Addressing COVID-19 Vaccine Hesitancy: The Role of Medical Students.

We conducted a survey study at the Icahn School of Medicine at Mount Sinai to assess COVID-19 vaccine attitudes and behaviors among medical students. Almost all respondents (96.5%, n = 222) believed vaccines were effective and reported being asked about the COVID-19 vaccine by family members (79.0%, n = 180). However, when asked how they respond when someone shares misinformation, 89.0% (n = 202) responded they agree to avoid conflict, 44.9% (n = 102) listened empathically, and 9.3% (n = 21) corrected the misinformation. Medical school education can address this disconnect, using standardized patients and role-playing to give students the tools to address vaccine hesitancy within their communities. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01670-2.

Social Determinants, Risk Factors, and Needs: A New Paradigm for Medical Education.

COVID-19 and the escalation of racism and bias that has come in its wake have had a devastating impact on health professions students. In addition to academic challenges and personal health risks, aspects of students' lives that have often gone unnoticed or inadequately addressed have come to light. Financial constraints that impact access to housing and food, neighborhood safety in light of the spike in hate crimes, and the bias inherent in the continuum from premedical education to undergraduate and graduate medical education are some examples. The authors believe that to better understand students' lived experiences and determine how to best support them, the social determinants of health framework should be applied. This framework, the social determinants of education, encompasses concepts such as social risk factors and social needs in an effort to focus more intentionally on what can be done at a policy, institutional, and individual level. In response to the pandemic, the authors expanded their appreciation of students' risk factors and needs by advancing the scope and refining the definitions of 3 key determinants: from well-being to the power of individual and communal resilience, from equity to centering racial justice, and from student health to public health and infection prevention. The authors propose applying this same paradigm to the lived experiences of staff in medical education, whose needs are often neglected in favor of students and faculty, and who, in many cases, were the most negatively impacted by COVID-19 of all the constituents in an academic health center.

Racial and ethnic differences in personal cervical cancer screening amongst post-graduate physicians: results from a cross-sectional survey.

BACKGROUND: Racial and ethnic disparities in cervical cancer screening have been attributed to socioeconomic, insurance, and cultural differences. Our objective was to explore racial and ethnic differences in adherence to cervical cancer screening recommendations among female post-graduate physicians. METHODS: We conducted a cross-sectional survey at one university hospital among a convenience sample of 204 female post-graduate physicians (52% of all potential participants), examining adherence to United States Preventive Services Task Force cervical cancer screening recommendations, perception of adherence to recommendations, and barriers to obtaining care. RESULTS: Overall, 83% of women were adherent to screening recommendations and 84% accurately perceived adherence or non-adherence. Women who self-identified as Asian were significantly less adherent when compared with women who self-identified as white (69% vs. 87%; Relative Risk [RR]=0.79, 95% Confidence Interval [CI], 0.64-0.97; P<0.01). Women who self-identified as East Indian were significantly less likely to accurately perceive adherence or non-adherence when compared to women who self-identified as white (64% vs. 88%; RR=0.73, 95% CI, 0.49-1.09, P=0.04). Women who self-identified as Asian were significantly more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 35%; RR=1.75, 95% CI, 1.24-2.47; P=0.001) and there was a non-significant tendency toward women who self-identified as East Indian being more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 34%; RR=1.74, 95% CI, 1.06-2.83; P=0.06). CONCLUSION: Among a small group of insured, highly-educated physicians who have access to health care, we found racial and ethnic differences in adherence to cervical cancer screening recommendations, suggesting that culture may play a role in cervical cancer screening.

Brief report: Housestaff adherence to cervical cancer screening recommendations.

BACKGROUND: Postgraduate training involves intensive clinical education characterized by long work hours with minimal flexibility. Time demands may be a barrier to obtaining preventive care for housestaff during postgraduate training. OBJECTIVE: Assess adherence to United States Preventive Services Task Force (USPSTF) cervical cancer screening recommendations. DESIGN: Cross-sectional survey. PARTICIPANTS: Convenience sample of female housestaff at 1 university hospital. MEASUREMENTS: Primary outcomes included (1) adherence to USPSTF recommendations, (2) perception of adherence to recommendations, and (3) barriers to obtaining preventive care. RESULTS: Surveys were completed by 204 housestaff. Overall, 81% of housestaff were adherent to USPSTF screening recommendations. Housestaff requiring screening in the past year were less likely to be adherent when compared with housestaff requiring screening in the past 3 years. Overall, 84% accurately perceived their screening behavior as adherent or nonadherent (kappa=0.58). Of the 43% who identified a barrier to obtaining preventive care, not having time to schedule or keep appointments was reported most frequently (n=72). CONCLUSIONS: Housestaff accurately perceived their need for cervical cancer screening and were generally adherent to USPSTF recommendations, even though lack of time during postgraduate training was frequently reported as a barrier to obtaining preventive care. However, we found lower adherence among a small subgroup of housestaff at a slightly greater risk for cervical disease and most likely to benefit from screening.