202 - Impact of a Community Pediatrics Curriculum Compared to Standard Clerkship Curriculum on Student Educational Development

Publication Number: 202.5398

Ria Gupta, Johns Hopkins University School of Medicine, Katy, TX, United States; Amy Davis, Johns Hopkins School of Medicine, Baltimore, MD, United States; C. Nicholas Cuneo, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Eric Balighian, Johns Hopkins University School of Medicine, Baltimore, MD, United States; W. Christopher Golden, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Emily Murphy, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Background: The Association of American Medical Colleges (AAMC) defines entrustable professional activities related to community health. Although successful community pediatric curricula have been reported in graduate medical education, a literature gap exists on how these curricula alter educational development for medical students (MS).

Objective: We assessed the change in experience and attitudes surrounding community pediatrics activities in pediatric clerkship MS either exposed or not exposed to a site-based community pediatrics curriculum (CPC).

Design/Methods: Johns Hopkins University School of Medicine (JHUSOM) MS rotating at the community pediatrics site, Ascension Saint Agnes Hospital (SAH), participate in a CPC. We compared students assigned to SAH exposed to the CPC and students at 2 academic Johns Hopkins (JH) pediatric sites exposed to a standard curriculum. The voluntary pre- and post-survey included evaluation of frequency of community activities (1=never, 5=substantial), confidence with community-related activities (1=not at all confident, 4=extremely confident), and level of agreement with community-related statement (1=strongly disagree, 5=strongly agree). SAH MS completed survey items related to curriculum completion and satisfaction. We performed descriptive statistics to describe frequencies and mean Likert scales by group, and two-way repeat measures ANOVA to compare change in scores between and within groups. The study was approved by the Institutional Review Board.

Results: 196 MS were sent surveys. 17 SAH MS (32.7%) and 53 JH MS (36.8%) responded to the pre-survey, and 9 SAH MS (17.3%) and 18 JH MS (12.5%) responded to the post-survey. While MS Likert scores increased post-clerkship across domains (Table 1), we observed a rotation-specific change in confidence in collaborating with community-based organizations (F 8.877, p=0.006) and agreement that MS should participate in post-discharge home visits (F 4.308, p=0.048). In the SAH cohort, partipation in CPC activities was variable, but CPC satisfaction was overall high (Table 3): 100% of students (9/9) reported that the CPC improved their clerkship experience, and 8/9 reported that the activities increased their empathy for patients.

Conclusion(s): Both standard and community-focused pediatric clerkship curricula result in changes in self-reported experience and attitudes, whereas the MS exposed to the CPC had a significant change in scores related to CPC-specific activities. While our study is limited by survey response rates, we found that MS curriculum satisfaction was high.

Table 1: Pre- and post-survey analysis of experience, confidence, and attitude of medical students with or without a site-based Community Pediatrics Curriculum
*Pre: JHCC N=48/130, JHACH N= 5/14; Post: JHCC + JHACH N=18/ 144
**F, p-value calculated from serial two-way repeated measures ANOVA analyses assessing the effect of the independent factors time (pre- vs. post-rotation) and rotation site (SAH vs. JH) on each dependent factor (survey outcome variables)
***Number approaches zero
Abbrev: SAH, Ascension St. Agnes Hospital; JHCC, Johns Hopkins Children’s Center; JHACH, Johns Hopkins All Children’s Hospital; SD, standard deviation; SDoH, social drivers of health

Table 2. Community Pediatrics Curriculum participation and satisfaction
Abbrev: SAH, Ascension St. Agnes Hospital