Global health on the front lines: an innovative medical student elective combining education and service during the COVID-19 pandemic.

BACKGROUND: An innovative medical student elective combined student-directed, faculty-supported online learning with COVID-19 response field placements. This study evaluated students' experience in the course, the curriculum content and format, and its short-term impact on students' knowledge and attitudes around COVID-19. METHODS: Students responded to discussion board prompts throughout the course and submitted pre-/post-course reflections. Pre-/post-course questionnaires assessed pandemic knowledge and attitudes using 4-point Likert scales. Authors collected aggregate data on enrollment, discussion posts, field placements, and scholarly work resulting from course activities. After the elective, authors conducted a focus group with a convenience sample of 6 participants. Institutional elective evaluation data was included in analysis. Authors analyzed questionnaire data with summary statistics and paired t-tests comparing knowledge and attitudes before and after the elective. Reflection pieces, discussion posts, and focus group data were analyzed using content analysis with a phenomenological approach. RESULTS: Twenty-seven students enrolled. Each student posted an average of 2.4 original discussion posts and 3.1 responses. Mean knowledge score increased from 43.8 to 60.8% (p <  0.001) between pre- and post-course questionnaires. Knowledge self-assessment also increased (2.4 vs. 3.5 on Likert scale, p <  0.0001), and students reported increased engagement in the pandemic response (2.7 vs. 3.6, p <  0.0001). Students reported increased fluency in discussing the pandemic and increased appreciation for the field of public health. There was no difference in students' level of anxiety about the pandemic after course participation (3.0 vs. 3.1, p = 0.53). Twelve students (44.4%) completed the institutional evaluation. All rated the course "very good" or "excellent." Students favorably reviewed the field placements, suggested readings, self-directed research, and learning from peers. They suggested more clearly defined expectations and improved balance between volunteer and educational hours. CONCLUSIONS: The elective was well-received by students, achieved stated objectives, and garnered public attention. Course leadership should monitor students' time commitment closely in service-learning settings to ensure appropriate balance of service and education. Student engagement in a disaster response is insufficient to address anxiety related to the disaster; future course iterations should include a focus on self-care during times of crisis. This educational innovation could serve as a model for medical schools globally.

Learning with experts: Incorporating community into gender-diverse healthcare education.

The Association of American Medical Colleges (AAMC) encourages but does not require medical schools to train students on LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.…) care and education on transgender, gender-diverse and/or intersex care is particularly lacking. This study evaluated the efficacy of a patient-centred educational intervention co-developed and facilitated with transgender and gender-diverse (TGD) patient collaborators on students' knowledge of TGD healthcare needs, perceived value of TGD healthcare training and TGD healthcare competency. The authors recruited second-year medical students from the Primary Care, Family and Community Medicine Clerkship at the University of Texas at Austin Dell Medical School (UT Dell Med) in Spring 2021. Students (n = 36) completed an online survey with closed- and open-ended questions that included AAMC TGD healthcare competencies, perceived value of TGD healthcare training, and knowledge of TGD healthcare needs before and after an educational intervention utilising clinical cases developed and delivered in collaboration with six TGD patient collaborators. The TGD patient collaborators completed a post-intervention survey evaluating the patient-centredness of the educational intervention's design and implementation and their perception of the student's competence during the intervention. There was a statistically significant increase in each AAMC TGD healthcare competency post-intervention, except for discussing sexual health practices. No changes in perceived value or knowledge were noted. Students reported that authentic engagement with TGD patient collaborators during the educational intervention had the most impact (n = 10, 58.4%). All responding TGD patient collaborators (n = 5, 100%) strongly agreed that their input was valued and at least somewhat agreed that they felt supported by the organiser of the educational intervention. Three respondents (75%) somewhat agreed that the development of the educational intervention was a collaborative process, with one (25%) somewhat disagreeing. Educational interventions that are co-developed with TGD patient collaborators may improve medical student understanding of gender diversity. Additional efforts are needed to further the patient-centredness of educational interventions.