Using Medicare Annual Wellness Visits and telehealth to enhance ambulatory geriatrics education among medical students.

The Medicare Annual Wellness visit (AWV) was mandated as a fully covered benefit for older adults to enhance preventive care and improve healthcare outcomes. Although the benefit of conducting AWV is proven, its adoption in primary care is far from universal. The COVID-19 pandemic affected medical education and clinical care in unprecedented ways. Telehealth became a prominent way of delivering healthcare. Older adults, being significantly affected by the pandemic-related mortality and morbidity, were less likely to engage in preventive care with their healthcare providers. Amidst this considerable shift, we conceptualized a clinical experience for third-year medical students during their Ambulatory Care - Geriatrics clerkship that involved a telehealth interaction with an older adult to review AWV components, followed by an in-person office visit with the geriatrician preceptor. Post-session survey data highlighted the beneficial effect on student learning about older adult health maintenance, immunizations and geriatric syndrome assessment. It also facilitated self-directed learning and increased student-patient rapport. Preceptors appreciated the additional elements of care identified by the telehealth call that would otherwise not have been addressed in a time-limited office visit. This hybrid clinical experience reduced crowding in ambulatory clinical space during the COVID-19 pandemic, yet enhanced learning for students in geriatrics preventive care.

Qualitative Assessment of Bias and Comfort in Inclusive Sexual History Taking Skills of Physician Assistant Students

PURPOSE: Sexual history taking is an integral skill for clinicians, as sexual health is a component of a complete medical evaluation. Medical curricula lack effective sexual history instruction, creating gaps in clinicians' confidence and proficiency. Average sexual and gender minority (SGM) curricular inclusion content is 5 hours over a 4-year span. This study investigated how students perceive their comfort level and biases during a simulated sexual history taking encounter. METHODS: Data were derived from student reflection assignments following simulated sexual history interviews. Researchers analyzed and coded data. Themes were labeled and paired with corresponding quotes from data. RESULTS: Comfort and bias were predetermined main themes, each with eight subcategories that emerged including embarrassment, insight, lack of exposure, comfort/discomfort with sexual subject matter, and preparedness. Students' personal perceptions of comfort and biases represented a broad spectrum within the overarching concepts. CONCLUSIONS: Trainee insight can guide educational and instructional modifications on proficient, inclusive sexual history taking. Exercises with sexual history interviews inclusive of SGM populations are essential tools to build student comfort with sexual content topics and diminish potential for invasive biases to undermine the integrity of sexual history taking. Future research is necessary, including implementation of pre and post surveys to gauge efficacy of instruction. J Allied Health 2022;51(2):97-103.