Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.
The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
BMC Med Educ. 2024 Mar 14;24(1):288. doi: 10.1186/s12909-024-05272-x.
Medical students can assist in reducing healthcare disparities and promote health equity by engaging with rural communities and gaining insights into their unique healthcare needs. A two-arm student-delivered program was designed and implemented during COVID-19 in a social-geographic peripheral area to assist clinics with complex chronic and/or socially disadvantaged patients and improve preventive behavior in townships through home visits delivering community kits.
We conducted a pre-post design study which included weekly structured medical student reports and monthly structured telephone interviews with clinic directors and municipal partners. Students completed pre-post program survey on their knowledge, skills, and capabilities to address chronic patients from diverse cultural backgrounds (n = 73). The Wilcoxon-Signed-Rank test for related samples was used to determine differences.
Following the program, the knowledge and awareness levels of students about working in the community (P < 0.001) and their knowledge of common chronic diseases were significantly improved (Mean Difference (MD) = 0.31; p < 0.001). The program significantly increased students' interest to integrate into community care alongside a hospital (P = 0.012). Thematic analysis of student reports revealed improved insight into the role of primary care. Clinic directors (90%) were highly satisfied and reported that students became an integral part of the clinics' teams.
Integrating medical students into the community through primary-care clinics and home visits in diverse communities, exposed students to the interwoven effect of clinical and social determinants on health and improve their knowledge of common chronic diseases. Participation in the program encouraged students to consider a career in community care.
医学生可以通过与农村社区接触并了解他们独特的医疗需求，来帮助减少医疗保健差距并促进健康公平。在 COVID-19 期间，在一个社会地理边缘地区设计并实施了一个两臂学生提供的计划，以帮助诊所为复杂的慢性和/或社会劣势患者提供服务，并通过家访提供社区工具包来改善乡镇的预防行为。
我们进行了一项前后设计研究，其中包括每周的结构化医学生报告和每月与诊所主任和市合作伙伴进行的结构化电话访谈。学生们完成了关于他们在不同文化背景下处理慢性患者的知识、技能和能力的前后方案调查（n=73）。使用相关样本的 Wilcoxon 符号秩检验来确定差异。
在该计划之后，学生们在社区工作方面的知识和意识水平（P<0.001）以及他们对常见慢性病的了解显著提高（平均差异（MD）=0.31；p<0.001）。该计划显著增加了学生们对与医院一起融入社区护理的兴趣（P=0.012）。学生报告的主题分析显示，他们对初级保健角色的理解得到了提高。诊所主任（90%）非常满意，并报告说学生成为诊所团队不可或缺的一部分。
通过初级保健诊所和在不同社区进行家访，将医学生融入社区，使学生了解临床和社会决定因素对健康的交织影响，并提高他们对常见慢性病的了解。参与该计划鼓励学生考虑从事社区护理工作。
