ABSTRACT
SETTING AND PARTICIPANTS: The H&P 360 is a modified medical history prompting students to routinely and systematically gather information from 7 domains - Biomedical Conditions, Patients' Goals and Values, Mental Health, Behavioral Health, Social Support, Living Environment and Resources, and Function. Initial studies in inpatient and standardized patient settings showed the H&P 360 enhances data gathering, patient rapport, and team care planning. Our goal was to examine the feasibility and usefulness of the H&P 360 in routine teaching contexts at three institutions. Setting and Participants: M3 and M4 medical students at the University of Chicago (UC;n=24), the University of Michigan (UM;n=38), and Florida International University (FIU;n=118) in 2020-21. Clinical settings included subinternships (UC), longitudinal clinics (UM), and community-based home visits (FIU). DESCRIPTION: All sites introduced students to the H&P 360 via a nonstandardized 1-2 hour introductory seminar. 3-6 months after implementation a previously developed student survey with 13 Likert-type and 3 text-response items querying implementation of the H&P 360 was administered. A parallel survey was developed for teaching faculty. EVALUATION: A total of 180 students participated. Response rates at UC, UM, and FIU were 46%, 34%, and 16%, respectively. Percent of students (UC, UM, FIU;Overall), responding 'Agree' or 'Strongly agree': 1. The H&P 360: - Was easy to use (67, 85, 89;81) - Helped me better understand patient goals (89, 100, 77;88) - Added valuable information that I woul otherwise not know (78, 85, 63;79) - Facilitated care planning that included other health professionals(56, 85, 71, 70) 2. Presentations using the H&P 360 were well received by my clinical team. (33, 46, 82;60) 3. Elements of the H&P 360 are potentially useful in all patient interactions. (67, 100, 95;88) Overall faculty response rates were low;most described unfamiliarity with the H&P 360 with limited incorporation into teaching. DISCUSSION / REFLECTION / LESSONS LEARNED: Discussion: Students in clinical teaching settings found the H&P 360 feasible, easy to use, and helpful for understanding patient priorities. Most reported it facilitated interprofessional planning. Potentially significant variation occurred across sites. Faculty incorporation into clinical teaching was limited. Overall survey response rates were low, partially due to COVID. Conclusions: The H&P 360 promotes information gathering critical for chronic disease management: clinical diagnosis, social determinants of health, and patient priorities. Such information should prove useful for fostering health equity. Future work should measure effects on patient care and outcomes. Our team is developing methods to better engage faculty with integrating the H&P 360 into clinical skills teaching throughout medical school and has a toolkit to facilitate implementation and additional studies.