Riding into Reality: How Ride-Alongs with Mobile Integrated Healthcare Shape Medical Student Understanding of Social Determinants of Health.

Abstract

Objectives: Medical students rarely get the opportunity to witness the impact of social determinants of health (SDOH) on patients within their community. Mobile integrated health care (MIH) programs utilize community paramedics (CPs) to tackle patient-specific SDOH to promote continuity of care and linkage to treatment for patients lacking access to health care resources. This study discusses the creation of an MIH ride-along program for medical students and assesses whether ride-along participation would influence medical students' knowledge and perceptions of SDOH and the role SDOH play in accessing health care resources.

Methods: First- or second-year medical students in the Southeastern United States completed at least one 8-hour ride-along with the MIH program. Pre-shift surveys assessed baseline SDOH knowledge and post-shift surveys reassessed SDOH knowledge and documented students' perceptions on the educational value of the ride-along. Five key categories of SDOH assessed included: 1) education quality and access, 2) health care quality and access, 3) economic stability, 4) neighborhood and built environment, and 5) social and community context. Paired t-tests assessed differences in the mean scores pretest and post-test.

Results: The 33 participants were predominantly White (72.0%) and female (64.0%), with an average age of 26 (±3.84). Students conducted home visits (93.0%), medication reconciliations (67.0%), chronic disease education (48.0%), lab draws (48%), and social and resource referrals (35.0%) during ride-alongs. Nearly all (94.0%) reported the MIH program improved their understanding of all five SDOH categories and health care challenges within their community. All but one recommended permanent integration of MIH ride-alongs into the medical school curriculum.

Conclusions: Working alongside CPs to care for underserved patients increased medical student knowledge of SDOH and heightened awareness of how SDOH impacts patients' health care within their local community. Most recommended integrating the MIH program into the medical school curriculum. Medical educators should consider incorporation of MIH interactions to enhance real-world experience with SDOH.