0.042). No differences were found in other parameters. Conclusion Our study showed no correlation between student background (notably sex and stage of medical school) and basic laparoscopic skills acquisition or stress during simulation. We therefore suggest that medical students are provided with more exposure to acquire basic laparoscopic skills regardless of their background. Take-home message Medical student background is not a discriminator in surgical simulation performance and stress. All medical students, regardless of their sex or stage of medical school, should be given the opportunity to practice laparoscopic skills.


Author(s):  
Umayya Musharrafieh ◽  
Khalil Ashkar ◽  
Dima Dandashi ◽  
Maya Romani ◽  
Rana Houry ◽  
...  

Introduction: Objective Structured Clinical Examination (OSCE) is considered a useful method of assessing clinical skills besides Multiple Choice Questions (MCQs) and clinical evaluations. Aim: To explore the acceptance of medical students to this assessment tool in medical education and to determine whether the assessment results of MCQs and faculty clinical evaluations agree with the respective OSCE scores of 4th year medical students (Med IV). Methods: performance of a total of 223 Med IV students distributed on academic years 2006-2007, 2007-2008, and 2008-2009 in OSCE, MCQs and faculty evaluations were compared. Out of the total 93 students were asked randomly to fill a questionnaire about their attitudes and acceptance of this tool. The OSCE was conducted every two months for two different groups of medical students who had completed their family medicine rotation, while faculty evaluation based on observation by assessors was submitted on a monthly basis upon the completion of the rotation. The final exam for the family medicine clerkship was performed at the end of the 4thacademic year, and it consisted of MCQsResults: Students highly commended the OSCE as a tool of evaluation by faculty members as it provides a true measure of required clinical skills and communication skills compared to MCQs and faculty evaluation. The study showed a significant positive correlation between the OSCE scores and the clinical evaluation scores while there was no association between the OSCE score and the final exam scores.Conclusion: Student showed high appreciation and acceptance of this type of clinical skills testing. Despite the fact that OSCEs make them more stressed than other modalities of assessment, it remained the preferred one.


2021 ◽  
pp. 105382592110486
Author(s):  
Jacquelyn B. Kercheval ◽  
Alec Bernard ◽  
Hanna Berlin ◽  
Nicole Byl ◽  
Boone Marois ◽  
...  

Background: Undergraduate outdoor orientation programs facilitate students’ transition into college. Research has yet to be conducted on the few programs at medical schools, which may have unique benefits given the specific challenges of transitioning to medical school and high rates of burnout among medical students. Purpose: This mixed methods study examines the impact of one medical school's outdoor orientation program on its participants. Methodology/Approach: A survey was administered immediately following the 2018 trip ( N = 56 responses). Follow-up focus groups were conducted with a sample of the same participants ( N = 18) in 2019. Responses were analyzed using descriptive statistics and thematic analysis. Findings/Conclusions: Participants felt that the program helped ease their transition into medical school, establish a support system, and hone personal development and wellness skills. Many of these effects persisted up to one year later. Implications: These findings are of particular interest to the medical and experiential education communities because many outcomes persisted for at least one year after the original trip and aligned with factors believed to protect against medical student burnout. There is opportunity for additional research as well as expansion of similar programs to other medical schools.


2018 ◽  
Vol 42 (4) ◽  
pp. 685-692 ◽  
Author(s):  
Mari K. Hopper ◽  
Daniela A. Brake

A large, multicampus, public medical school underwent curricular renewal, emphasizing a student-centered approach with 50% of all course contact time devoted to active learning. Determining the impact of active learning on student engagement and higher order skill (HOS) proficiency was the primary aim of this study. Following Institutional Review Board approval, two cohort groups of first-year medical students were enrolled. The first cohort ( n = 54) included students before curriculum reform in the legacy curriculum (LC). The second cohort ( n = 73) included students completing studies in the renewed curriculum (RC). Near the end of the first year of medical school, both cohorts completed a validated survey of student engagement, and a proctored problem-based assessment of HOS proficiency [Collegiate Learning Assessment (CLA+)]. Results indicated RC students perceived greater levels of engagement than LC (39.5+5.8 vs. 33.3+5.6), and greater reliance on HOS, including analysis, synthesis, and application. However, there were no significant differences between cohorts in proficiency of HOS when assessed by the CLA+ (LC = 1,878 ± 161 vs. RC = 1,900 ± 157). Additionally, poor correlation between engagement and HOS for both LC and RC indicated more engaged students do not necessarily possess greater HOS proficiency. Ceiling effect may explain results as medical students enter medical school as highly skilled learners with potentially little room for improvement. It will be informative to continue to track engagement and HOS of both cohort groups as they continue their medical studies.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039357
Author(s):  
Sara Sorrell ◽  
Halah Ibrahim

ObjectivesMedical school serves as a critical developmental period for future physicians, during which students begin to form a professional identity. Just as personal appearance, particularly clothing, is an important external expression of one’s personal identity, ‘uniforms’ in healthcare, including white coats and scrubs, symbolise status and a group identity. There are, however, limited studies on the impact of physician attire on medical students’ formation of professional identity. Accordingly, through qualitative analysis of written narratives, we sought to analyse medical students’ experiences of wearing professional physician attire, namely scrubs, and how the uniform impacted their confidence level, performance and behaviours, as well as their identity as future physicians.DesignQualitative analysis of medical student’s written narratives.SettingKhalifa University College of Medicine and Health Sciences (KU CMHS) is a new medical school in the United Arab Emirates, with an inaugural class of 30 students admitted in August 2019. It is the only medical school in the city of Abu Dhabi, and the only school in the country that follows a postgraduate medical curriculum.ParticipantsAll first year medical students at KU CMHS were purposively sampled.MethodsStudents completed a voluntary online anonymous questionnaire. We employed a social identity approach to data analysis. Thematic content analysis was conducted on their narratives to identify themes.ResultsWe identified three major themes, namely (1) emotions, (2) logistics and (3) interpersonal relationships.ConclusionsMedical students form early perceptions regarding physician attire and its impact on their professional identity. Engaging in conversations regarding professional attire with educators or mentors could provide an important opportunity for students to discuss and explore professional identity early in training.


2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Vasiliki Nataly Rahimzadeh ◽  
David Lessard ◽  
Peter Nugus

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.                                                                  Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.                    Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.


PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.


Author(s):  
David Wastell ◽  
Sue White

This chapterr shifts the focus from animals to humans, and examines the extant literature on the human epigenome. It reviews seminal work on the impact of natural disasters (such as the Dutch Hunger Winter) on the epigenetic profile of those subject to these calamities. It describes how gestation and early infancy are reconfigured as a site of risk. It interrogates the nature of the claims made within the literature and also examines the thought style and presuppositions, particularly in those studies which seek to translate findings from laboratory to the clinic and public health policy. The small size of the effects on human populations is also highlighted, compared to other influences such as social deprivation.


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