PC2087: Population Science and Policy in Practice: Integrating PSP in the Pediatrics Clerkship

Background: The Department of Population Science and Policy (PSP) at Southern Illinois University School of Medicine (SIU SOM) aimed to integrate Health Systems Science (HSS) topics into the Pediatrics clinical clerkship, and train residents and faculty on how to recognize and teach HSS in clinical settings.

As PSP worked to formalize the preclinical HSS curriculum for medical students in years one and two, it became apparent that there is a need to address how students apply their knowledge of HSS in clinical experiences during year three. Concurrently, the Department of Pediatrics (Pediatrics) Residency program utilized their annual survey and found that residents identified a need for increased education around social determinants of health (SDH) and healthcare disparities (HCD). In collaboration with Pediatrics, PSP developed curriculum to aid students, residents, and faculty in recognizing opportunities to incorporate these learning issues during clinical encounters.

Methods: During the Pediatrics clerkship orientation, a faculty member or resident gives a lecture that reviews the HSS curriculum, goals for PSP in the clerkship, and specific examples of SDH and HCD in Pediatrics. Content is focused on helping students understand the historical and systemic barriers that impact pediatric health outcomes, and how policy can affect both population health and individual patients. A similar lecture was also presented to residents and faculty.

During orientation, students are asked to complete an anonymous, voluntary survey that gauges self-assessment of knowledge and confidence level around clinical examples of SDH and HCD in Pediatrics. This survey established a basis of pre-clerkship knowledge, explored students’ perceived confidence in identifying HSS topics in a clinical setting and how to address those issues once identified, and gave feedback to the residents and faculty about teaching these topics during clerkship. At the end of the clerkship, students are invited to an optional lunchtime session to discuss and share their experience and complete a post-survey. Similar surveys were also given to residents and faculty.

Results: The students demonstrated an overall increase in confidence (20-63%) in identifying and applying SCD and HCD knowledge to clinical situations in Pediatrics. Student surveys noted the residents and faculty were very receptive to HSS topic discussion. Faculty also provided positive feedback about the recommended methods for incorporating HSS teaching into everyday pediatric clinical encounters.

Conclusion: Integrating HSS topics into clinical clerkships helps students strengthen connections between their preclinical knowledge and what they see in practice, as well as learning how to apply these important concepts in patient encounters. Of those students that completed both the pre and post-surveys, there was a consistent increase in confidence levels for all areas assessed.
Future work will broaden the curriculum to all third-year clerkships and assess application of knowledge to clinical situations.