In the wake of the Black Lives Matter and other antiracism justice movements, medical education i... more In the wake of the Black Lives Matter and other antiracism justice movements, medical education is evolving to incorporate health equity principles for all medical students and residents, while also increasing institutional diversity recruitment of minoritized physicians. As the demographics of U.S. medical trainees shift to reflect a rapidly evolving patient population, the prevalence of culturally concordant patient–physician visits, where patients share elements of language, religion, customs, and identities with their physician, is also expected to increase. However, existing antiracist curricula are standardized to all learners and there is a dearth of cultural sensitivity training designed specifically for minoritized learners to interrogate the culturally concordant space they share with patients and mentors. In this article, the authors propose a new model for minoritized learners’ cultural training, culturally reflective medicine (CRM) that identifies unanticipated tensions that may arise as minoritized learners bridge both White and Eurocentric professional and personal identities, examines how intersectionality can both strengthen encounters and lead to shared blind spots, and empowers minoritized physicians with tools for self- and group reflection to advocate for their communities. CRM is contextualized within the current landscape of cultural sensitivity training in medical education. The authors provide 2 clinical vignettes to demonstrate how CRM can unveil more nuanced understandings of health disparities than existing cultural training. As institutions work toward diversity, equity, justice, and antioppression, CRM provides a novel framework for redesigning medical education that better acknowledges and incorporates the unique knowledge of minoritized learners.
Problem Value-added medical education (VAME) has been difficult to implement due to student and e... more Problem Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused mass transitions to online learning, removed students from clinical settings, and underscored students’ desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions. Approach The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer review process. After 2 months, the authors expanded the service to local community clinicians. Outcomes The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions. Next Steps The SFCS is a novel, student-initiated VAME curriculum focused on increasing students’ meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning.
International Journal of Environmental Research and Public Health, Sep 20, 2019
China's increasing attention to patient satisfaction evaluation is part of an international trend... more China's increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups.
PROBLEM Value-added medical education (VAME) has been difficult to implement due to student and e... more PROBLEM Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused a mass transition to online learning, removed students from clinical settings, and underscored students' desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions. APPROACH The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students, but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer-review process. After two months, the authors expanded the service to local community clinicians. OUTCOMES The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions. NEXT STEPS The SFCS is a novel, student-initiated VAME curriculum focused on increasing students' meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning.
International Journal of Environmental Research and Public Health, 2019
China’s increasing attention to patient satisfaction evaluation is part of an international trend... more China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process manag...
With recent outbreaks of infectious diseases such as Ebola and Zika and rising rates of chronic d... more With recent outbreaks of infectious diseases such as Ebola and Zika and rising rates of chronic disease such as asthma and obesity worldwide, there has been a growing awareness of the urgency to develop novel approaches to public health and the investigation of disease. As biomedical and genomic research generate new data, knowledge, and methods of treatment, many questions remain about the evolution, proliferation and history of a number of conditions of global health concern. Archaeology, as both a methodological approach and an analytical framework, has a unique potential to contribute to these efforts. In particular, collaborations with the biological and ecological sciences can produce a finer-grained narrative of how specific diseases and health conditions proliferated in the past, and the ways in which humans have responded to these issues. When combined with social theory and history, these approaches offer a historical perspective that can inform preventative and treatment strategies for the future. This session aims to showcase archaeological research into issues related to global health and medicine to date, and to offer a creative space for archaeologists to shape discourse that will drive future investigations.
In the wake of the Black Lives Matter and other antiracism justice movements, medical education i... more In the wake of the Black Lives Matter and other antiracism justice movements, medical education is evolving to incorporate health equity principles for all medical students and residents, while also increasing institutional diversity recruitment of minoritized physicians. As the demographics of U.S. medical trainees shift to reflect a rapidly evolving patient population, the prevalence of culturally concordant patient–physician visits, where patients share elements of language, religion, customs, and identities with their physician, is also expected to increase. However, existing antiracist curricula are standardized to all learners and there is a dearth of cultural sensitivity training designed specifically for minoritized learners to interrogate the culturally concordant space they share with patients and mentors. In this article, the authors propose a new model for minoritized learners’ cultural training, culturally reflective medicine (CRM) that identifies unanticipated tensions that may arise as minoritized learners bridge both White and Eurocentric professional and personal identities, examines how intersectionality can both strengthen encounters and lead to shared blind spots, and empowers minoritized physicians with tools for self- and group reflection to advocate for their communities. CRM is contextualized within the current landscape of cultural sensitivity training in medical education. The authors provide 2 clinical vignettes to demonstrate how CRM can unveil more nuanced understandings of health disparities than existing cultural training. As institutions work toward diversity, equity, justice, and antioppression, CRM provides a novel framework for redesigning medical education that better acknowledges and incorporates the unique knowledge of minoritized learners.
Problem Value-added medical education (VAME) has been difficult to implement due to student and e... more Problem Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused mass transitions to online learning, removed students from clinical settings, and underscored students’ desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions. Approach The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer review process. After 2 months, the authors expanded the service to local community clinicians. Outcomes The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions. Next Steps The SFCS is a novel, student-initiated VAME curriculum focused on increasing students’ meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning.
International Journal of Environmental Research and Public Health, Sep 20, 2019
China's increasing attention to patient satisfaction evaluation is part of an international trend... more China's increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups.
PROBLEM Value-added medical education (VAME) has been difficult to implement due to student and e... more PROBLEM Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused a mass transition to online learning, removed students from clinical settings, and underscored students' desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions. APPROACH The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students, but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer-review process. After two months, the authors expanded the service to local community clinicians. OUTCOMES The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions. NEXT STEPS The SFCS is a novel, student-initiated VAME curriculum focused on increasing students' meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning.
International Journal of Environmental Research and Public Health, 2019
China’s increasing attention to patient satisfaction evaluation is part of an international trend... more China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process manag...
With recent outbreaks of infectious diseases such as Ebola and Zika and rising rates of chronic d... more With recent outbreaks of infectious diseases such as Ebola and Zika and rising rates of chronic disease such as asthma and obesity worldwide, there has been a growing awareness of the urgency to develop novel approaches to public health and the investigation of disease. As biomedical and genomic research generate new data, knowledge, and methods of treatment, many questions remain about the evolution, proliferation and history of a number of conditions of global health concern. Archaeology, as both a methodological approach and an analytical framework, has a unique potential to contribute to these efforts. In particular, collaborations with the biological and ecological sciences can produce a finer-grained narrative of how specific diseases and health conditions proliferated in the past, and the ways in which humans have responded to these issues. When combined with social theory and history, these approaches offer a historical perspective that can inform preventative and treatment strategies for the future. This session aims to showcase archaeological research into issues related to global health and medicine to date, and to offer a creative space for archaeologists to shape discourse that will drive future investigations.
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