A Community-engaged Curriculum at Alpert Medical School: Centering Patient Communities in Medical Education.

BACKGROUND: Incorporating opportunities for community engagement into undergraduate medical education (UME) can help learners to identify and address social determinants of health (SDoH). Multiple challenges exist in operationalizing these experiences. METHODS: Using the Assessing Community Engagement (ACE) model, course directors at the Warren Alpert Medical School of Brown University (AMS) mapped community engagement initiatives to the four-year curriculum. FINDINGS: Service-learning, community engagement projects, and clinical rotations at health centers and free clinics aim to equip learners at AMS with the necessary skills to address SDoH. Careful consideration should be given to the time and resources required to facilitate relationships with community-based agencies, learner reflection, program evaluation, and community-level outcomes. CONCLUSIONS: Community engagement activities should be aligned with learning objectives during the pre-clerkship and clerkship stages of the existing UME curricula. Embarking on a curriculum redesign can create opportunities to expand partnerships with local agencies and deepen student engagement.

My Life, My Story: Integrating a Life Story Narrative Component Into Medical Student Curricula.

INTRODUCTION: Medical students experience burnout, depersonalization, and decreases in empathy throughout medical training. My Life, My Story (MLMS) is a narrative medicine project that aims to combat these adverse outcomes by teaching students to interview patients about their life story, with the goal of improving patient-centered care competencies, such as empathy. METHODS: The MLMS project was started in the Veterans Affairs (VA) system and has since spread to dozens of VA sites. We adapted and integrated this project into the Warren Alpert Medical School of Brown University curriculum. As part of the required curriculum, first- and third-year medical students participated in a life story interview with a community-based volunteer or a patient in the inpatient hospital setting, transcribed the story, and reviewed the written story with the patient. We assessed student perceptions of the project, changes in empathy, and changes in burnout symptoms. RESULTS: A total of 240 students participated in this project. Students spent an average of 70.7 minutes interviewing patients. A majority of the students believed MLMS was a good use of time (77%), fostered connection with patients (79%), and was effective in recognizing patients' thoughts and feelings (69%). DISCUSSION: To our knowledge, this is one of the first life story interview interventions to be implemented into a required medical school curriculum and outside the VA setting. MLMS may assist students in improving clinical empathy skills and create a structure for medical trainees to better understand their patients.