ENRICHING CLINICAL COMPETENCY AND CONFIDENCE VIA EXPERIENTIAL LEARNING: A STUDENT-RUN INPATIENT CONSULT SERVICE FOR THE UNHOUSED

Document Type

Conference Proceeding

Publication Date

6-27-2024

Publication Title

J Gen Intern Med

Keywords

case management, clinician, community resource, conference abstract, electronic medical record, experiential learning, female, follow up, harm reduction, health care access, housing, housing instability, human, immunization, leadership, major clinical study, male, medical record review, medical student, non profit hospital, participation, patient care, physician, workflow

Abstract

SETTING AND PARTICIPANTS: This presentation highlights the workflow and benefits of a medical student-led consult service based in an urban academic non-profit hospital in the Midwest region. DESCRIPTION: The Street Medicine consult service is tailored towards providing compassionate, systems-based care and long-term follow-up to individuals experiencing housing insecurity. While working as consult leaders, students hone their patient care skills while also learning to facilitate healthcare accessibility for unhoused individuals. The workflow involves three phases: completing the inpatient consult, forming a treatment and follow-up plan, and facilitating post-discharge follow-up. Consults are placed by the patient's primary team, at which point a medical student consultant sees the patient and completes a standardized note. The student then consults with our supervising attending to create a plan to address the patient's short and long-term medical and social needs. Afterward, the student consultant contacts a member of our Street Leader team to discuss the patient's needs and find an appropriate time to follow up with them post-discharge. The Street Leader team then finds the patient during their street or shelter run and provides them with resources such as harm reduction, housing information, or case management. EVALUATION: Within the past 9 months, the team has completed 76 consults. During clinical encounters, all 9 medical student consultants endorsed often or always practicing skills including note writing, patient interviewing, obtaining alcohol/drug use history, inter-team communication, and creating an actionable plan alongside an attending physician. 8 of 9 consultants endorsed often or always participating in chart review and completing hand-offs, and 5 of 9 consultants endorsed often or always obtaining sexual history and performing immunization counseling. Seven months after joining the team, students were surveyed on the benefits of consult system participation in their confidence in carrying out various clinical skills. 100% of respondents endorsed agreement or strong agreement that participation as a consultant has increased their confidence in independently seeing patients, utilizing community resources, and obtaining alcohol/drug use history. 67% of students endorsed agreement or strong agreement that the consult system has made them more comfortable obtaining sexual histories, addressing immune hesitancy, and navigating and writing notes in the EMR. 100% of consultants believed that their experiences as consultants have positively influenced their performance and team contributions during clerkships and increased their preparedness for residency. DISCUSSION / REFLECTION / LESSONS LEARNED: The Street Medicine consult service provides medical students with the opportunity to work independently within the hospital setting, increasing students' confidence and competency in clinical skills required for residency while also providing members of the unhoused community with more comprehensive and longitudinal healthcare. .

Volume

39

First Page

S572

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