Impact on Medical Students Participating in Forensic Examinations of Asylum Seekers: A Pilot Study

K. Blanton, Hannah Smati, S. Ashrafzadeh, Dominic Schnabel, Sandy Samuel, Sana Batool, Alison Mosier-Mills, Emily Witt, Caroline C. Lee, J. Boyd, Katherine R. Peeler
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Abstract

Background: Student-run asylum clinics handle an increasing proportion of forensic medical evaluation requests for asylum cases across the country, but the impact on medical students participating in these evaluations remains poorly understood. This study investigates the self-reported backgrounds, roles, and experiences of medical students who directly participated in forensic evaluations of asylum-seekers at a student-run forensic asylum clinic between 2017 and 2021.Methods: Electronic surveys were sent to 40 medical students who had completed at least one asylum evaluation through the student clinic. Survey questions asked about student background, motivations, volunteer roles, and learning experiences during the evaluation process. Frequencies were calculated for multiple choice and 10-point Likert scale responses. Reviewers independently identified themes in free-response answers. Responses were subsequently coded using a consensus theme bank.Results: Eighteen of 40 (45%) students emailed completed the survey. Seventy-eight percent of respondents reported a personal or familial history of immigration. Almost all wrote the first draft of the medical affidavit. All respondents to the question reported improvement in their confidence working with patients who had experienced physical or psychological trauma as a result of persecution or feared persecution, because of their participation in an asylum evaluation. Conclusions: Students frequently were motivated to participate in forensic examinations of asylum-seekers for personal reasons related to their immigrant backgrounds. Our findings suggest that asylum evaluations promote professional development and skills working with survivors of trauma, though there remain technical and emotional challenges that mandate adequate training and support for student volunteers.
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对医学生参与寻求庇护者法医检查的影响:一项试点研究
背景:学生开办的庇护诊所处理了全国越来越多的庇护案件法医评估请求,但对参与这些评估的医学生的影响仍然知之甚少。本研究调查了2017年至2021年间在学生经营的法医庇护诊所直接参与寻求庇护者法医评估的医学生的自我报告的背景、角色和经历。方法:对40名通过学生诊所完成至少一次庇护评估的医学生进行电子问卷调查。在评估过程中,调查问题涉及学生的背景、动机、志愿者角色和学习经历。计算了多项选择和10分李克特量表反应的频率。审稿人在自由回答的答案中独立确定主题。随后使用共识主题库对答复进行编码。结果:通过电子邮件发送的40名学生中有18名(45%)完成了调查。78%的受访者表示有个人或家族移民史。几乎所有人都写了医疗宣誓书的初稿。对这个问题作出答复的所有人都报告说,由于参与庇护评估,他们在与因迫害或害怕迫害而遭受身体或心理创伤的病人一起工作时,信心有所提高。结论:学生经常出于与移民背景有关的个人原因而参加对寻求庇护者的法医检查。我们的研究结果表明,庇护评估促进了与创伤幸存者一起工作的专业发展和技能,尽管仍然存在技术和情感上的挑战,要求对学生志愿者进行充分的培训和支持。
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