Medical Student Views of the Affordable Care Act.

INTRODUCTION: With new insurance coverage under the Affordable Care Act (ACA) beginning in 2014 and the ever-changing practice of medicine, it is important to understand medical students' recent perspectives on health policy and reform. OBJECTIVE: This study describes the opinions, perceptions, and comprehension of the ACA and health care reform by a cross-section of medical students in Wisconsin. METHODS: A total of 578 students (35%) completed an original survey developed from previous surveys. RESULTS: Of those sampled, one-half identified as liberal or very liberal and 20% as conservative or very conservative. Respondents were split equally in their opinions of whether the United States or other nations had the highest quality care. One-half felt that faculty physicians and the media influenced their opinion of the ACA, while two-thirds felt that coursework and peers had no influence on their views. The vast majority sampled thought everyone is entitled to adequate medical care regardless of ability to pay and that physicians have a major responsibility to help reduce health care costs. A majority of liberal students and a minority of conservative students, supported the ACA. Personal and family experience as a patient influenced most liberals to support and most conservatives to oppose the ACA. One-half felt that medical school spent adequate time on health care policy education.

Integrative cases for preclinical medical students: connecting clinical, basic science, and public health approaches.

BACKGROUND: Healthcare and public health systems are each transforming, resulting in a need for better integration between clinical and population-based approaches to improve the health of populations. These changes also demand substantial transformations in the curriculum for medical students. Integrative Cases were designed for all first- and second-year medical students to provide them with more awareness, knowledge, and skills in integrating public health into clinical medicine. Each case examines basic science factors, clinical approaches, and public health determinants, including risk factors and direct and indirect contributing factors. PURPOSE: This study was designed to evaluate the effectiveness of Integrative Cases in the medical student curriculum. METHODS: Integrative Cases were formatively evaluated using standardized online post-event questionnaires emailed to students after each case. The questionnaires focused on goals specific to each case, ratings of particular sessions and facilitators, general impressions of the case, and student suggestions for improvement. RESULTS: Student evaluations indicate that Integrative Cases achieved their goals, especially providing experiences that offer a more expansive view of medicine and public health, stimulating interest and questions that anticipate future learning and making connections across basic science, medicine, and health. Students also indicated that these cases added to their understanding of public health issues and how to apply what they had learned to patient care. CONCLUSIONS: Integrative Cases demonstrate the effectiveness of a comprehensive approach that integrates clinical medicine with basic science and public health perspectives.