Department of Medical Education, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Med Educ Online. 2022 Dec;27(1):2122106. doi: 10.1080/10872981.2022.2122106.
Medical students engage with medically underserved communities (MUC) and vulnerable populations but often lack preparation to advocate appropriately for these communities. While preclinical programs with an experiential community component effectively increase knowledge about serving MUC, the pandemic limited clinical opportunities in community settings for learners. We examined the impact of a streamlined, hybrid service learning curriculum on first-year medical student attitudes towards MUC and their readiness and interest in addressing health barriers faced by this population. The redesigned curriculum for the student-led program required participants to attend nine virtual seminars led by faculty and community members with expertise serving MUC. Students partnered with one of three community agencies to organize service projects and gain exposure to the life experiences of MUC using virtual and in-person approaches. Of the fifteen first year medical students who participated in the program, positive attitudes were sustained across all scales using the Medical Student Attitudes Toward the Underserved (MSATU) questionnaire after one year. A majority (≥50%) of students reported a large increase in their knowledge of the health challenges faced by underserved populations after each didactic session. Despite the mostly virtual nature of community partnerships, students reported increased confidence in their ability to direct MUC patients to local resources (p < 0.01). The program also had a positive impact on student interest in working with medically underserved patients in the future, with 71% of participants indicating a significant impact on their interest in working in a medically underserved area. Our redesigned elective curriculum provided participants with foundational knowledge to advocate appropriately for underserved populations and demonstrated the efficacy of virtual approaches for community service and service learning. Our findings suggest hybrid and virtual experiential learning opportunities are a viable and non-inferior curricular approach to teaching health equity and community health.
医学生与医疗服务不足的社区(MUC)和弱势群体接触,但通常缺乏适当倡导这些社区的准备。虽然具有体验式社区组成部分的临床前课程有效地增加了有关服务 MUC 的知识,但大流行限制了学习者在社区环境中的临床机会。我们研究了简化的混合服务学习课程对一年级医学生对 MUC 的态度以及他们解决该人群面临的健康障碍的准备和兴趣的影响。该学生主导计划的重新设计课程要求参与者参加九次由具有服务 MUC 专业知识的教师和社区成员领导的虚拟研讨会。学生与三个社区机构之一合作,组织服务项目,并通过虚拟和面对面的方式接触 MUC 的生活经历。在参与该计划的十五名一年级医学生中,使用医学学生对服务不足人群的态度量表(MSATU)在一年后对所有规模的学生的积极态度均保持不变。大多数(≥50%)学生报告说,在每次讲座后,他们对服务不足人群面临的健康挑战的了解都有了很大的提高。尽管社区伙伴关系主要是虚拟的,但学生报告说,他们对指导 MUC 患者到当地资源的能力的信心有所增强(p<0.01)。该计划还对学生未来与医疗服务不足的患者合作的兴趣产生了积极影响,有 71%的参与者表示对他们在医疗服务不足地区工作的兴趣产生了重大影响。我们重新设计的选修课程为参与者提供了适当倡导弱势群体的基础知识,并展示了虚拟方法在社区服务和服务学习中的功效。我们的研究结果表明,混合和虚拟体验式学习机会是一种可行且非劣效的教学方法,可以教授健康公平和社区健康。