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J Health Care Poor Underserved ; 32(2): 598-606, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34120960


In response to the COVID-19 pandemic, the Herbert Wertheim College of Medicine's Neighborhood Health Education Learning Program (NeighborhoodHELP) initiated a longitudinal assessment and mitigation of social and health care challenges for a population of approximately 850 underserved households. Here, we describe the needs assessment, ensuing interventions, and lessons learned during this pandemic.

COVID-19/epidemiologia , Determinação de Necessidades de Cuidados de Saúde , Populações Vulneráveis , Adolescente , Adulto , Idoso , Criança , Serviços de Saúde Comunitária , Informação de Saúde ao Consumidor , Feminino , Florida/epidemiologia , Assistência Alimentar , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Pandemias , Determinantes Sociais da Saúde , Adulto Jovem
South Med J ; 114(1): 17-22, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33398355


OBJECTIVES: Previous negative experiences with the medical community often leave transgender people reluctant to seek medical care. Inadequate teaching and exposure to transgender health during medical training perpetuates the health disparities experienced by this community. Although undergraduate medical education is uniquely positioned to address these disparities, curricular coverage of these topics remains inadequate. METHODS: The second-year clinical skills course at the Florida International University Herbert Wertheim College of Medicine includes a workshop consisting of a 1-hour lecture about the inclusive sexual history, followed by a 1.5-hour small group during which students interview a standardized patient playing the role of a transgender man and participate in a faculty-facilitated debriefing. To evaluate the 2019 workshop, students were provided with an optional, anonymous, pre- and postsession survey consisting of multiple choice and Likert-type questions. RESULTS: After the session, there was a statistically significant increase in students' knowledge of the components of an inclusive sexual history, in the number of students who believed that their medical training had prepared them to effectively provide care for transgender patients, and in the number who reported feeling comfortable taking a sexual history from a patient who identifies as transgender. Most students thought the standardized patient case was realistic and found the postencounter debriefing session helpful in identifying their own strengths and weaknesses. CONCLUSIONS: Our findings suggest that students found this brief, interactive sexual history workshop, which included a lecture and standardized patient case, to be an effective component of their medical training. Although our transgender patient case was acted primarily by cis-gender people, students perceived this as a realistic opportunity to actively explore the nuances of obtaining a history from a transgender patient. In addition, our findings suggest that it is possible to merge teaching on sexual history and transgender health care, which is important in time-limited undergraduate medical education curricula.

Assistência à Saúde Culturalmente Competente/métodos , Anamnese/métodos , Simulação de Paciente , Ensino/normas , Pessoas Transgênero/educação , Assistência à Saúde Culturalmente Competente/estatística & dados numéricos , Educação/métodos , Humanos , Ensino/estatística & dados numéricos , Pessoas Transgênero/psicologia
Fam Med ; 52(7): 523-527, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32640477


BACKGROUND AND OBJECTIVES: Although the subinternship (sub-I) is considered integral in many medical schools' curricula, family medicine does not have standardized course recommendations. Given the variable nature of this clinical experience, this study investigated the potential role of a standardized sub-I curriculum in family medicine. METHODS: Questions about sub-Is were created and data were gathered and analyzed as part of the 2019 Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors. The survey was distributed via email to 126 US and 16 Canadian recipients between June 19, 2019 and August 2, 2019 through the online program SurveyMonkey. RESULTS: A total of 101 (71.1%) of 142 clerkship directors responded to the survey. Most (84.2%) schools require sub-Is. There was a positive association between students matching into family medicine and having family medicine sub-Is at residency programs (P<.001). There was no relationship between higher family medicine match rates and the presence of family medicine sub-Is at nonresidency sites (P=.48) or having an advanced ambulatory rotation requirement (P=.16). CONCLUSIONS: A sub-I is a way to further expose students to family medicine, and increasing sub-I positions at residency programs may influence the number who pursue the specialty. Creation of a standardized sub-I curriculum presents an opportunity to enhance a critical educational experience in family medicine.

J Immigr Minor Health ; 22(2): 421-425, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31620965


In 2016, the NeighborhoodHELP mobile health centers (MHCs) started to provide free long acting reversible contraception (LARC) for uninsured patients who lacked access due to cost. All female patients with appointments from May 1st, 2016 through April 30th, 2017 were identified. LARC uptake rate, as well as demographics for patients aged 15-44 who underwent LARC insertion versus those who did not, were determined. Of the 520 female patients seen on the MHCs during the study period, 170 were of reproductive age. Seventeen (10%) patients opted for LARC; 100 % of these patients spoke Spanish or English and 82 % identified as White and Hispanic/Latino. Results show a 10% LARC uptake, which is slightly above the national rate, but lower than rates in other studies in which cost barriers were removed. Further investigation into barriers influencing LARC uptake in our patient population is warranted.

Serviços de Planejamento Familiar , Contracepção Reversível de Longo Prazo , Unidades Móveis de Saúde , Adolescente , Adulto , Anticoncepcionais Femininos , Registros Eletrônicos de Saúde , Feminino , Florida , Acesso aos Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Determinantes Sociais da Saúde , Adulto Jovem
MedEdPORTAL ; 14: 10772, 2018 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-30800972


Introduction: Sexual health is influenced by a myriad of social factors including health care access, social and cultural norms, insurance status, educational level and health literacy, economic status, sex, gender identity, and sexual orientation and behavior. It is pivotal to educate future physicians about these social determinants so that they can work to mitigate the resulting disparities and thereby improve the health of patients and their communities. Methods: This 2-hour, large-group session for second-year medical students was first given in the fall of 2017. It included a 1-hour, case-based lecture followed by a patient panel. Panelists discussed their interactions with the medical system and how these related to their sex and gender identity. Ninety students (77.5% response rate) completed both pre- and postsurveys and an overall assessment of the session. Results: Students reported high levels of satisfaction with the session. Eighty-seven percent felt they would benefit from more classes including a patient panel, and 93% reported specifically that the panel helped them to identify their own biases related to sexual orientation and gender. In the postsurvey, there was a significant (p < .05) increase in the number of students reporting increased comfort regarding various aspects of sexual history taking and interacting with patients of different sexual orientations and gender identities. Discussion: This instructional format provided an effective way to teach medical students about the social determinants of sexual and reproductive health. Students both appreciated the session format and reported increased comfort and confidence related to the subject matter.

Saúde Reprodutiva/tendências , Determinantes Sociais da Saúde , Estudantes de Medicina/psicologia , Currículo/tendências , Educação de Graduação em Medicina/métodos , Feminino , Humanos , Masculino , Saúde Reprodutiva/normas , Educação Sexual/métodos , Comportamento Sexual/psicologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos