Enhancing Medical Students' Understanding of Team-Based Care to Address Social Determinants of Health: A Case-Based Experience.

BACKGROUND AND OBJECTIVES: Social and structural factors play a critical role in driving inequitable health outcomes, resulting in the need for undergraduate medical education to include important care components such as team-based care to address social determinants of health. Research shows that learning strategies such as case-based initiatives are valuable opportunities to impact knowledge of population health, health disparities, and social determinants that impact care. The purpose of this study was to assess the impact of a clinical case-based experience on medical students' self-efficacy and future intent to use the team-based care necessary to address social determinants of health. METHODS: We used a retrospective analysis of program data from 640 third-year medical students who engaged in a case-based experience and small-group debriefing around the impact of team-based care and social determinants of health on patient care during their family medicine clerkship between July 2020 and April 2022. RESULTS: We found a statistically significant improvement in students' reported self-efficacy and intent to collaborate with other health care workers (team-based care) to address patient care needs in rural and urban underserved community settings. CONCLUSIONS: Our students reported that a case-based experience coupled with a small-group debriefing was an effective method for teaching them how to use a team-based approach to address social determinants of health.

Enhancing the Workforce Pathway: A Physical and Occupational Therapy Career Exploration Camp for High School Youth.

There is a workforce shortage in the physical therapy (PT) and occupational therapy (OT) fields. Pathway programs may help guide students with career exploration. This retrospective study assessed changes in students' knowledge about health careers and intent to pursue a health career based on their experience at a PT OT career exploration camp. Between 2018 and 2022, 60 high-school students participated in the camp and completed a pre- and post-program evaluation survey. The results showed a significant improvement in participants' knowledge about health careers and plans to pursue education to become a health professional. Partnering with organizations with the resources to offer career exploration programs help build a strong pathway of students into the PT and OT professions.

Using area health education centers to promote interest in rural practice.

INTRODUCTON: In the USA, area health education centers (AHECs) work to recruit and educate students to serve in medically underserved communities, primary care, and rural settings. One important aspect of their work is connecting students with rural clinical experiences. Within these experiences, AHECs incorporate a community health/socioeconomic experience within the family medicine clerkship that may not be as prevalent in the standard family medicine clerkship experiences. The purpose of the study was to assess the relationship between AHEC-sponsored family medicine clerkships with a self-reported intent to practice in a rural setting upon graduation. METHODS: The study compared third-year medical students with the Indiana University School of Medicine, which participated in AHEC-sponsored family medicine clerkships to the standard family medicine clerkship. Following the 4-week clerkship, students were asked to report their intent to work in a rural setting using a five-point Likert scale. A χ2 test was used to determine the association of AHEC sponsorship, clerkship site location (rural/urban) and intent to practice in a rural setting. RESULTS: The study consisted of 587 students. There was a statistically significant association between self-reported intent and rural clerkship site, χ2 (1, N=587)=6.542, p=0.01. Furthermore, 21.6% (n=25) of students with a rural clerkship experience reported a greater intent compared to 12.3% (n=58) of students with non-rural clerkship experience. CONCLUSIONS: The study confirmed a significantly positive association between participation in medical clerkship experiences in a rural primary care setting and the intent to practice in a rural setting upon graduation. The results also support the potential value-added benefits through academic-community partnerships with AHECs, family medical and other primary care specialty clerkship programs may perhaps succeed in increasing student interest in pursuing a practice serving in rural communities upon graduation.

Does an AHEC-Sponsored Clerkship Experience Strengthen Medical Students' Intent to Provide Care for Medically Underserved Patients?

The mission of Area Health Education Centers (AHECs) is to recruit and educate students to serve as practicing health care professionals in rural, primary care, and medically underserved communities. We sought to determine if participation in an AHEC-sponsored family medicine clerkship experiences during medical school are significantly associated with a self-reported intent to practice primary care in a medically underserved environment upon graduation. The study was a prospective cohort study comparing third-year family medicine students with the Indiana University School of Medicine who participated in either an AHEC-sponsored family medicine clerkship to those who completed their required family medicine clerkship outside of the AHEC setting. Following the 160-h clinical clerkship, all students completed a mandatory, electronic survey and were asked to self-report their intent to the following question: "Which of the following statements best describes the impact of the family medicine clerkship on your intention to provide care to underserved patients when you complete residency training?" The question was integrated into a mandatory post-clerkship evaluation form required by the Indiana University School of Medicine, Department of Family Medicine. A Chi square test of independence as well as a multivariate logistic regression analysis was used to determine the independent association of AHEC clerkship participation and reported intent. A total of 1138 students completed the survey. There were not significant differences in age, gender, race, and ethnicity between students that completed an AHEC clerkship and those that did not. After adjusting for gender, race, and ethnicity, AHEC participants were significantly more likely to report an intention to practice primary care in a medically underserved setting upon graduation. Female students were found to be 1.2-3.4 times as likely to report increased intent compared to male students (95 % CI 1.241-3.394). Participation in an AHEC-supported clerkship was associated with a significant increase in self-reported intent to practice primary care in a medically underserved setting. Additional research is required to determine if participation and/or reported intent are predictive of practice selection after graduation.

A study on the correlation between program contact hours and the successful matriculation into college.

Area Health Education Centers (AHECs) play an important role in the recruitment and training of students to serve as practicing health care professionals in rural, primary care, and medically underserved communities. To analyze the relationship between the accumulated contact hours of past students in AHEC programs and their known matriculation into college. 5,189 students, whom participated in Indiana AHEC Network programs, were grouped into eight categories based on accumulated contact hours and matched against two college matriculation databases. The relationship between the number of accumulated contact hours and known college matriculation was statistically significant. The analysis of the data suggests two significant break points in which the number of accumulated contact hours appears to be correlated with increased known college matriculation. The findings indicate accumulated contact hours are significantly correlated with known college matriculation. Furthermore, two significant break points in contact hours at the 5 and 20 contact hours demonstrated increased correlations between program contact hours and known college matriculation. The results of this analysis between participation in area health education center programming and matriculation into higher education may be transferable to other areas of health education.