Meagan Spencer, Mary Beth Seibel, Emily Beard, Emily Christensen
Aim: This study aimed to explore the clinic learning models through student perspectives using that insight to explore how these students viewed a newly established speech clinic program and understand the organizational and learning benefits and limitations of the clinic and how it can be improved for future service for student learning. Methods: This exploratory study utilized an observation analysis to understand how the student-led functioning of the clinic fits into both the learning models of Bloom’s Taxonomy and Bandura’s Triadic Reciprocal Model of Causality and the factors that contribute most to these learning models. These models were chosen due to the systemic and progressive nature of learning that reflects the academic mission of the university’s accrediting body: the Southern Association of Colleges and Schools Commission on Colleges. A mixed closed and open-ended student questionnaire was utilized to gain insight into themes that influence the student-led learning model. Results: The clinic was overall seen as a place of relationship building and skills development. The main contributors to this relationship-building and skills development lie in the ability of students to apply what they have been learning in the classroom to a functional situation, as well as the opportunity to serve the community and build confidence and leadership skills. Conclusion: Student leadership roles in the clinic are leading to self-efficacy which is seen in the highest level of Bloom’s Taxonomy and Bandura’s Triadic Reciprocal Model of Causality.
{"title":"Building a No Cost Undergraduate Community Speech Clinic","authors":"Meagan Spencer, Mary Beth Seibel, Emily Beard, Emily Christensen","doi":"10.59586/jsrc.v10i1.399","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.399","url":null,"abstract":"Aim: This study aimed to explore the clinic learning models through student perspectives using that insight to explore how these students viewed a newly established speech clinic program and understand the organizational and learning benefits and limitations of the clinic and how it can be improved for future service for student learning. \u0000Methods: This exploratory study utilized an observation analysis to understand how the student-led functioning of the clinic fits into both the learning models of Bloom’s Taxonomy and Bandura’s Triadic Reciprocal Model of Causality and the factors that contribute most to these learning models. These models were chosen due to the systemic and progressive nature of learning that reflects the academic mission of the university’s accrediting body: the Southern Association of Colleges and Schools Commission on Colleges. A mixed closed and open-ended student questionnaire was utilized to gain insight into themes that influence the student-led learning model. \u0000Results: The clinic was overall seen as a place of relationship building and skills development. The main contributors to this relationship-building and skills development lie in the ability of students to apply what they have been learning in the classroom to a functional situation, as well as the opportunity to serve the community and build confidence and leadership skills. \u0000Conclusion: Student leadership roles in the clinic are leading to self-efficacy which is seen in the highest level of Bloom’s Taxonomy and Bandura’s Triadic Reciprocal Model of Causality.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"62 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140252421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joy Li, Bunnarin Theng, Roland Yu, Daniel Bao, Nadia Ahmed
Background: St. Vincent's Clinic (SVC) is a free, student-run clinic affiliated with the University of Texas Medical Branch that has been an invaluable resource in providing free healthcare services to marginalized populations in Galveston, Texas. The clinic offers a wide variety of specialty services along with free resources such as transportation and medication assistance, telehealth options, and interpreter services. Despite these resources, the clinic has faced challenges with consistently high no-show rates and long encounter lengths, impacting overall efficiency and patient care. We aimed to explore factors that may contribute to these challenges and uncover opportunities to improve patient satisfaction and optimize clinic efficiency. Methods: A retrospective chart review was conducted on all patients seen at SVC across all specialty clinics between March 2021 and March 2023. Patient demographics, appointment status, encounter length, language spoken, department specialty, and appointment modality were recorded. A series of statistical analyses were conducted on collected variables, including chi-square analysis, unpaired t-tests, and single-factor analysis of variance (ANOVA) tests, to assess significant associations. Results: The average encounter length varies significantly across different spoken languages and specialty clinics, but no significance was observed between different appointment modalities. The no-show rates were significantly different depending on the appointment modality, specialty clinic, and patient language spoken. Notably, while the encounter length was significantly shorter for English-speaking patients, Spanish-speaking patients had a lower no-show rate and were more likely to keep scheduled appointments. Conclusions: Language barriers and specialty clinic types can impact the encounter lengths and no-show rates, highlighting the need for targeted interventions such as proper resource allocation. Limitations include potential data discrepancies from factors such as human error or variations in documenting appointments. Future research should explore patient perspectives and experiences to improve patient satisfaction and overall optimize clinic operations.
{"title":"Examining Factors Impacting Encounter Length and Missed Appointments at a Student-Run Free Clinic: A Retrospective Analysis","authors":"Joy Li, Bunnarin Theng, Roland Yu, Daniel Bao, Nadia Ahmed","doi":"10.59586/jsrc.v10i1.432","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.432","url":null,"abstract":"Background: St. Vincent's Clinic (SVC) is a free, student-run clinic affiliated with the University of Texas Medical Branch that has been an invaluable resource in providing free healthcare services to marginalized populations in Galveston, Texas. The clinic offers a wide variety of specialty services along with free resources such as transportation and medication assistance, telehealth options, and interpreter services. Despite these resources, the clinic has faced challenges with consistently high no-show rates and long encounter lengths, impacting overall efficiency and patient care. We aimed to explore factors that may contribute to these challenges and uncover opportunities to improve patient satisfaction and optimize clinic efficiency. \u0000Methods: A retrospective chart review was conducted on all patients seen at SVC across all specialty clinics between March 2021 and March 2023. Patient demographics, appointment status, encounter length, language spoken, department specialty, and appointment modality were recorded. A series of statistical analyses were conducted on collected variables, including chi-square analysis, unpaired t-tests, and single-factor analysis of variance (ANOVA) tests, to assess significant associations. \u0000Results: The average encounter length varies significantly across different spoken languages and specialty clinics, but no significance was observed between different appointment modalities. The no-show rates were significantly different depending on the appointment modality, specialty clinic, and patient language spoken. Notably, while the encounter length was significantly shorter for English-speaking patients, Spanish-speaking patients had a lower no-show rate and were more likely to keep scheduled appointments. \u0000Conclusions: Language barriers and specialty clinic types can impact the encounter lengths and no-show rates, highlighting the need for targeted interventions such as proper resource allocation. Limitations include potential data discrepancies from factors such as human error or variations in documenting appointments. Future research should explore patient perspectives and experiences to improve patient satisfaction and overall optimize clinic operations.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"58 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Wrucke, Stephen Stevanovic, Naisarg Vanani, Ryan Klauck, Bryan Johnston
Background: The opioid epidemic has been worsening. Fortunately, studies show that bystanders can effectively administer naloxone to reverse opioid overdose, and overdose education programs result in improved ability to respond to overdose. However, there has been limited research investigating opioid overdose risk and response preparedness among patients without insurance. This descriptive report aimed to assess risk of opioid overdose among patients without insurance in addition to their family members and close contacts and assess whether these patients, as crucial bystanders, were prepared to respond to opioid overdose. Methods: Patients without insurance at a student-run free clinic completed an anonymous, voluntary survey during in-person appointments. Data were collected for eight months from 2021-2022. One-proportion Z-test compared respondent rates of opioid use with overall statewide community rates reported by the Wisconsin Department of Health Services (DHS) Opioid Dashboard. Subgroup analysis further described the data collected, and hypothetical number needed to screen (NNS) calculations explored possible screening methods for naloxone distribution. Results: Seventy-two patients responded to the survey. The past-year rate of medically prescribed opioid use in the study population (12.5%) did not differ from the rate statewide (15.8%; p=0.44). Zero respondents reported personal opioid overdose in the past year, but six overdoses had been witnessed. Among respondents with family or close contacts who use opioids, 50% of those respondents who do not carry naloxone do not know where to get it, but 75% of those respondents who are not trained on how to respond to overdose would like to be. Lastly, screening for family or close contact opioid use offered the lowest hypothetical NNS of screening methods considered. Conclusions: Patients without insurance at student-run free clinics, including those with family members or close contacts who use opioids, likely represent a target population for opioid overdose education and naloxone distribution.
{"title":"Assessment of Opioid Overdose Risk and Response Readiness Among Patients at a Clinic for Uninsured Patients","authors":"Benjamin Wrucke, Stephen Stevanovic, Naisarg Vanani, Ryan Klauck, Bryan Johnston","doi":"10.59586/jsrc.v10i1.387","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.387","url":null,"abstract":"Background: The opioid epidemic has been worsening. Fortunately, studies show that bystanders can effectively administer naloxone to reverse opioid overdose, and overdose education programs result in improved ability to respond to overdose. However, there has been limited research investigating opioid overdose risk and response preparedness among patients without insurance. This descriptive report aimed to assess risk of opioid overdose among patients without insurance in addition to their family members and close contacts and assess whether these patients, as crucial bystanders, were prepared to respond to opioid overdose. \u0000Methods: Patients without insurance at a student-run free clinic completed an anonymous, voluntary survey during in-person appointments. Data were collected for eight months from 2021-2022. One-proportion Z-test compared respondent rates of opioid use with overall statewide community rates reported by the Wisconsin Department of Health Services (DHS) Opioid Dashboard. Subgroup analysis further described the data collected, and hypothetical number needed to screen (NNS) calculations explored possible screening methods for naloxone distribution. \u0000Results: Seventy-two patients responded to the survey. The past-year rate of medically prescribed opioid use in the study population (12.5%) did not differ from the rate statewide (15.8%; p=0.44). Zero respondents reported personal opioid overdose in the past year, but six overdoses had been witnessed. Among respondents with family or close contacts who use opioids, 50% of those respondents who do not carry naloxone do not know where to get it, but 75% of those respondents who are not trained on how to respond to overdose would like to be. Lastly, screening for family or close contact opioid use offered the lowest hypothetical NNS of screening methods considered. \u0000Conclusions: Patients without insurance at student-run free clinics, including those with family members or close contacts who use opioids, likely represent a target population for opioid overdose education and naloxone distribution.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"17 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140427704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annie E Altman-Merino, Shreyas G. Krishnapura, Sachin K Aggarwal, Christopher Terry, Jordan Wright, Eleanor O Weaver, Babatunde Carew, Robert F Miller, M. Lloyd
Background: Growing evidence suggests that medical students and faculty preceptors have limited familiarity with continuous glucose monitors (CGMs), which may negatively affect how care teams counsel patients and monitor the use of CGMs. Although studies have shown that structured training for care teams may improve knowledge and comfort with various healthcare tools, to our knowledge, no study has attempted to do so for CGMs. Methods: We designed a user experience course for medical students and faculty mentors to address this gap at a student-run free clinic. This course allowed twenty participants to wear a CGM for two weeks and participate in three interactive didactic sessions and group reflections. We evaluated how knowledge and comfort with CGMs among participants changed after the course with a survey and focus group. Results: The cohort showed improvement in self-reported confidence in using the device, teaching patients how to use the device, and interpreting data (p<0.001). The majority of participants demonstrated improvement across all survey domains with higher post-intervention scores than pre-intervention scores. Qualitative analysis of group reflections elucidated three primary themes across participant experiences: the emotional impact of wearing the device, attitude changes with prolonged use, and behavior modification in response to glucose data. Conclusion: This novel educational initiative may improve knowledge about CGMs, ability to counsel patients to use the device, and understanding patients' experiences among medical students and faculty mentors. We plan to expand this educational opportunity to additional clinic volunteers, include patient perspectives, and share the curriculum with other student-run clinics.
{"title":"Experiential Learning With Continuous Glucose Monitors: A Novel Curriculum for Volunteers in a Student-Run Free Clinic","authors":"Annie E Altman-Merino, Shreyas G. Krishnapura, Sachin K Aggarwal, Christopher Terry, Jordan Wright, Eleanor O Weaver, Babatunde Carew, Robert F Miller, M. Lloyd","doi":"10.59586/jsrc.v10i1.426","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.426","url":null,"abstract":"Background: Growing evidence suggests that medical students and faculty preceptors have limited familiarity with continuous glucose monitors (CGMs), which may negatively affect how care teams counsel patients and monitor the use of CGMs. Although studies have shown that structured training for care teams may improve knowledge and comfort with various healthcare tools, to our knowledge, no study has attempted to do so for CGMs. \u0000Methods: We designed a user experience course for medical students and faculty mentors to address this gap at a student-run free clinic. This course allowed twenty participants to wear a CGM for two weeks and participate in three interactive didactic sessions and group reflections. We evaluated how knowledge and comfort with CGMs among participants changed after the course with a survey and focus group. \u0000Results: The cohort showed improvement in self-reported confidence in using the device, teaching patients how to use the device, and interpreting data (p<0.001). The majority of participants demonstrated improvement across all survey domains with higher post-intervention scores than pre-intervention scores. Qualitative analysis of group reflections elucidated three primary themes across participant experiences: the emotional impact of wearing the device, attitude changes with prolonged use, and behavior modification in response to glucose data. \u0000Conclusion: This novel educational initiative may improve knowledge about CGMs, ability to counsel patients to use the device, and understanding patients' experiences among medical students and faculty mentors. We plan to expand this educational opportunity to additional clinic volunteers, include patient perspectives, and share the curriculum with other student-run clinics.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"19 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annie E Altman-Merino, Shreyas G. Krishnapura, Sachin K Aggarwal, Christopher Terry, Jordan Wright, Eleanor O Weaver, Babatunde Carew, Robert F Miller, M. Lloyd
Background: Growing evidence suggests that medical students and faculty preceptors have limited familiarity with continuous glucose monitors (CGMs), which may negatively affect how care teams counsel patients and monitor the use of CGMs. Although studies have shown that structured training for care teams may improve knowledge and comfort with various healthcare tools, to our knowledge, no study has attempted to do so for CGMs. Methods: We designed a user experience course for medical students and faculty mentors to address this gap at a student-run free clinic. This course allowed twenty participants to wear a CGM for two weeks and participate in three interactive didactic sessions and group reflections. We evaluated how knowledge and comfort with CGMs among participants changed after the course with a survey and focus group. Results: The cohort showed improvement in self-reported confidence in using the device, teaching patients how to use the device, and interpreting data (p<0.001). The majority of participants demonstrated improvement across all survey domains with higher post-intervention scores than pre-intervention scores. Qualitative analysis of group reflections elucidated three primary themes across participant experiences: the emotional impact of wearing the device, attitude changes with prolonged use, and behavior modification in response to glucose data. Conclusion: This novel educational initiative may improve knowledge about CGMs, ability to counsel patients to use the device, and understanding patients' experiences among medical students and faculty mentors. We plan to expand this educational opportunity to additional clinic volunteers, include patient perspectives, and share the curriculum with other student-run clinics.
{"title":"Experiential Learning With Continuous Glucose Monitors: A Novel Curriculum for Volunteers in a Student-Run Free Clinic","authors":"Annie E Altman-Merino, Shreyas G. Krishnapura, Sachin K Aggarwal, Christopher Terry, Jordan Wright, Eleanor O Weaver, Babatunde Carew, Robert F Miller, M. Lloyd","doi":"10.59586/jsrc.v10i1.426","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.426","url":null,"abstract":"Background: Growing evidence suggests that medical students and faculty preceptors have limited familiarity with continuous glucose monitors (CGMs), which may negatively affect how care teams counsel patients and monitor the use of CGMs. Although studies have shown that structured training for care teams may improve knowledge and comfort with various healthcare tools, to our knowledge, no study has attempted to do so for CGMs. \u0000Methods: We designed a user experience course for medical students and faculty mentors to address this gap at a student-run free clinic. This course allowed twenty participants to wear a CGM for two weeks and participate in three interactive didactic sessions and group reflections. We evaluated how knowledge and comfort with CGMs among participants changed after the course with a survey and focus group. \u0000Results: The cohort showed improvement in self-reported confidence in using the device, teaching patients how to use the device, and interpreting data (p<0.001). The majority of participants demonstrated improvement across all survey domains with higher post-intervention scores than pre-intervention scores. Qualitative analysis of group reflections elucidated three primary themes across participant experiences: the emotional impact of wearing the device, attitude changes with prolonged use, and behavior modification in response to glucose data. \u0000Conclusion: This novel educational initiative may improve knowledge about CGMs, ability to counsel patients to use the device, and understanding patients' experiences among medical students and faculty mentors. We plan to expand this educational opportunity to additional clinic volunteers, include patient perspectives, and share the curriculum with other student-run clinics.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"36 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Prenatal care is a cornerstone of maternal and child health. This paper describes the creation of a free prenatal clinic for uninsured families following recognition of a significant disparity in birth outcomes in Alachua County, Florida including: the development of essential community re- source collaborations, clinical operations in a dual aim patient care-medical education site, preliminary outcomes after one year of clinical operation, identified challenges, and next steps for our growing program. Methods: A retrospective chart review of all sixteen patients enrolled with the student run free prenatal clinic in its first year of clinical operation. Analysis included assessment of the prenatal care course using descriptive statistics. Specific dimensions assessed include timing of transition of care to a traditional obstetrics clinic, clinical findings and diagnoses identified at the prenatal clinic, and birth out- comes during the study period and report findings as descriptive statistics. Results: The clinic has demonstrated the ability to identify and treat numerous pathologies which may impact maternal-fetal morbidity and mortality. The clinic has seen very high rates of patient retention and has demonstrated successful transition of patients to higher levels of care when indicated. Finally, the clinical model provides an uncommon opportunity for medical and physician assistant students to care for patients throughout the first 32 weeks of pregnancy and receive additional training in point-of-care ultrasound, diagnostics, and medical decision making. Conclusion: While the small sample size limits the ability to assess the effectiveness of the prenatal clinic intervention, there are numerous promising features based on preliminary results.
{"title":"Providing Prenatal Care in a Student Run Free Clinic","authors":"Chloe Warpinski, Nathan Burke, Sanaz Dovell, Michelle McCraw, Caroline King, Amy Stanley, Krystal Stennett, Tory Finley, Michelle Nall, Mallory LeBlanc, Nicole Diaz, Phillip Mackie, Erica Smith, Lauren Silva, Kathleen Green, Reem Abu-Rustum","doi":"10.59586/jsrc.v10i1.392","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.392","url":null,"abstract":"Background: Prenatal care is a cornerstone of maternal and child health. This paper describes the creation of a free prenatal clinic for uninsured families following recognition of a significant disparity in birth outcomes in Alachua County, Florida including: the development of essential community re- source collaborations, clinical operations in a dual aim patient care-medical education site, preliminary outcomes after one year of clinical operation, identified challenges, and next steps for our growing program. \u0000Methods: A retrospective chart review of all sixteen patients enrolled with the student run free prenatal clinic in its first year of clinical operation. Analysis included assessment of the prenatal care course using descriptive statistics. Specific dimensions assessed include timing of transition of care to a traditional obstetrics clinic, clinical findings and diagnoses identified at the prenatal clinic, and birth out- comes during the study period and report findings as descriptive statistics. \u0000Results: The clinic has demonstrated the ability to identify and treat numerous pathologies which may impact maternal-fetal morbidity and mortality. The clinic has seen very high rates of patient retention and has demonstrated successful transition of patients to higher levels of care when indicated. Finally, the clinical model provides an uncommon opportunity for medical and physician assistant students to care for patients throughout the first 32 weeks of pregnancy and receive additional training in point-of-care ultrasound, diagnostics, and medical decision making. \u0000Conclusion: While the small sample size limits the ability to assess the effectiveness of the prenatal clinic intervention, there are numerous promising features based on preliminary results.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"7 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139796345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Prenatal care is a cornerstone of maternal and child health. This paper describes the creation of a free prenatal clinic for uninsured families following recognition of a significant disparity in birth outcomes in Alachua County, Florida including: the development of essential community re- source collaborations, clinical operations in a dual aim patient care-medical education site, preliminary outcomes after one year of clinical operation, identified challenges, and next steps for our growing program. Methods: A retrospective chart review of all sixteen patients enrolled with the student run free prenatal clinic in its first year of clinical operation. Analysis included assessment of the prenatal care course using descriptive statistics. Specific dimensions assessed include timing of transition of care to a traditional obstetrics clinic, clinical findings and diagnoses identified at the prenatal clinic, and birth out- comes during the study period and report findings as descriptive statistics. Results: The clinic has demonstrated the ability to identify and treat numerous pathologies which may impact maternal-fetal morbidity and mortality. The clinic has seen very high rates of patient retention and has demonstrated successful transition of patients to higher levels of care when indicated. Finally, the clinical model provides an uncommon opportunity for medical and physician assistant students to care for patients throughout the first 32 weeks of pregnancy and receive additional training in point-of-care ultrasound, diagnostics, and medical decision making. Conclusion: While the small sample size limits the ability to assess the effectiveness of the prenatal clinic intervention, there are numerous promising features based on preliminary results.
{"title":"Providing Prenatal Care in a Student Run Free Clinic","authors":"Chloe Warpinski, Nathan Burke, Sanaz Dovell, Michelle McCraw, Caroline King, Amy Stanley, Krystal Stennett, Tory Finley, Michelle Nall, Mallory LeBlanc, Nicole Diaz, Phillip Mackie, Erica Smith, Lauren Silva, Kathleen Green, Reem Abu-Rustum","doi":"10.59586/jsrc.v10i1.392","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.392","url":null,"abstract":"Background: Prenatal care is a cornerstone of maternal and child health. This paper describes the creation of a free prenatal clinic for uninsured families following recognition of a significant disparity in birth outcomes in Alachua County, Florida including: the development of essential community re- source collaborations, clinical operations in a dual aim patient care-medical education site, preliminary outcomes after one year of clinical operation, identified challenges, and next steps for our growing program. \u0000Methods: A retrospective chart review of all sixteen patients enrolled with the student run free prenatal clinic in its first year of clinical operation. Analysis included assessment of the prenatal care course using descriptive statistics. Specific dimensions assessed include timing of transition of care to a traditional obstetrics clinic, clinical findings and diagnoses identified at the prenatal clinic, and birth out- comes during the study period and report findings as descriptive statistics. \u0000Results: The clinic has demonstrated the ability to identify and treat numerous pathologies which may impact maternal-fetal morbidity and mortality. The clinic has seen very high rates of patient retention and has demonstrated successful transition of patients to higher levels of care when indicated. Finally, the clinical model provides an uncommon opportunity for medical and physician assistant students to care for patients throughout the first 32 weeks of pregnancy and receive additional training in point-of-care ultrasound, diagnostics, and medical decision making. \u0000Conclusion: While the small sample size limits the ability to assess the effectiveness of the prenatal clinic intervention, there are numerous promising features based on preliminary results.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"26 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139855917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To mitigate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the pandemic, many ambulatory healthcare practices were either deferred or temporarily discontinued. Concern surrounding exposure risk to the virus has also deterred patients from seeking elective or preventative care. Similarly, medical schools were forced to rapidly adapt and develop protocols to protect students that suspended direct patient contact, especially if this experience was deemed elective to their primary academic requirements. At the intersection of these challenges to providing safe patient care and didactic training for students were student-run free clinics. The Coyote Clinic is a medical student-run clinic affiliated with the University of South Dakota Sanford School of Medicine and Avera Medical Group Health Care Clinic that provides free, basic healthcare services and screening to uninsured community members of the greater Sioux Falls, South Dakota area. On the heels of the coronavirus disease 2019 (COVID-19) pandemic, a decreased patient volume forced multiple instances of closures at the Coyote Clinic. In an effort to catalyze the return of patients to the clinic and enhance the educational enrichment for the student volunteers, a novel on-call workflow was devised that prioritizes walk-in patients. This on-call model is more attractive to attending physician volunteers and offers an alternative learning avenue for trainees. Here, we describe the new model we have implemented at the Coyote Clinic for other student-run free clinics that may be facing similar barriers in re-establishing themselves in their communities.
{"title":"Calling All Coyotes: An On-Call Model for Student-Run Free Clinics","authors":"Tiffany Bender, Riley Paulsen, Alaire Buysse, Jamuna Buchanan, Mamoon Ahmed, Mark Beard","doi":"10.59586/jsrc.v10i1.389","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.389","url":null,"abstract":"To mitigate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the pandemic, many ambulatory healthcare practices were either deferred or temporarily discontinued. Concern surrounding exposure risk to the virus has also deterred patients from seeking elective or preventative care. Similarly, medical schools were forced to rapidly adapt and develop protocols to protect students that suspended direct patient contact, especially if this experience was deemed elective to their primary academic requirements. At the intersection of these challenges to providing safe patient care and didactic training for students were student-run free clinics. The Coyote Clinic is a medical student-run clinic affiliated with the University of South Dakota Sanford School of Medicine and Avera Medical Group Health Care Clinic that provides free, basic healthcare services and screening to uninsured community members of the greater Sioux Falls, South Dakota area. On the heels of the coronavirus disease 2019 (COVID-19) pandemic, a decreased patient volume forced multiple instances of closures at the Coyote Clinic. In an effort to catalyze the return of patients to the clinic and enhance the educational enrichment for the student volunteers, a novel on-call workflow was devised that prioritizes walk-in patients. This on-call model is more attractive to attending physician volunteers and offers an alternative learning avenue for trainees. Here, we describe the new model we have implemented at the Coyote Clinic for other student-run free clinics that may be facing similar barriers in re-establishing themselves in their communities.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"42 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139806008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To mitigate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the pandemic, many ambulatory healthcare practices were either deferred or temporarily discontinued. Concern surrounding exposure risk to the virus has also deterred patients from seeking elective or preventative care. Similarly, medical schools were forced to rapidly adapt and develop protocols to protect students that suspended direct patient contact, especially if this experience was deemed elective to their primary academic requirements. At the intersection of these challenges to providing safe patient care and didactic training for students were student-run free clinics. The Coyote Clinic is a medical student-run clinic affiliated with the University of South Dakota Sanford School of Medicine and Avera Medical Group Health Care Clinic that provides free, basic healthcare services and screening to uninsured community members of the greater Sioux Falls, South Dakota area. On the heels of the coronavirus disease 2019 (COVID-19) pandemic, a decreased patient volume forced multiple instances of closures at the Coyote Clinic. In an effort to catalyze the return of patients to the clinic and enhance the educational enrichment for the student volunteers, a novel on-call workflow was devised that prioritizes walk-in patients. This on-call model is more attractive to attending physician volunteers and offers an alternative learning avenue for trainees. Here, we describe the new model we have implemented at the Coyote Clinic for other student-run free clinics that may be facing similar barriers in re-establishing themselves in their communities.
{"title":"Calling All Coyotes: An On-Call Model for Student-Run Free Clinics","authors":"Tiffany Bender, Riley Paulsen, Alaire Buysse, Jamuna Buchanan, Mamoon Ahmed, Mark Beard","doi":"10.59586/jsrc.v10i1.389","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.389","url":null,"abstract":"To mitigate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the pandemic, many ambulatory healthcare practices were either deferred or temporarily discontinued. Concern surrounding exposure risk to the virus has also deterred patients from seeking elective or preventative care. Similarly, medical schools were forced to rapidly adapt and develop protocols to protect students that suspended direct patient contact, especially if this experience was deemed elective to their primary academic requirements. At the intersection of these challenges to providing safe patient care and didactic training for students were student-run free clinics. The Coyote Clinic is a medical student-run clinic affiliated with the University of South Dakota Sanford School of Medicine and Avera Medical Group Health Care Clinic that provides free, basic healthcare services and screening to uninsured community members of the greater Sioux Falls, South Dakota area. On the heels of the coronavirus disease 2019 (COVID-19) pandemic, a decreased patient volume forced multiple instances of closures at the Coyote Clinic. In an effort to catalyze the return of patients to the clinic and enhance the educational enrichment for the student volunteers, a novel on-call workflow was devised that prioritizes walk-in patients. This on-call model is more attractive to attending physician volunteers and offers an alternative learning avenue for trainees. Here, we describe the new model we have implemented at the Coyote Clinic for other student-run free clinics that may be facing similar barriers in re-establishing themselves in their communities.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139865550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer J Bu, Arash Delavar, John Kevin Dayao, Alexander Lieu, Benton G Chuter, Kevin Chen, Taiki Nishihara, Leo Meller, Andrew S Camp, Jeffrey E Lee, Sally L Baxter
Background: Diabetic retinopathy (DR) is a sight-threatening condition that causes progressive retina damage. Student-run free clinics represent a valuable opportunity to provide DR screenings to high-risk populations. We characterized the patient population, evaluated the performance, and conducted a needs assessment of DR screenings at the University of California, San Diego Student-Run Ophthalmology Free Clinic, which provides care to predominantly uninsured, Latino patients.
Methods: Retrospective chart review was conducted of all patients seen at the free clinic since 2019 with a diagnosis of type II diabetes. Date and outcome of all DR-related screenings or visits from 2015 onward, demographics information, and DR risk factors such as A1c and insulin dependence were recorded. Predictors of diabetic retinopathy and frequency of DR screenings for each patient were analyzed using multiple logistic regression, t-test for equality of means, and Pearson's correlation.
Results: Of 179 uninsured diabetic patients receiving care at the free clinic, 71% were female and average age was 59. 83% had hypertension, 93% had hyperlipidemia, and 79% had metabolic syndrome. Prevalence of non-proliferative DR was 34% and that of proliferative DR was 15% in diabetic patients. The free clinic capacity in recent years plateaued at just under 50% of patients seen for DR screening or visit per year, though average wait time was over 2 years between visits. Patients with higher no-show rates had less frequent DR screenings. Chronic kidney disease and poor glycemic control were the strongest predictors of DR.
Conclusion: The student-run free ophthalmology clinic has been effective in providing screening and follow-up care for DR patients. Creation of a protocol to identify which patients are at highest risk of DR and should be seen more urgently, addressing no-shows, and implementation of a tele-retina program are potential avenues for improving clinic efficiency in a resource-limited setting for vulnerable populations.
背景：糖尿病视网膜病变（DR）是一种危及视力的疾病，会导致视网膜逐渐受损。学生开办的义诊是为高危人群提供糖尿病筛查的宝贵机会。我们对加利福尼亚大学圣地亚哥分校学生开办的眼科免费诊所的患者群体进行了描述，对其表现进行了评估，并对 DR 筛查的需求进行了评估：方法：对自 2019 年以来在免费诊所就诊的所有诊断为 II 型糖尿病的患者进行回顾性病历审查。记录了自 2015 年以来所有与糖尿病相关的筛查或就诊的日期和结果、人口统计学信息以及糖尿病风险因素（如 A1c 和胰岛素依赖性）。使用多元逻辑回归、均值 t 检验和皮尔逊相关性分析了每位患者的糖尿病视网膜病变预测因素和糖尿病视网膜病变筛查频率：在免费诊所接受治疗的 179 名无保险糖尿病患者中，71% 为女性，平均年龄为 59 岁。83%患有高血压，93%患有高脂血症，79%患有代谢综合征。糖尿病患者中，非增殖性 DR 的发病率为 34%，增殖性 DR 的发病率为 15%。近年来，免费诊所的接待能力趋于稳定，每年仅有不到 50%的患者接受 DR 筛查或就诊，但两次就诊之间的平均等待时间超过 2 年。未就诊率较高的患者接受 DR 筛查的频率较低。慢性肾病和血糖控制不佳是预测 DR 的最主要因素：由学生开办的免费眼科诊所在为 DR 患者提供筛查和后续治疗方面非常有效。在资源有限的情况下，为弱势群体提高诊所效率的潜在途径包括：制定一项协议，以确定哪些患者罹患 DR 的风险最高，应立即就诊；解决爽约问题；以及实施远程视网膜计划。
{"title":"Evaluation and Optimization of Diabetic Retinopathy Screenings for Uninsured Latinx Patients in a Resource-Limited Student-Run Free Clinic.","authors":"Jennifer J Bu, Arash Delavar, John Kevin Dayao, Alexander Lieu, Benton G Chuter, Kevin Chen, Taiki Nishihara, Leo Meller, Andrew S Camp, Jeffrey E Lee, Sally L Baxter","doi":"10.59586/jsrc.v10i1.407","DOIUrl":"10.59586/jsrc.v10i1.407","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a sight-threatening condition that causes progressive retina damage. Student-run free clinics represent a valuable opportunity to provide DR screenings to high-risk populations. We characterized the patient population, evaluated the performance, and conducted a needs assessment of DR screenings at the University of California, San Diego Student-Run Ophthalmology Free Clinic, which provides care to predominantly uninsured, Latino patients.</p><p><strong>Methods: </strong>Retrospective chart review was conducted of all patients seen at the free clinic since 2019 with a diagnosis of type II diabetes. Date and outcome of all DR-related screenings or visits from 2015 onward, demographics information, and DR risk factors such as A1c and insulin dependence were recorded. Predictors of diabetic retinopathy and frequency of DR screenings for each patient were analyzed using multiple logistic regression, t-test for equality of means, and Pearson's correlation.</p><p><strong>Results: </strong>Of 179 uninsured diabetic patients receiving care at the free clinic, 71% were female and average age was 59. 83% had hypertension, 93% had hyperlipidemia, and 79% had metabolic syndrome. Prevalence of non-proliferative DR was 34% and that of proliferative DR was 15% in diabetic patients. The free clinic capacity in recent years plateaued at just under 50% of patients seen for DR screening or visit per year, though average wait time was over 2 years between visits. Patients with higher no-show rates had less frequent DR screenings. Chronic kidney disease and poor glycemic control were the strongest predictors of DR.</p><p><strong>Conclusion: </strong>The student-run free ophthalmology clinic has been effective in providing screening and follow-up care for DR patients. Creation of a protocol to identify which patients are at highest risk of DR and should be seen more urgently, addressing no-shows, and implementation of a tele-retina program are potential avenues for improving clinic efficiency in a resource-limited setting for vulnerable populations.</p>","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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