Lessons Learned From Early Undergraduate Exposure to the Medical School Curriculum: A Qualitative Analysis.

BACKGROUND:  Students considering the health profession as a career rarely have an opportunity to explore medical school experiences. Pathway programs and "mini-medical school" programs exist but rarely involve integrating participants into the medical school experience. A novel for-credit undergraduate course was developed to embed students into a clinical skills course for medical students beginning in 2013. To better understand the impact of these experiences, this study explored former students' perceptions and career trajectories. METHODS: Participants were contacted via email to participate in a virtual, semi-structured interview. Virtual interviews were recorded and transcribed verbatim. Three investigators analyzed 17 interview transcripts independently and developed a codebook. Investigators met to discuss common themes and outcomes. RESULTS: Participants received early education on patient interviewing and physical examination skills, health policy, and ultrasound. They noted their course experience was a productive way to gain insight into medical school and often cited it when applying for their chosen professional school. Although not a formal part of the course curriculum, many received guidance on the medical school application process, and some obtained letters of recommendation from physician facilitators. Participants emphasized the sense of belonging within the medical school community and affirmation of pursuing a health professional degree. CONCLUSION: Participants found their experience to be meaningful and cited it as an influential factor in deciding to pursue a health professional degree. The course could be adopted by other institutions to enhance the variety of pre-health experiences for future medical students or health profession students.

Correction to: Implementing a Blood Pressure Measurement Curriculum for First-Year Medical Students.

[This corrects the article DOI: 10.1007/s40670-023-01825-9.].

Implementing a Blood Pressure Measurement Curriculum for First-Year Medical Students.

A core clinical skill medical students need to learn is obtaining an accurate blood pressure (BP) reading. We developed a standardized BP curriculum for first-year medical students. Medical students completed online modules and a hands-on skills session to learn BP skills. Pre- and post-surveys and an observed structured clinical encounter (OSCE) assessed student confidence and ability to accurately measure BP. Student confidence and mean OSCE scores (pre = 2.63, post = 6.51; p < 0.001) improved upon completion of the curriculum. The curriculum was feasible, well received, and improved student's skills for taking an accurate BP.

Assessing the Impact of Early Undergraduate Exposure to the Medical School Curriculum.

BACKGROUND: Programs such as mini-medical school programs have been implemented to introduce students to the medical school curriculum through a series of lectures in foundational sciences and healthcare topics. Since 2013, the UNC School of Medicine (SOM) has offered the Introduction to Clinical Medicine for Undergraduates (ICMU) course as an opportunity for UNC undergraduate students to be introduced to the medical school curriculum and integrated into the introductory clinical skills curriculum. This study explored the relationship between experiences from taking this course, pursuit of further education in healthcare professions, and preparedness for future clinical courses. METHODS: An anonymous survey was distributed to all students who took the ICMU course at UNC-Chapel Hill as an undergraduate from 2013 to present. The locally developed survey consisted of 13 scaled questions asking about their experiences in the course and decisions to pursue further healthcare professional education. Survey results were analyzed using descriptive and correlational statistics. RESULTS: Respondents perceived the experience increased their confidence and preparedness for future clinical courses in the competency measures of taking a patient history, performing a physical examination, and developing a differential diagnosis. Inclusion of students in the clinical skills course was significantly associated with their confidence going into their health professions school of choice (p = .002). Additionally, exposure to UNC SOM students, faculty, and culture was found to play a role in students choosing to attend UNC SOM. CONCLUSION: Integration of undergraduate students into the medical school curriculum has motivated continued pursuit of education in a healthcare profession. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01449-x.

Social Factors of Health Care: a Thematic Analysis of First and Second Year Medical Student Reflections.

BACKGROUND: Addressing health disparities is necessary to ensure appropriate care for patients. This study examined the impact of Clinical Week experiences on students' recognition of social determinants of health early in their medical education. METHODS: A 5-day experience each of the first three semesters of medical school provided direct patient care experiences. Two Clinical Weeks were spent in outpatient clinics located primarily in rural areas. Students completed a reflective writing assignment about their experiences after each 5-day experience. Ninety-two reflections during AY 2018-2019 included discussions about social determinants of health. Two investigators analyzed these essays independently using narrative inquiry techniques. After inductive coding was complete, researchers discussed themes and their broader meaning. RESULTS: Themes emerged related to health disparities experienced by rural communities, minority populations, and both uninsured and underinsured patients. Reflections emphasized a lack of public accommodations in rural settings, such as public transportation and access to healthy food. Students noted how ethnic, cultural, and linguistic identity affect a patient's experience with healthcare. Other themes involved the challenges patients face affording treatment plans and conversely how health status can impact economic stability. Finally, students emphasized the importance of physician advocacy in overcoming such barriers to quality health care. CONCLUSIONS: Although not the emphasis of Clinical Week, students' reflections identified critical social issues impacting the health of patients they encountered. This experience could be adapted at other institutions.

Medical Students Learning to Take a Complete Military History.

BACKGROUND AND OBJECTIVES: Many United States military personnel are not full-time service members. Because of their part-time service, these veterans may not self-report their military service during medical visits. Consequently, past military service can be overlooked when taking a social history. We developed a case to provide preclinical medical students patient interview experience wherein the diagnosis relied on identifying past military service. Our objective was to determine if medical record write-ups included social history details about occupational information after this innovation. METHODS: We conducted this case discussion in small groups during year 1 of medical school. We analyzed clinical skills examination write-ups before and after the case discussion to determine if the social history included occupational issues. RESULTS: Initial results showed increased occupational issues as potential diagnoses or contributing factors. CONCLUSIONS: This case methodology specifically raised awareness of health issues related to military service and generally increased students' likelihood of identifying occupational risk factors when conducting the social history. The template for this military case will allow us to develop additional cases focusing on different occupational health issues to complement other organ systems blocks.

Working collaboratively across schools to promote oral health education through interprofessional education.

PURPOSE: The Association of American Medical Colleges and American Dental Education Association have identified oral health knowledge, skills, and attitudes shared by both medical and dental professionals. Although oral health was deemed an essential competency for medical practitioners, our state struggled to ensure learners received proper training. This training deficit resulted in conducting a needs assessment and implementing an oral health interprofessional module at our schools. METHODS: First-year medical students and clinical faculty were emailed surveys in 2016 to obtain baseline information. A team of faculty and students from the Schools of Medicine and Dentistry reviewed the curriculum to determine where to augment oral health content. An oral health module to teach a basic head, neck, and oral examination to first-year medical students during their patient-centered care small-group sessions was implemented and evaluated. RESULTS: Only 13.6% of faculty respondents were aware of national oral health competency recommendations, and <50% rated oral health important for primary care physicians (PCPs) to include in history, physical exam, or oral health counseling. On baseline, ≤25% of PCP respondents reported integrating the listed skills in their practice, and most indicated lacking expertise to teach oral health. Teaching sessions were rated helpful by students and faculty. After the teaching sessions, ratings on the importance of including oral health significantly increased from baseline. CONCLUSION: Collaboration between Schools of Dentistry and Medicine successfully integrated oral health into medical school curriculum and improved the tutors' attitudes of its importance.

Interprofessional Education: Oral Health in the Medical Curriculum.

Schools of medicine and dentistry on the same geographical campus have an opportunity to promote oral health by training physicians to become more skilled in screening for oral disease in addition to counseling and referring patients to dental health professionals.

Lung nodule CAD software as a second reader: a multicenter study.

RATIONALE AND OBJECTIVES: The purpose of this multicenter, multireader study was to evaluate the performance of computed tomography (CT) lung nodule computer-aided detection (CAD) software as a second reader. METHODS AND MATERIALS: The study involved 109 patients from four sites. The data were collected from a variety of multidetector CT scanners and had different scan parameters. Each chest CT scan was divided into four quadrants. A group of three expert thoracic radiologists identified nodules between 4 and 30 mm in maximum diameter within each quadrant. The standard of reference was established by a consensus read of these experienced radiologists. The cases were then interpreted by 10 other radiologist readers with varying degrees of experience, without and then with CAD software. These readers identified nodules and assigned an actionability rating to each quadrant before and after using CAD software. Receiver operating characteristic curves were used to measure the performance of the readers without and with CAD software. RESULTS: The average increase in area under the curve for the 10 readers with CAD software was 1.9% for a 95% confidence interval (0.8-8.0%). The area under the curve without CAD software was 86.7% and with CAD software was 88.7%. A nonsignificant correlation was observed between the improvement in sensitivity and experience of the radiologists. The readers also showed a greater improvement in patients with cancer as compared to those without cancer. CONCLUSIONS: In this multicenter trial, CAD software was shown to be effective as a second reader by improving the sensitivity of the radiologists in detecting pulmonary nodules.