How M2s can help drive change in community health

There is an eternal rule in real estate: Location, location, location. Perhaps unsurprisingly, public health has a counterpart: Community, community, community, which is the focus of some medical education.

The following are highlights from “Community Health in Action: Arizona AT Still University School of Osteopathic Medicine,” Chapter 10 of Value-added roles for medical students, which explores real-world examples of successful community-based student-led primary care projects.

Value-added roles for medical students is part of the AMA MedEd Innovation Series, which provides practical guidance for local implementation of education innovations tested and refined by the AMA Consortium for Accelerating Change in Medical Education. In addition to presenting case studies, the textbook lays out the historical background and conceptual foundations that underlie the roles of medical students who add value to the health system as well as their education.

When AT Still University (ATSU) established its School of Osteopathic Medicine in Arizona (SOMA) in 2007, it formed a partnership with the National Association of Community Health Centers through which students are integrated full-time into community health centers for a second , third and fourth years of their undergraduate medical education. By 2020, ATSU-SOMA had 15 partner sites in 11 states.

“By working and living in these settings, ATSU-SOMA students develop an authentic perspective on the challenges patients experience when trying to access care,” wrote the authors, Joy H. Lewis, DO, PhD, professor of medicine and Public Health and Kate Whelihan, MPH, Instructor of Public Health at ATSU-SOMA. Challenges can be financial, linguistic, cultural, geographical or mobility-related.

“In this way, they learn how to actively contribute to improving the health outcomes of vulnerable individuals and populations,” they write.

Learn more with the AMA about how value-added roles can transform medical education.

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To better understand population health, all second-year students at ATSU-SOMA participate in a year-long sequence of courses in epidemiology, biostatistics, and preventive medicine.

Simultaneously, they work with health center leaders, community members, and other stakeholders to develop, implement, and evaluate primary care projects that address the social determinants of health.

Community-based primary care projects represent an “ideal structure for medical students,” the authors write, noting that students use their early medical knowledge and various life skills to provide services and programs that meet local needs.

Community-based primary care projects “serve as experiential learning opportunities,” they added. “They allow students to learn about community health, research methods, program development and evaluation.”

Students work in groups and learn to follow all the steps required of each researcher, including conducting needs assessments, conducting literature reviews, developing detailed project proposals, and presenting their projects for peer review.

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The projects address unwanted pregnancy, adverse childhood experiences, poor connections with community resources, and the physical and mental well-being of refugees.

“The majority of students rated their experience with the projects as favorable,” the authors write. “Students have consistently expressed that they understand the value of the community project as a learning experience and as a way to give back to their CHC community.”

The chapter includes a readiness assessment checklist for partner sites and a summary of the toolkit used by students and faculty to implement the projects, as well as key tips for feasibility and sustainability.

Value-added roles for medical students includes case studies from additional long-term experience, as well as guidance for planning, launching, sustaining and growing value-added roles.

Additionally, in 2020, the AMA released the second edition of the Health Systems Science textbook. companion, Health Systems Science Reviewprovides case-based questions followed by discussion of answers and suggested readings.

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