Purpose: To develop a longitudinal clinical program pairing first-year
medical students with prenatal patients.
Background: Students who participate in early clinical,
longitudinal experiences report greater confidence in communication, comfort in
clinical settings, and self-esteem during transition to clerkship year.
However, few longitudinal experiences exist for preclinical students at
Columbia University Vagelos College of Physicians and Surgeons.
Methods: A retrospective needs assessment evaluating interest,
motivating factors, and perceived barriers to participation was distributed to
second-year students. In response, we developed a program pairing ten
first-year students with pregnant patients. Students partake in lectures and
accompany patients to prenatal visits. Initial perceptions about the
patient-physician relationship were assessed in both groups using the
Patient-Practitioner Orientation Scale (PPOS), with 1 indicating
“doctor-/disease-centered,” and 6 indicating “patient-centered.”
Results: 49% of students completed the needs assessment. 90%
reported that they would be at least “somewhat interested” in a longitudinal
prenatal pairing program. Motivating factors included desiring longitudinal
experience (87%), early clinical exposure (82%), and patient advocacy/community
engagement (78%). Our program was designed accordingly. All first-year students
were invited to apply; ten were accepted. At recruitment, mean student PPOS
score was 4.64 compared to 3.95 for patients.
Discussions: Students in early medical education are enthusiastic about
longitudinal patient experiences and demonstrate patient-centered mindsets.
Programs such as ours may help maintain and cultivate patient-centeredness,
with the potential to improve patient satisfaction(1) and create positive
attitudes towards medical student involvement.
1 Krupat
E et al. Patient orientations of physicians and patients: the effect of
doctor-patient congruence of satisfaction. Patient Educ Couns 2000;
39:49-59.
Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Patient Care, Medical Knowledge, Professionalism, UME, Independent Study, Team-Based Learning, Advocacy, General Ob-Gyn,
Logan Mauney, MD, BWH and MGH; Elizabeth McMillen;
Emily Auran; Rini Ratan, MD