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1.
Cancer Causes Control ; 34(7): 621-624, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37081154

RESUMO

Engagement of community participation is an innovative driver of modern research. However, to benefit the communities being studied, it is imperative to continuously evaluate ethical considerations, the relationship dynamic between researchers and community members, and the responsiveness of research teams to the needs and preferences of communities. Northwestern University's Center for Health Equity Transformation founded a community scientist program in 2018 that implemented a study using the Community-Based Participatory Research (CBPR) model. This project is an ongoing study of heavy metal exposure by geographic location in Chicago. Community scientists from various backgrounds, communities, and organizations formed an advisory panel, partnering with the cancer research team. This commentary describes lessons learned in structuring meaningful community involvement and benefit in CBPR, with a focus on three lessons learned that relate to ethics, relationships, and responsiveness. Our findings lay new groundwork for iteratively shaping best practices in CBPR.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Médicos , Humanos , Projetos de Pesquisa , Chicago
2.
MedEdPORTAL ; 18: 11226, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372682

RESUMO

Introduction: Hispanic/Latinx patients experience health disparities in endocrine disease, such as higher rates of mortality due to diabetes mellitus, worse outcomes in the surgical treatment of thyroid cancer, and lack of knowledge about bone health and osteoporotic fracture prevention. Educational strategies to teach cultural and linguistic medical Spanish knowledge to medical students have the potential to improve Hispanic/Latinx endocrine health. Methods: We created an 8-hour medical Spanish endocrine module targeting language and cultural skills acquisition. Specifically, students practiced obtaining a past medical history, obtaining a medications history, providing and explaining a diagnosis, explaining discharge instructions, and discussing sociocultural aspects of endocrine health. We divided the module into four 2-hour sessions: (1) preclass self-study, (2) class period, (3) role-play/interviewing practice session, and (4) case/cultural activity assignment. Participants completed a pre- and postassessment to measure student confidence level and knowledge. Results: We implemented the module four times at one medical school, with 47 fourth-year medical students with intermediate or higher general Spanish skills. Confidence increased for all learners in the endocrine-focused interview and exam in Spanish. Heritage Spanish learners, who were exposed to Spanish at home as children, reported higher postmodule confidence in eliciting the past medical history of endocrine problems. Discussion: The medical Spanish endocrine module improved the communication skills of medical students with intermediate through advanced Spanish proficiency. Future study should evaluate learner clinical performance metrics and applications to other groups of learners, such as resident physicians or health professions involved in the care of patients with endocrine disease.


Assuntos
Educação Médica , Estudantes de Medicina , Criança , Hispânico ou Latino , Humanos , Idioma , Faculdades de Medicina
3.
Clin Teach ; 19(2): 155-161, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35001549

RESUMO

BACKGROUND: Linguistic and cultural discordance between clinicians and patients contributes to suboptimal care of Latinx patients with diabetes. Bilingual pedagogies may help learners with pre-existing Spanish skills to improve health communication with linguistic minorities. APPROACH: We designed a diabetes workshop for health professions students that applied the educational principles of bilingual pedagogies, focus on learners with prior Spanish skills, and intersectionality of language and culture. The session introduced diabetes concepts in Spanish and English, applied Latinx cultural beliefs to clinical conversations about diabetes and explored the impact of clinician language and cultural skills on diabetes-related communication. EVALUATION: Voluntary surveys evaluated learner knowledge, confidence and attitudes before and after the intervention. Of 60 attendees, 57 participants (95%) completed surveys. Comparison of pre and post responses yielded statistically significant increases in respondents' cultural knowledge and confidence in explaining diabetes concepts in Spanish (all p < 0.001). When controlling for Spanish level, most items still showed a significant improvement. Latinx and heritage learners were more likely to express lower confidence in explaining diabetes post-workshop (p < 0.05), suggesting an increased awareness of limitations. IMPLICATIONS: Bilingual educational interventions that emphasise culturally appropriate clinical skills may be an effective way to prepare health professions students who are heritage Spanish or second-language learners to better communicate with Latinx patients about diabetes. We provide actionable recommendations for clinical educators interested in incorporating communication skills training for linguistically diverse patient care.


Assuntos
Diabetes Mellitus , Idioma , Comunicação , Diabetes Mellitus/terapia , Humanos , Grupos Minoritários
4.
J Immigr Minor Health ; 23(5): 1105-1109, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33835381

RESUMO

Medical Spanish education aims to reduce linguistic barriers in healthcare and has historically been led by Hispanic/Latinx students and faculty, often without formal training or institutional support. We surveyed 158 US medical schools about their medical Spanish programs. We then examined national trends in Underrepresented in Medicine and Hispanic/Latinx faculty and students as factors associated with meeting medical Spanish basic standards for curricula, educators, assessment, and course credit. We received responses from 125 schools (79%), of which 98 (78%) reported offering some form of medical Spanish. Schools with greater racial/ethnic diversity were more likely to have medical Spanish required courses (P-values < 0.01) but not curricular electives. Overall, likelihood of meeting all basic standards did not differ by diversity characteristics. High-quality medical Spanish requires more than recruitment of diverse students and faculty. Institutions should prioritize meaningful inclusion by supporting evidence-based curricula and faculty educators.


Assuntos
Currículo , Faculdades de Medicina , Atenção à Saúde , Docentes , Humanos , Estudantes
5.
J Gen Intern Med ; 36(9): 2724-2730, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33782890

RESUMO

BACKGROUND: Most medical schools offer medical Spanish education to teach patient-physician communication skills with the growing Spanish-speaking population. Medical Spanish courses that lack basic standards of curricular structure, faculty educators, learner assessment, and institutional credit may increase student confidence without sufficiently improving skills, inadvertently exacerbating communication problems with linguistic minority patients. OBJECTIVE: To conduct a national environmental scan of US medical schools' medical Spanish educational efforts, examine to what extent existing efforts meet basic standards, and identify next steps in improving the quality of medical Spanish education. DESIGN: Data were collected from March to November 2019 using an IRB-exempt online 6-item primary and 14-item secondary survey. PARTICIPANTS: All deans of the Association of American Medical Colleges member US medical schools were invited to complete the primary survey. If a medical Spanish educator or leader was identified, that person was sent the secondary survey. MAIN MEASURES: The presence of medical Spanish educational programs and, when present, whether the programs met four basic standards: formal curricular structure, faculty educator, learner assessment, and course credit. KEY RESULTS: Seventy-nine percent of medical schools (125 out of 158) responded to either or both the primary and/or secondary surveys. Among participating schools, 78% (98/125) of medical schools offered medical Spanish programming; of those, 21% (21/98) met all basic standards. Likelihood of meeting all basic standards did not significantly differ by location, school size, or funding type. Fifty-four percent (53/98) report formal medical Spanish curricula, 69% (68/98) have faculty instructors, 57% (56/98) include post-course assessment, and 31% (30/98) provide course credit. CONCLUSIONS: Recommended next steps for medical schools include formalizing medical Spanish courses as electives or required curricula; hiring and/or training faculty educators; incorporating learner assessment; and granting credit for student course completion. Future studies should evaluate implementation strategies to establish best practice recommendations beyond basic standards.


Assuntos
Educação Médica , Faculdades de Medicina , Currículo , Docentes , Humanos , Relações Médico-Paciente , Inquéritos e Questionários , Estados Unidos
6.
MedEdPORTAL ; 17: 11071, 2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33473381

RESUMO

Introduction: While many medical schools provide opportunities in medical Spanish for medical students, schools often struggle with identifying a structured curriculum. The purpose of this module was to provide a flexible, organ system-based approach to teaching and learning musculoskeletal and dermatologic Spanish terminology, patient-centered communication skills, and sociocultural health contexts. Methods: An 8-hour educational module for medical students was created to teach musculoskeletal and dermatologic medical communication skills in Spanish within the Hispanic/Latinx cultural context. Participants included 47 fourth-year medical students at an urban medical school with a starting minimum Spanish proficiency at the intermediate level. Faculty provided individualized feedback on speaking, listening, and writing performance of medical Spanish skills, and learners completed a written pre- and postassessment testing skills pertaining to communication domains of vocabulary, grammar, and comprehension as well as self-reported confidence levels. Results: Students demonstrated improvement in vocabulary, grammar, comprehension, and self-confidence of musculoskeletal and dermatologic medical Spanish topics. While students with overall lower starting proficiency levels (intermediate) scored lower on the premodule assessment compared to higher proficiency students (advanced/native), the postmodule assessment did not show significant differences in skills performance among these groups. Discussion: An intermediate Spanish level prerequisite for this musculoskeletal and dermatologic module can result in skills improvement for all learners despite starting proficiency variability. Future study should evaluate learner clinical performance and integration of this module into other educational settings such as graduate medical education (e.g., orthopedic, rehabilitation, and dermatology residency programs) and other health professions (e.g., physical therapy and nursing).


Assuntos
Currículo , Estudantes de Medicina , Comunicação , Humanos , Aprendizagem
7.
Acad Med ; 95(1): 22-31, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31365394

RESUMO

Medical Spanish (MS) education is in growing demand from U.S. medical students, providers, and health systems, but there are no standard recommendations for how to structure the curricula, evaluate programs, or assess provider performance or linguistic competence. This gap in medical education and assessment jeopardizes health care communication with Hispanic/Latino patients and poses significant quality and safety risks. The National Hispanic Health Foundation and University of Illinois College of Medicine convened a multidisciplinary expert panel in March 2018 to define national standards for the teaching and application of MS skills in patient-physician communication, establish curricular and competency guidelines for MS courses in medical schools, propose best practices for MS skill assessment and certification, and identify next steps needed for the implementation of the proposed national standards. Experts agreed on the following consensus recommendations: (1) create a Medical Spanish Taskforce to, among other things, define educational standards; (2) integrate MS educational initiatives with government-funded research and training efforts as a strategy to improve Hispanic/Latino health; (3) standardize core MS learner competencies; (4) propose a consensus core curricular structure for MS courses in medical schools; (5) assess MS learner skills through standardized patient encounters and develop a national certification exam; and (6) develop standardized evaluation and data collection processes for MS programs. MS education and assessment should be standardized and evaluated with a robust interinstitutional medical education research strategy that includes collaboration with multidisciplinary stakeholders to ensure linguistically appropriate care for the growing Spanish-speaking U.S. population.


Assuntos
Competência Clínica/normas , Educação Médica/normas , Faculdades de Medicina/normas , Consenso , Competência Cultural/educação , Currículo/normas , Educação Médica/tendências , Hispânico ou Latino/estatística & dados numéricos , Humanos , Estudos Interdisciplinares , Aprendizagem/fisiologia , Relações Médico-Paciente/ética , Estudantes de Medicina/classificação , Estados Unidos/epidemiologia
8.
Acad Med ; 95(3): 365-374, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31425183

RESUMO

In 2015, the Medical College Admission Test (MCAT) was redesigned to better assess the concepts and reasoning skills students need to be ready for the medical school curriculum. During the new exam's design and rollout, careful attention was paid to the opportunities examinees had to learn the new content and their access to free and low-cost preparation resources. The design committee aimed to mitigate possible unintended effects of the redesign, specifically increasing historical mean group differences in MCAT scores for examinees from lower socioeconomic status (SES) backgrounds and races/ethnicities underrepresented in medicine compared with those from higher SES backgrounds and races/ethnicities not underrepresented in medicine.In this article, the authors describe the characteristics and scores of examinees who took the new MCAT exam in 2017 and compare those trends with historical ones from 2013, presenting evidence that the diversity and performance of examinees has remained stable even with the exam's redesign. They also describe the use of free and low-cost MCAT preparation resources and MCAT preparation courses for examinees from higher and lower SES backgrounds and who are enrolled in undergraduate institutions with more and fewer resources, showing that examinees from lower SES backgrounds and who attend institutions with fewer resources use many free and low-cost test preparation resources at lower rates than their peers. The authors conclude with a description of the next phase of this research: to gather qualitative and quantitative data about the preparation strategies, barriers, and needs of all examinees, but especially those from lower SES and underrepresented racial/ethnic backgrounds.


Assuntos
Teste de Admissão Acadêmica , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Habilidades para Realização de Testes/psicologia , Habilidades para Realização de Testes/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Estados Unidos , Adulto Jovem
9.
Cureus ; 11(10): e5825, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31754560

RESUMO

INTRODUCTION:  Language concordance between doctors and patients and increased matriculation of underrepresented minorities in medical school are commonly cited goals of medical centers and medical schools in addressing health disparities for individuals with limited English proficiency. Pre-medical education may represent a high-yield untapped opportunity to address both through a Spanish Health Topics, or Temas de Salud, course for Latino pre-health students.  Methods: The authors implemented a longitudinal course for pre-health, Latino, undergraduate students to prepare them for success in bilingual health careers. The course included educational components of health knowledge, Spanish terminology, Hispanic/Latino sociocultural context, and exposure to medical learning formats presented during monthly sessions spread out over two years. A post-course survey with comfort and knowledge assessments was administered after each one-year cycle of the program.  Results: One hundred and sixteen students (57%) out of 203 course-participants responded to the Spanish Health Topics course survey. The student comfort level and self-perceived knowledge about specific health issues increased for both students of native-level Spanish and less advanced fluency, though a larger improvement was noted in several health topics for native speakers. Eighty-five percent of students reported perceiving the class to be useful for their future careers, and 92% of respondents indicated having applied learned concepts in social and/or academic settings outside of class. DISCUSSION:  Most students reported benefits of the course. Future studies should focus on a more detailed evaluation of enrolled students' knowledge, attitudes, confidence, and long-term retention compared to students in a standard premedical path. Temas de Salud may enhance the bilingual, bicultural skillset of Latino underrepresented minorities in medicine, and can be replicated at other institutions.

10.
Prog Community Health Partnersh ; 13(5): 113-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31378741

RESUMO

BACKGROUND: Health care career pipeline training programs are one solution to increasing the number of minority and underrepresented health care providers. The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) Research Fellows Program, a tri-institutional effort between the University of Illinois at Chicago (UIC), Northeastern Illinois University (NEIU), and Northwestern University (NU), provides a holistic, 8-week summer research fellowship that facilitates self-reflection, professional development, and exposes and guides the novice undergraduate and postbaccalaureate student toward a health care career inclusive of research and scientific discovery. OBJECTIVES: The number of underrepresented students achieving health care careers is minimal. We outline curriculum development, innovation, lessons learned, and selected outcomes from the first three cohorts of the ChicagoCHEC Research Fellows program. METHODS: A tri-institutional, collaborative curricular team was formed consisting of research faculty and staff at NEIU, UIC and NU. Once accepted, fellows experience a cohort model curriculum with particular emphasis to mindful inclusion of nontraditional students. The ChicagoCHEC Research Fellows Program uses evidence-based mentorship models, group reflection, and extensive program evaluation to continuously improve its program model. CONCLUSIONS: The 48 fellow alumni from the first 3 years reported high satisfaction with the program and will continued to be tracked for academic success. The ChicagoCHEC Research Fellows program will continue to provide academic and professional tools, sponsorship, and mentorship opportunities to underrepresented students as they progress toward health care careers. A program such as the ChicagoCHEC Fellows Program can serve as a useful model for increasing the number of minority researchers in health care careers.


Assuntos
Ocupações em Saúde/educação , Grupos Minoritários , Universidades/organização & administração , Escolha da Profissão , Relações Comunidade-Instituição , Humanos , Relações Interinstitucionais , Mentores , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
12.
MedEdPublish (2016) ; 7: 274, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-38089240

RESUMO

This article was migrated. The article was marked as recommended. Background: Medical schools seek admissions methods that identify applicants who hold promise to become physicians who will navigate and shape the future medical landscape. The focus on traditional cognitive measures for admission has prompted calls for holistic admissions review during the past five years. Yet, empirical evidence linking selection measures to holistic admissions practices has not been fully established, including their relationship with professional identity formation over time. A non-cognitive admissions situational judgment screening test (CASPer) measuring personal and professional characteristics was added to the University of Illinois College of Medicine admissions process two years ago, as we implemented a new curriculum that emphasizes professional identity development. Purpose: This study examined associations among admissions measures (Medical College Admission Test [MCAT], grade point average [GPA], interview, and CASPer), and their predictive relationships with curricular measures of professional identity formation (Professional Identity Essay [PIE]) and moral reasoning (Defining Issues Test [DIT2]). Methods: Data were taken from two entering cohorts ( n = 596; entering class of 2017 and 2018 across 3 regional sites). Correlations and regression analyses were used to examine associations between admissions and professional identity measures. Results: CASPer and in-person admissions interview ratings had significant positive correlations, suggesting that CASPer can contribute to effective screening processes. In addition, CASPer demonstrated statistically significant positive relationships with professional identity (CASPer and PIE, r=.10, p<.05) and a measure of moral reasoning (CASPer and DIT2 type indicator, r=.09, p<.05). Association between CASPer and PIE remained consistent, even after controlling for MCAT, interview, and GPA. Conclusion: Our institutional focus on professional identity formation has provided new ways to conceptualize students' readiness for medical school - demonstrated academic rigor as well as signs of professionalism, ethics, and motivation. Non-academic factors measured in situational judgment tests may promote better alignment of admissions practices and desired educational outcomes.

13.
Med Sci Educ ; 27(2): 329-337, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29910972

RESUMO

BACKGROUND: There is no standardized curriculum or assessment method that addresses Spanish skills in U.S. medical schools. The authors implemented a 10-week Clinical Medical Spanish elective for fourth-year medical students. METHODS: Data were collected for 58 students from 2013 to 2015 pertaining to pre- and post-course self-evaluation of Medical Spanish comfort level and Objective Structured Clinical Examinations. RESULTS: Student comfort level with Spanish-speaking patients improved for performing history and examination skills (P < 0.05). Standardized Patient (SP) and faculty-rated fluency were each higher than the student self-rated pre-course fluency (P < 0.001). Fluency levels were higher than the faculty rating of student ability to perform the medical interview (P < .001). DISCUSSION: Differences in student self-rating, SP scores, and faculty assessment illustrate the complexities of assessing medical skills in a second language, and highlight the importance of training and evaluating medical students and hospital staff in the appropriate use of Medical Spanish.

14.
J Racial Ethn Health Disparities ; 3(2): 245-9, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27271065

RESUMO

THEORY: Language concordance between patient and provider has been shown to improve health outcomes for Limited English Proficiency (LEP) patients. However, health care teams often use available ad hoc interpreters without knowing whether their language skills are adequate. Little is known about the role of medical students working as ad hoc interpreters. HYPOTHESIS: Bilingual medical students are engaged as interpreters in the care of LEP patients and may serve as a potential resource for health care teams caring for LEP patients. METHOD: We conducted a multi-institutional online survey of graduating medical students at the University of Illinois and the University of Chicago in 2011 and 2012, containing both qualitative and quantitative questions regarding their experiences as interpreters for LEP patients. RESULTS: Half (216/430) of contacted students completed the survey; 40 % (87/216) of responding students reported being bilingual. Of these students, the vast majority, 84 % (73/87), had been asked to interpret for patients in the clinical setting. Only 12 % (10/87) of students reported having felt uncomfortable interpreting for patients "often" or "very often." Over half (53 %, 46/87) described incidents during which they felt uncomfortable interpreting. Seventeen (17/46, 37 %) students described those incidents as high-stakes clinical settings. CONCLUSIONS: Medical schools and health care institutions should establish guidelines for students who identify as fluent in another language and are interested in interpreting for LEP patients in clinical settings, to protect both students and patients when language poses a barrier to quality care.


Assuntos
Barreiras de Comunicação , Relações Médico-Paciente , Estudantes de Medicina , Tradução , Humanos , Idioma , Faculdades de Medicina
16.
Acad Med ; 90(12): 1658-66, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26488566

RESUMO

PURPOSE: Medical school graduates are poorly prepared to address health care inequities found in urban, underserved communities. The University of Illinois College of Medicine developed the Urban Medicine Program (UMed) to prepare students for the roles of advocate, researcher, policy maker, and culturally competent practitioner through a four-year curriculum integrating principles of public health with direct interventions in local, underserved communities. This study assessed the program's effectiveness and evaluated early outcomes. METHOD: The authors analyzed data for UMed students (graduating classes 2009-2013) from pre- and postseminar assessments and longitudinal community project progress reports. They also compared UMed and non-UMed outcomes from the same classes, using graduation data and data from two surveys: Medical Students' Attitudes Toward the Underserved (MSATU) and the Intercultural/Professional Assessment. RESULTS: UMed students were more likely than non-UMed students to endorse MSATU constructs ("Universal medical care is a right" [P = .01], "Access to basic medical care is a right" [P = .03], "Access is influenced by social determinants" [P = .03]); to be selected for the Gold Humanism Honor Society (P < .0001); to complete joint degrees (P < .0001); and to enter primary care residencies (P = .002). CONCLUSIONS: Early outcomes reveal that a longitudinal, experiential curriculum can provide students with competencies that may prepare them for leadership roles in advocacy, research, and policy making. Contact with diverse communities inculcates-in medical students with predispositions toward helping underserved populations-the self-efficacy and skills to positively influence underserved, urban communities.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Educação de Graduação em Medicina/organização & administração , Área Carente de Assistência Médica , Saúde Pública/educação , Adulto , Currículo , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Faculdades de Medicina/organização & administração , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos , Serviços Urbanos de Saúde , População Urbana
17.
Med Educ ; 49(1): 84-92, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25545576

RESUMO

OBJECTIVES: This study aimed to evaluate a selection and programmatic intervention designated 'Conditional Admissions' (CA), which is intended to expand access to medical education for individuals from under-represented ethnic, racial and rural groups. Further aims were to establish principles of practice designed to increase access for under-represented groups based on an empirical comparison of programmatic changes made to CA in 2005, and to quantify the costs associated with its implementation. METHODS: Data for all students admitted between 1999 and 2009 (n = 3227) were compiled; these included demographic data, undergraduate college performance grades, medical school performance indicators, and information on honours, residency placement and md degree completion. To examine the outcomes of the CA intervention, students were divided into two cohorts of those admitted through the CA initiative during 1999-2004 and 2005-2009, respectively, and analysed for differences. Costs associated with CA were also calculated. RESULTS: There were 274 students admitted through CA (8.5% of all admittances) during 1999-2009; of these, 81.4% were from under-represented ethnic or racial backgrounds and 18.6% were from rural backgrounds. These students had more hours of science coursework, lower science and cumulative grade point averages (GPAs), and lower mean Medical College Admission Test (MCAT) scores than non-CA students. However, first-time pass rates and mean scores on the US Medical Licensing Examination (USMLE) Step 1 and USMLE Step 2 Clinical Knowledge increased significantly in the CA cohort during 2005-2009. Additional costs incurred per student ranged between US$849 and US$3801. CONCLUSIONS: Interventions such as CA can significantly increase diversity in the physician workforce. Interventions must be based on careful assessment of academic preparedness, as well as on non-academic factors that contribute to ability to successfully manage the rigors of medical education. Furthermore, the selection and subsequent professional development of students must nurture commitment to addressing the health care needs of diverse communities. Equity must be viewed as a means of increasing fairness for both prospective medical students and the residents of communities that may benefit from the eventual service.


Assuntos
Diversidade Cultural , Educação de Graduação em Medicina , Grupos Minoritários/educação , Critérios de Admissão Escolar , Estudantes de Medicina , Logro , Adolescente , Adulto , Estudos de Coortes , Educação de Graduação em Medicina/economia , Escolaridade , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos , Grupos Minoritários/psicologia , Critérios de Admissão Escolar/tendências , Responsabilidade Social , Adulto Jovem
18.
J Immigr Minor Health ; 15(3): 517-24, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23054545

RESUMO

Patient-reported experiences of care are an important focus in health disparities research. This study explored the association of patient-reported experiences of care with race and acculturation status in a primary care setting. 881 adult patients (African-American 34%; Hispanic--classified as unacculturated or biculturated--31%; Caucasian 33%; missing race 2%), in outpatient Family Medicine clinics, completed a written survey in Spanish or English. Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group (CAG) Survey Adult Primary Care instrument was used for experiences of care and Short Form-12 survey for health status. Controlling for other variables, race and acculturation were significantly associated with several CAG subscales. Hispanic patients gave significantly higher ratings for care experiences and expressed greater interest in shared decision making. Selected patient-reported measures of care are associated with patients' race and acculturation status (for Hispanic patients). We discuss implications for both provision and measurement of quality care.


Assuntos
Aculturação , Negro ou Afro-Americano , Atenção à Saúde/etnologia , Hispânico ou Latino , Autorrelato , População Branca , Adolescente , Adulto , Idoso , Competência Cultural , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Estados Unidos , Adulto Jovem
19.
Acad Med ; 87(11): 1600-8, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23018320

RESUMO

The landscape of combined baccalaureate-MD programs has changed substantially in the last two decades but has not been documented in detail. The authors review the current state of these programs and discuss opportunities for future study of their evolving role and potential impact.In 2011, using a definition of baccalaureate-MD program built on prior research, the authors reviewed Association of American Medical Colleges sources and medical school Web sites to identify and characterize 81 active programs. In addition, they surveyed the 57 medical schools offering those programs; 31 schools with 39 programs responded. The resulting database inventories the number and distribution of programs; institutional affiliations; missions or goals; length; size; admissions criteria; curricula; and retention requirements.Since the inception of combined programs in 1961, their number and curricular length have increased. Pressures that spurred earlier programs remain evident in the goals of today's programs: attract talented high school or early college students, especially from diverse backgrounds; prepare physicians to meet societal needs; and offer an enriched premedical environment. Baccalaureate educational activities achieve program goals through special courses, medical experiences, community service, and learning communities tailored to students' needs. Admission and retention criteria are comparable to those of traditional medical schools.Combined baccalaureate-MD programs have evolved along several paths during the last half century and have enriched the baccalaureate experiences of medical students. Shifting expectations for the selection and education of future physicians warrant focused research on these programs to document their effectiveness in addressing those expectations.


Assuntos
Currículo , Educação de Graduação em Medicina/métodos , Educação Pré-Médica/métodos , Docentes de Medicina , Logro , Diversidade Cultural , Humanos , Modelos Educacionais , Critérios de Admissão Escolar , Faculdades de Medicina , Estados Unidos
20.
Perspect Biol Med ; 54(1): 17-23, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21399379

RESUMO

The Flexner Report established guidelines for medical education and made the university the obligate home for medical education. Flexner mandated specific elements necessary for university-based premedical education. With the exception of the MCAT, much less attention has been paid to premedical education and its integration into the scope of medical education than to education within the confines of the medical school. This article reviews the history of premedical education, describes some recent critiques of premedical education, discusses a newer program for premedical education evolving at the University of Illinois at Chicago, and offers some suggestions for the future.


Assuntos
Educação Médica/métodos , Educação Pré-Médica/métodos , Conhecimentos, Atitudes e Prática em Saúde , Critérios de Admissão Escolar/tendências , Faculdades de Medicina/história , Currículo , Educação Médica/história , Educação Pré-Médica/história , Avaliação Educacional , Escolaridade , História do Século XX , História do Século XXI , Humanos
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