Belkowitz Julia, Sanders Lee M, Zhang Chi, Agarwal Gauri, Lichtstein Daniel, Mechaber Alex J, Chung Esther K
Departments of Pediatrics (Dr Belkowitz) and Department of Medicine (Drs Agarwal and Lichtstein), University of Miami Miller School of Medicine Regional Medical Campus, Boca Raton, Florida; Department of Pediatrics, Stanford University, Stanford Center for Health Policy, Center for Policy, Outcomes and Prevention, Stanford, California (Dr Sanders); Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida (Drs Zhang and Mechaber); and Department of Pediatrics at Jefferson Medical College of Thomas Jefferson University and Nemours, Jefferson Pediatrics/Nemours, Philadelphia, Pennsylvania (Dr Chung).
J Public Health Manag Pract. 2014 Nov-Dec;20(6):E10-9. doi: 10.1097/PHH.0000000000000031.
Many encourage service learning and health advocacy training in medical student education, but related evaluation is limited.
To assess (1) impact of a required community health advocacy training for medical students on student attitudes, knowledge, and skills; (2) student characteristics associated with higher advocacy knowledge and skills; and (3) perspectives of community-based organizations (CBOs).
Cross-sectional surveys.
University of Miami Miller School of Medicine (UMMSM) Regional Medical Campus and main campus.
Medical students at both UMMSM campuses.
Required community health advocacy training for first- and second-year students including classroom experiences and hands-on project in partnership with a CBO.
Student characteristics, health advocacy-related attitudes, self-reported and objective knowledge, and skills. Scores were compared between campuses, with multivariable modeling adjusting for individual student characteristics. Community-based organization perspectives were assessed via separate surveys.
Ninety-eight (77%) regional campus students (intervention group) and 139 (30%) main campus students (comparison group) completed surveys. Versus the comparison group, the intervention group reported greater: mean knowledge of community health needs: 34.6 versus 31.1 (range: 11-44, P < .01), knowledge about CBOs: 3.0 versus 2.7 (range 1-4, P < .01) and knowledge of community resources: 5.4 versus 2.3 (range, 0-11, P < .01), and mean skill scores: 12.7 versus 10.5 (score range: 4-16, P < .01), following the intervention. Using adjusted analysis across both groups, female gender was associated with higher attitudes score. High level of previous community involvement was associated with higher attitude and skill scores. Higher self-reported educational debt was associated with higher skill scores. Community-based organization perspectives included high satisfaction and a desire to influence the training of future physicians.
Medical student advocacy training in partnership with community-based organizations could be beneficial in improving student advocacy knowledge and skills in addressing community health issues and in developing sustainable community partnerships.
许多人鼓励在医学生教育中开展服务学习和健康宣传培训，但相关评估有限。
评估（1）医学生必修的社区健康宣传培训对学生态度、知识和技能的影响；（2）与较高宣传知识和技能相关的学生特征；（3）社区组织（CBO）的观点。
横断面调查。
迈阿密大学米勒医学院（UMMSM）区域医学中心和主校区。
UMMSM两个校区的医学生。
为一、二年级学生提供必修的社区健康宣传培训，包括课堂体验和与社区组织合作开展的实践项目。
学生特征、与健康宣传相关的态度、自我报告的和客观的知识及技能。对两个校区的分数进行比较，并通过多变量模型对个体学生特征进行调整。通过单独的调查评估社区组织的观点。
98名（77%）区域校区学生（干预组）和139名（30%）主校区学生（对照组）完成了调查。与对照组相比，干预组报告称：社区健康需求的平均知识得分更高：34.6对31.1（范围：11 - 44，P < 0.01），关于社区组织的知识得分：3.0对2.7（范围1 - 4，P < 0.01），社区资源知识得分：5.4对2.3（范围：0 - 11，P < 0.01），以及平均技能得分：12.7对10.5（得分范围：4 - 16，P < 0.01），在干预后。对两组进行调整分析后，女性性别与较高的态度得分相关。之前较高的社区参与度与较高的态度和技能得分相关。自我报告的较高教育债务与较高的技能得分相关。社区组织的观点包括高度满意度以及影响未来医生培训的愿望。
与社区组织合作开展的医学生宣传培训可能有助于提高学生在解决社区健康问题方面的宣传知识和技能，并有助于建立可持续的社区伙伴关系。
