BRONX, N.Y., July 29, 2015 /PRNewswire-USNewswire/ -- An
innovative three-month elective course has helped make some
first-year medical students at Albert Einstein College of Medicine
more confident about dealing with health disparities they'll likely
encounter as physicians, according to a follow-up study published
online today in the journal Academic Medicine.
Health disparities—gaps in health and healthcare that mirror
differences in socioeconomic status, race, ethnicity and
education—remain pervasive in the United
States. They are especially pronounced in the Bronx, a racially and ethnically diverse
borough with high rates of poverty and disease.
Professional organizations emphasize that learning about health
disparities is essential to physician training, but few medical
school curricula cover the topic. "We designed an elective course
that makes medical students aware of how they may inadvertently
contribute to health disparities and of systemic causes of health
disparities, and offers them skills for working to reduce them,"
said Cristina Gonzalez, M.D., M.Ed., Einstein class of 2004,
associate professor of clinical medicine at Einstein and attending
physician, internal medicine at Montefiore Health System.
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Dr. Gonzalez's work as a hospitalist in the division of hospital
medicine has made her aware of the need to uncover the social
determinants of health and for doctors to become aware of and
manage their subconscious biases and advocate for their patients on
a regular basis. "Our positive experience with this elective
makes it a potential candidate for the required curriculum," added
Dr. Gonzalez.
A key element early in the 13-session course was a role-playing
vignette of a patient with AIDS and end-stage renal disease who was
refusing hemodialysis. "Role playing helped the students recognize
their own biases and develop strategies to manage them," said Dr.
Gonzalez. Students were later offered instruction in skills such as
strategic planning, grass-roots organizing, meeting with
legislators and media communications.
Dr. Gonzalez and her team tested 48 students before and after
the course. The researchers found that:
- Mean self-reported confidence scores increased significantly
between the course's start and its conclusion, from 10.7 to 14.4 on
a scale of 16.
- Student knowledge about disparities increased significantly,
from an average of 63.6 to 76.4 on a scale of 100.
As their next step, Dr. Gonzalez and her team will assess how
their curriculum affects student behaviors in standardized patient
encounters. Later they hope to see how students who took the course
retain and apply the knowledge during clinical rotations and other
patient interactions.
The paper is titled "The Evolution of an Elective in Health
Disparities and Advocacy: Description of Instructional Strategies
and Program Evaluation." Co-authors were Aaron Fox, M.D., M.S., and
Paul Marantz, M.D., M.P.H., both at Einstein and Montefiore.
The study was supported by grants from the Health Resources and
Service Administration (D3 EHP16488-03), National Institutes of
Health (K23 DA03454, R25 DA023021, 1R25HD068835, 5UL1RR025750,
5KL2RR025749, and 5TL1RR025748) and the Robert Wood Johnson
Foundation Amos Medical Faculty Development Program. The authors
declare no financial conflicts of interest.
About Albert Einstein College
of Medicine
Albert Einstein College of Medicine of
Yeshiva University is one of the
nation's premier centers for research, medical education and
clinical investigation. During the 2014-2015 academic year,
Einstein is home to 742 M.D. students, 212 Ph.D. students, 102
students in the combined M.D./Ph.D. program, and 292 postdoctoral
research fellows. The College of Medicine has more than 2,000
full-time faculty members located on the main campus and at its
clinical affiliates. In 2014, Einstein received $158 million in awards from the National
Institutes of Health (NIH). This includes the funding of major
research centers at Einstein in aging, intellectual development
disorders, diabetes, cancer, clinical and translational research,
liver disease, and AIDS. Other areas where the College of Medicine
is concentrating its efforts include developmental brain research,
neuroscience, cardiac disease, and initiatives to reduce and
eliminate ethnic and racial health disparities. Its partnership
with Montefiore Medical Center, the University Hospital and
academic medical center for Einstein, advances clinical and
translational research to accelerate the pace at which new
discoveries become the treatments and therapies that benefit
patients. Through its extensive affiliation network involving
Montefiore, Jacobi Medical Center—Einstein's founding hospital, and
three other hospital systems in the Bronx, Brooklyn and on Long
Island, Einstein runs one of the largest residency and
fellowship training programs in the medical and dental professions
in the United States. For more
information, please visit www.einstein.yu.edu, read our blog,
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YouTube.
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SOURCE Albert Einstein College of
Medicine