Witt Laurel, Nilsen Kari M, Kohman Megan, Petz Austin, Moser Scott, Walling Anne
Department of Family Medicine and Community Health, University of Kansas School of Medicine- Kansas City (KUSM-KC), Kansas City, KS USA.
Department of Family & Community Medicine, University of Kansas School of Medicine-Wichita (KUSM-W), Wichita, KS USA.
Med Sci Educ. 2021 Jul 20;31(5):1653-1662. doi: 10.1007/s40670-021-01356-1. eCollection 2021 Oct.
In a prior qualitative study of the impact of a new (ACE) medical school curriculum, students and faculty reported decreased participation in the student-run free clinic (SRFC) attributed to more intensive scheduling and more frequent testing compared to the previous (Legacy) curriculum.
To verify and understand this perception formed during curriculum reform, we conducted a mixed method study to measure student participation in the SRFC before and after curricular change and assessed student beliefs and motivations about SRFC participation using focus groups.
Overall SRFC participation did not decrease among students in the ACE cohort following curriculum change. Additionally, both Legacy and ACE groups showed lower participation during test weeks, but the decrease was not significantly different between the ACE and Legacy cohorts. Focus groups confirmed the pervasive misbelief that SRFC participation was indeed lower among ACE students and attributed to reduced student discretionary time plus increased preparation time for frequent testing. Focus groups also revealed several "values" about volunteering at the SRFC which should be endorsed and promoted by schools considering curricular change. Participants valued the SRFC for educational items that were most effectively taught in the SRFC, notably social determinants of health, interprofessional practice, and interviewing with medical interpreters. They also valued the SRFC for professional validation, opportunities to apply course content, practice clinical skills, form important professional relationships, and provide community service.
Our findings validate the value of SRFC experience as reported by students and demonstrate that, contrary to misbeliefs, participation was not negatively impacted by curricular reform.
在之前一项关于新的（ACE）医学院课程影响的定性研究中，学生和教师报告称，与之前的（传统）课程相比，由于课程安排更紧凑、测试更频繁，参与学生运营的免费诊所（SRFC）的人数减少。
为了验证和理解课程改革期间形成的这种看法，我们进行了一项混合方法研究，以衡量课程改革前后学生在SRFC中的参与情况，并通过焦点小组评估学生对参与SRFC的信念和动机。
课程改革后，ACE队列中的学生在SRFC的总体参与率并未下降。此外，传统组和ACE组在考试周的参与率都较低，但ACE组和传统组之间的下降幅度没有显著差异。焦点小组证实了普遍存在的错误观念，即ACE学生在SRFC中的参与率确实较低，原因是学生的自由支配时间减少，以及频繁测试的准备时间增加。焦点小组还揭示了在SRFC志愿服务的几个“价值”，考虑课程改革的学校应该认可并推广这些价值。参与者重视SRFC，因为在SRFC中能最有效地教授一些教育内容，特别是健康的社会决定因素、跨专业实践以及与医学口译员的面谈。他们还重视SRFC的专业认可、应用课程内容的机会、临床技能的练习、建立重要的专业关系以及提供社区服务。
我们的研究结果证实了学生所报告的SRFC经历的价值，并表明，与错误观念相反，课程改革并未对参与产生负面影响。
