Case Western Reserve University, School of Medicine, 9501 Euclid Ave, 401J, Cleveland, OH, 44106, USA.
Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
J Gen Intern Med. 2022 Apr;37(5):1155-1160. doi: 10.1007/s11606-021-07168-8. Epub 2021 Oct 12.
To explore how early meaningful experiential learning in community settings impacted medical students' application of systems thinking, their perceptions of systems navigation, and their professional identity as health system change agents.
Following an immersive Health Systems Science course, first-year medical students partnered with veterans or newly arrived refugee families and served as health system patient navigators embedded within primary care teams for a year. Across two cohorts, fifty-six students participated in the elective. Three voluntary focus groups were conducted each year for a total of six groups with 50 patient navigator students. Inductive content analysis of focus group transcripts was conducted.
Qualitative analysis produced three major themes: program impact on students, student impact on patients, and student perceptions of the role of healthcare providers. Students reported a rich understanding of social determinants of health. By improving patient awareness of health and well-being, building capacity to understand medical issues, and increasing medication adherence through teaching, students recognized their impact on patient care. The importance of interprofessional collaboration with social workers also emerged and helped shape students' understanding of how they as physicians are part of a coordinated team working toward better patient care.
The Case Western Reserve University WR2 curriculum teaches students how to address complex determinants of health and how to consider their role in dynamic health systems. This study highlights rich themes that emerged from students as they recognized the context that creates health for both individuals and communities. It underscores the role of such experiences in reinforcing systems thinking and development of change agency, both contributing to their professional identity formation as physicians.
探索早期在社区环境中的有意义的体验式学习如何影响医学生系统思维的应用、他们对系统导航的看法以及他们作为医疗体系变革推动者的专业身份认同。
在一门沉浸式健康系统科学课程结束后，一年级医学生与退伍军人或新到的难民家庭合作，并作为健康系统患者导航员，在基层医疗团队中服务一年。在两个队列中，共有 56 名学生参加了这门选修课。每年进行三次自愿焦点小组讨论，共有六组，每组有 50 名患者导航员学生。对焦点小组转录本进行了归纳内容分析。
定性分析产生了三个主要主题：项目对学生的影响、学生对患者的影响以及学生对医疗保健提供者角色的看法。学生们报告说对健康和福利的社会决定因素有了深刻的理解。通过提高患者对健康和福利的认识、提高他们理解医疗问题的能力以及通过教学提高药物依从性，学生们认识到他们对患者护理的影响。与社会工作者的跨专业合作的重要性也显现出来，并帮助学生理解他们作为医生是协调团队的一部分，共同努力为患者提供更好的护理。
凯斯西储大学 WR2 课程教导学生如何解决健康的复杂决定因素，以及如何考虑他们在动态医疗体系中的角色。本研究突出了学生们在认识到创造个人和社区健康的背景时所产生的丰富主题。它强调了这种体验在强化系统思维和变革推动者的发展中的作用，这两者都有助于他们作为医生的专业身份认同的形成。
