Learning Together: Implementing Medical Student Experiential Learning Through Patient Education

From the 2023 HVPA National Conference

Dominick Myers MD (Creighton University School of Medicine), Stephen Toth MD (Creighton University School of Medicine), Joshua Babbin BS, Bradley Haupts BS, Eva Holland BS, Venkata Andukuri MD, MPH

Background:
It has been well demonstrated that improving patient health literacy positively impacts patient adherence to their treatment plan as well as patient satisfaction. The time just before hospital discharge is particularly important because the provider can summarize the admission including what the possible etiologies were that prompted admission, in-hospital therapies utilized, and what the patient can do (medications, lifestyle modifications) to control their conditions and prevent any future decompensations requiring hospitalization. As the healthcare system continues to be strained by staff shortages, it is possible for patient education to be easily overlooked. While many aspects of medical education are conducted through hands on practice, patient education is not typically entrusted to students. The aim of our quality improvement project is to implement a student-driven patient education program at one institution and determine whether this is an effective strategy for increasing student comfort in discussing these matters with their current and future patients.

Objectives:
To implement and assess the impact of a student driven patient education initiative on student confidence in three key areas of patient education.

Methods:
Medical students at this institution participated in an eight-week internal medicine rotation during their third year of training. During the first week of their rotation, the students were given a three-question survey on their subjective confidence level in three areas of patient education on a scale of one to five (1=not comfortable at all, 5=extremely comfortable). These areas include confidence in education of three important areas: patients’ disease processes, treatment plan, and social aspects of their health (Pre-). The students were then given a short orientation on how to educate patients with some basic approaches. Each week during the rotation, a member of the research team would meet with the student groups to gauge their progress and address any barriers to patient education. The same survey was administered at the end of the rotation and the results were compared (Post-).

Results:
Our results show that students felt significantly more confident in all three areas by the end of the rotation when utilizing this program. A statistically significant difference was measured in all three portions of the survey; however, the effect was the greatest in the “treatment” education section with pre-exposure students exhibiting a mean score of 2.69/5 (95% CI 2.48-2.88) and post-exposure students exhibiting a mean score of 3.89/5 (95% CI 3.73-4.06). Statistical significance was maintained when data was broken down by each rotation group.

Conclusions:
The data indicates that our program provides a statistically significant increase in student comfort with patient education in three key areas over an eight-week internal medicine rotation. This study has the potential to substantially improve both medical student education and patient education, however, more studies are needed to determine the effect of our program on patient centered outcomes.

Clinical Impacts:
While the direct impact on patient care was not measured in this instance, it has been established that better patient education significantly increases patient adherence. Therefore, early comfort in discussing these topics by future physicians may improve patient treatment adherence in the future. Further study is planned to assess the immediate impacts of the above interventions on patient satisfaction and understanding.

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