Abstract
BackgroundThe purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health.MethodsThis was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement.ResultsGreater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students’ medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient’s health nor did it clearly influence students’ future practice goals.ConclusionsThe MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.
Highlights
The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health
SRC experiences typically occur in the pre-clinical years with varying involvement of upper-class medical students, and they address the “service learning/community service” competency of the Liaison Committee on Medical Education 2020 Standards for Accreditation of Medical Education Programs [3]
The majority of Mayo Clinic Alix School of Medicine (MCASOM) SRC patients were Hispanic (38%) or Caucasian (28%), and 70% lived below 133% of the federal poverty level
Summary
The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health. Student-run clinics (SRCs) have become an important component of the early clinical curriculum at many medical schools in the United States [1, 2]. Prior studies among students (using surveys, qualitative interviews, and mixed methods approaches) have shown that they enjoy the SRC experience [7, 8], find it to be a beneficial educational experience for primary care topics [9], and perceive that exposure to SDH through an SRC is important to develop an understanding of barriers their patients face [6]. Assessment of patient satisfaction with SRCs has generally been reported as high [12,13,14], satisfaction with wait-times and perceived privacy have been found to be lower in the SRC setting [12]
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