Telehealth Monitoring for Individuals Experiencing Homelessness During the Early COVID-19 Pandemic: An Innovative Clinical and Medical Education Model.

BACKGROUND: People experiencing homelessness (PEH) are recognized as members of a vulnerable population with significant health and social disparities. Due to the COVID-19 pandemic, these populations are at risk for increased morbidity and mortality. The Herbert Wertheim College of Medicine (HWCOM) of Florida International University (FIU) in collaboration with the Miami-Dade County Homeless Trust presents this case series based on the results of the Telemedicine Homeless Monitoring Project, launched in April 2020. METHODS: Utilizing a faculty-student educational model, medical students at FIU HWCOM called PEH patients residing in isolation hotels on a daily basis to monitor their symptoms using a COVID-19 risk assessment template. Thirty-one PEH patients were followed for the duration of 12 weeks between April 2020 and August 2020. A retrospective chart review was then conducted, and four exemplar patients were chosen, highlighting common themes. Variables in the risk assessment included demographics, comorbidities, past medical history, indications for isolation or quarantine, length of stay, clinical and social needs identified, and qualitative data regarding barriers or successes of the telehealth platform. RESULTS: Thirty-one patients, between the ages of 20 and 84 and with an average age of 50.74, were followed in the program. There were eight females and 23 males in the study. Four exemplar PEH patients were discussed, highlighting the common themes identified; the lack of basic necessities that PEH face, the burden of chronic medical illnesses, a lack of health literacy, the burden of mental illnesses, and the acute stress caused by COVID-19 itself. CONCLUSION: Our research identified numerous characteristics of the homeless population that providers should pay special attention to during the pandemic. The relationship between the Homeless Trust and FIU HWCOM provided medical students with an excellent learning opportunity by letting them participate in clinical care while under lockdown due to the COVID-19 outbreak. Based on the results of the study, we believe that models like this will be useful in the event of a future epidemic.

Family Medicine Clerkship Teaching About Contraception: Meeting a Need.

INTRODUCTION: Women's healthcare including preventive care, obstetric care, and family planning and counseling are important medical education topics that student physicians frequently encounter during their Family Medicine Clerkship in medical training; however, despite its brief emphasis, many students feel underprepared to counsel patients in a clinical setting. With this in mind, a case-based curriculum focused on women's health was developed for students enrolled in the Family Medicine Clerkship. METHODS: During the 2018-2019 academic year, 127 students on the Family Medicine Clerkship at the Florida International University Herbert Wertheim College of Medicine (HWCOM) participated in three two-hour sessions on the topics of adolescent preventive health care, obstetric care, and contraceptive counseling. These sessions incorporated cases, role-play activities, and pre-session readings. An optional, anonymous, paper-based pre-session survey of Likert-type questions was administered prior to the first session and a post-session survey of Likert-type questions was given following the final session. IRB exemption was obtained. RESULTS: The pre-session survey showed that 41.67% of students agreed or strongly agreed that they were confident in their ability to perform female contraceptive counseling. After the sessions, 92.68% of students agreed or strongly agreed that the case addressing contraceptive counseling was of clinical value to their learning needs. CONCLUSION: Given that less than half of the students felt confident in their counseling abilities prior to these sessions, this curriculum is potentially addressing an unmet educational need. Students found this session to be relevant, indicating that a case-based discussion curriculum that incorporates both pre-session reading materials and role-play interactions may be a promising educational approach.

Barriers to college success among students that experienced adverse childhood events.

Objective: This study examines the relationship between adverse childhood experiences (ACEs) and academic barriers to college success. Participants: College students (n = 525) were surveyed about exposure to ACEs and academic barriers on a large university campus in the Southeast. Methods: Multivariate regression was used to model the academic barriers among college students for students with different levels of ACEs exposure controlling for depression, health and family barriers, and sociodemographic characteristics. Results: Students with ACEs reported more family difficulties and health problems compared with those without ACEs. Depressive symptomology, poorer health ratings, and other health and family issues significantly predicted higher counts of academic barriers. Conclusions: Students with ACEs face greater difficulty with relation to health and family barriers which in turn impacts academic barriers.