Journal of student-run clinics最新文献

{"title":"Otolaryngology in Medical Education: Hands-on Training at an SRFC Community Site Improves Medical Student Knowledge and Skills","authors":"Abigail Groszkiewicz, Hemchandra Patel, Joseph Walden, Benjamin Dreskin, Adam McCann, Raisa Tikhtman, Joseph Kiesler, Megan Rich","doi":"10.59586/jsrc.v10i1.446","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.446","url":null,"abstract":"Background: There are known otolaryngology education gaps and exposure inequalities in existing medical school curricula. It has been shown that students participating in otolaryngology instruction sessions emerge with increased knowledge and confidence in skills. The population our student-run free clinic serves is high-risk for head and neck cancers, and evidence has shown that clinical exams are a very effective tool for early detection of these lesions. In this study, our clinic offered head and neck cancer screening events to meet community needs as well as student training nights to meet student education needs. \u0000Methods: Medical students of all training levels were invited to participate. Participating students first completed a pre-training interests and skills assessment survey and a knowledge test. Students then attended a training night led by otolaryngology residents that included an educational lecture and hands-on skills practice. Afterwards, students re-took the knowledge test. One week later, students participated in the live screening event at the clinic. Afterwards, students completed another interest and skills assessment survey. \u0000Results: Sixty students attended our three student training nights. Pre-participation (n=53), 52.5% of students were interested in otolaryngology as a specialty, most students felt little to no confidence in performing a general head and neck exam (66%) or taking a head and neck cancer history (81%), and the average knowledge test score was 58% correct. The post-training (n=41) average knowledge test score increased to 78.3% correct, a statistically significant increase (p < 0.001). Post-event participation (n=20), most students reported increased interest in otolaryngology (75%), and improved confidence in performing an exam (95%) and taking a history (95%). \u0000Conclusions: Participation in our student training night and head and neck cancer screening event increased students’ interest in otolaryngology as a specialty, their confidence in otolaryngology physical exam skills and their knowledge about head and neck cancer.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"57 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141923575","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}

{"title":"Improving Documentation of and Access to Diabetic Retinopathy Screening at a Student-Run Free Clinic","authors":"Aleksandra Zarska, Sharmi Amin, Joshua R Ehrlich, Hari Conjeevaram","doi":"10.59586/jsrc.v10i1.438","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.438","url":null,"abstract":"Background: Diabetic retinopathy (DR) affects approximately 9.6 million people in the United States (US) and is the leading cause of vision loss in working-age adults. However, less than 50% of people with diabetes in the US undergo the recommended screening. We aimed to assess need for DR screening (DRS) at the University of Michigan Student-Run Free Clinic (UMSRFC) and examine current DRS documentation practices to inform quality improvement initiatives at the clinic. \u0000Methods: We conducted a needs-assessment survey of 67 patients to examine access to eye and vision care among patients seen at the UMSRFC between January and April 2023. Descriptive analysis of survey data was performed. A retrospective chart review of all patients seen at the clinic between March 2021 and March 2023 was conducted to evaluate documentation of DRS in the medical record. These results informed the development of a DRS initiative at the clinic. \u0000Results: Of the 67 patients surveyed, 17 had a diagnosis of diabetes. Twenty-six patients reported an eye problem, of which 16 (62.0%) reported blurry vision, 9 (35.0%) reported floaters, and 1 (4.0%) reported dark/empty areas in their vision. Chart review yielded 404 patients, of which 70 had a diagnosis of type 2 diabetes. Twenty-eight (40.0%) had any mention of a diabetic eye exam in their chart, and 12 of these were up to date with the American Diabetes Association (ADA) screening guidelines. Twenty-three (33.0%) patients had any mention of a referral to an optometrist or ophthalmologist in their chart. On the DRS day, three patients were screened for DR. No cases of DR were identified. \u0000Conclusion: Survey and chart review data indicated a need for increased DRS and improved documentation practices of DRS at the UMSRFC. A DRS initiative was successfully implemented at the UMSRFC under the oversight of an ophthalmologist.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670948","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}

{"title":"Success and Challenges of Establishing a Teledermatology Pilot Service at a Student-Run Clinic","authors":"Hannah Rashdan, Georgia E Williams, Daniel Bamrick-Fernandez, Alma Rosa Rivera, Attilie Carrig, Dayna Diven","doi":"10.59586/jsrc.v10i1.410","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.410","url":null,"abstract":"Background: Dermatologic issues are the primary reason people experiencing homelessness (PEH) seek care.1 Furthermore, the closure of clinics and shelters during the coronavirus disease 2019 (COVID-19) pandemic highlighted care disparities and the need for telehealth services.2,3 Though teledermatology is feasible and reliable, many PEH do not have access to dermatologists, often due to few dermatologists accepting public health insurance programs.4 This study investigated the challenges and successes of a teledermatology pilot within an existing student-led clinic for PEH, the diagnostic concordance between onsite primary care providers (PCP) and teledermatologists, as well as the quality of life of PEH with dermatologic issues to better understand the impact of cutaneous conditions of the unhoused. \u0000Methods: A teledermatology consultation service was established at a student-led clinic in Austin, Texas. Teleconsultations were conducted with offsite dermatology residents using a secure messaging platform. PCP diagnoses were recorded prior to the teledermatologist consultation. Patients completed the Dermatology Life Quality Index survey upon visit completion. \u0000Results: We had several successes in implementing this teledermatology pilot service, including smooth integration of the service, sustainability through cross-class collaboration, earlier in-person follow-up, and dermatologic education for PEH. However, we also encountered challenges, including limited patient volume with ongoing construction and remote site location, inadequate patient access to medication with no onsite pharmacy, and limited medical literacy. \u0000Conclusions: In this pilot program, reasonable patient volume suggests this model is sustainable for both student-led clinics and dermatology residents. PCPs can limit use of this service to diagnostic and therapeutic dilemmas given the high concordance in diagnoses. Future directions include increasing the magnitude of patients served and collaborating with the student-run clinic team to address upstream social determinants of health. We hope this pilot study provides evidence that this teledermatology model is replicable in other clinic settings and potentially with other specialties.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"60 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353255","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}

{"title":"Pushing and Establishing New Frontiers: An Examination of Publication Patterns From 2015-2023 in the Journal of Student-Run Clinics","authors":"Oliver T Nguyen, Joseph C Rumenapp, David Lee, Hardik Patel, Kevin Chen, Kendall Major","doi":"10.59586/jsrc.v10i1.483","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.483","url":null,"abstract":"Background: The Journal of Student-Run Clinics (JSRC) has published research from student-run clinics (SRCs) for almost ten years. However, to date, no study has aimed to summarize publishing trends observed at JSRC. Thus, we aimed to characterize these JSRC publications in order to identify patterns in published research topics, identify research gaps, and inform future research priorities. \u0000Methods: We adapted scoping review methodology and included all articles published in the JSRC from 2015 to 2023. For each article, we assessed for publication year, article type, university affiliated with the SRC, region of the United States (US) the SRC is located in, disease focus, outcomes studied, data collection methods used, sample size, interventions involved, analytic approaches used, and concept domains involved. Concept domains were determined using a taxonomy from the Agency for Healthcare Research and Quality (AHRQ) to identify patterns in topical content from published articles. \u0000Results: This review included 167 articles. Over time, we observed an increasing trend of overall publication volume (e.g., 5 in 2015 vs 23 in 2023). Studies typically occurred in the primary care context with fewer studies in other outpatient specialties (e.g., ophthalmology, physical therapy). The most common domains were workforce (21.3%), workflows (17.4%) and practice/quality improvement (17.4%). Empirical studies typically used surveys (52.1%) or chart reviews of patient records (38.5%) for data sources. Less than half of the studies aimed to assess the impact of an intervention. \u0000Conclusion: This review highlighted significant strides made on research in SRCs. Future studies reporting intervention may benefit from adhering to established reporting guidelines. Additional studies are needed across several areas, including understanding the impact of non-primary care SRCs, assessing quality of care and clinical outcomes, and employing qualitative and/or mixed methods approaches when studying interventions’ impact on patients and volunteers.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"19 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123877","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}

{"title":"Standardization of Clinic Flow to Improve Patient Experience in a Student-Run Free Clinic","authors":"Neal Modi, Pranav Nandan","doi":"10.59586/jsrc.v10i1.434","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.434","url":null,"abstract":"The Saint Louis University Health Resource Center, a student-run free clinic, has seen a rapid expansion in both the number of services supplied by the clinic and the number of patients seen at clinic. While we are excited to serve more patients, the increase in volume has resulted in increased wait times and clinic throughput, the most frequent complaint of patients. To combat these growing concerns, we standardized the route patients take through the services the clinic provides and embedded this flow into a new statusboard that automatically logs the amount of time patients spend with each service and in the clinic overall. This information feeds directly into a process map of the clinic that better visualizes clinic processes. The utilization of a standardized statusboard resulted in a significant 12 minute and 44 second reduction in the median time patients spend in clinic and identified key decision points where bottlenecks occur in clinic flow. It also resulted in a statistically significant improvement in patent satisfaction. Our results demonstrate that standardizing clinic flow via an automated statusboard improves clinic efficiency, reduces throughput time, and can also significantly improve patient satisfaction. The resulting process map can also identify areas needing intervention and opportunities to continue expanding. As we continue to gather data on where clinic patients are spending the most time, we will continue to optimize services to provide the best experience possible for our patients.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"36 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975657","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}

{"title":"Development of a Medication Refill System - A Collaboration Between Telemedicine and Pharmacy Departments","authors":"Stephen Denton, Delaney Cairns, Gabrielle Marchese, Adam Rich, Aditya Jadcherla, David Scott, Jacob Dyer, Rebecca Lundh, Staci Young, Rachele Harrison","doi":"10.59586/jsrc.v10i1.412","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.412","url":null,"abstract":"Background: The Saturday Clinic for the Uninsured (SCU) has an on-site dispensary that provides free medications to patients. Many patients request urgent refills when they run out leaving them without medications prior to their appointments. A prior study showed a reminder phone call can effectively assist with medication refills.1 However, little data exists for how to develop such a system at a free clinic. Our team implemented this methodology utilizing a system where patients were contacted before their medications ran out to arrange refills and analyzed its effectiveness. \u0000Methods: All clinic patients receiving medications from the on-site dispensary had their expected refill date logged. Patients 3 weeks away from needing a refill had their chart reviewed to determine if they should be contacted. When indicated, patients were contacted one time via telephone by students to assess their needs and schedule refills. System outcomes were gathered over 18 weeks and analyzed to determine the number of potential medication gaps prevented and system success rate. \u0000Results: 131 patient charts were reviewed for potential follow-up. 58 patients were contacted, of which 32 patients were reached and spoken with resulting in 32 refills scheduled. The system prevented 24.4% of potential medication gaps with a system success rate of 55.2%. \u0000Conclusion: This system successfully reduced medication gaps among patients. The most and least effective methods for scheduling refills were by directly speaking with patients and leaving voicemails respectively. A trend observed was a decrease in urgent patient calls regarding medication gaps. Future directions include making multiple contact attempts, using multiple contact methods including texts and emails, and evaluating adherence.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994350","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}

{"title":"Recruitment of Hard-To-Reach Populations in Randomized Controlled Trials Using Medical Students and Electronic Con-sents","authors":"Austin Jones, Anadil Zakaria, Latha Rajan, Patricia Kissinger","doi":"10.59586/jsrc.v10i1.363","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.363","url":null,"abstract":"Viral hepatitis is concentrated in populations with low healthcare system engagement, including non-white, rural, non-English speaking, and low socioeconomic status persons. Recruiting these participants for clinical trials has immense implications for trial feasibility and generalizability. Through the example of a trial delivering a behavioral intervention to patients with hepatitis C virus (HCV) in a network of medical student-run clinics, we describe the implementation of a student-run HCV testing program in the community and describe novel strategies to improve the recruitment of hard-to-reach participants using medical student counselors and electronic consents.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994779","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}

{"title":"Anxiety and Depression Prevalence in Free Clinic Patients","authors":"Jack Kovarik, Macie Bokelman, Margaret Smith","doi":"10.59586/jsrc.v10i1.419","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.419","url":null,"abstract":"Background: Disparities in mental health services are often observed in under-resourced low-income communities, which are at an increased risk for compromised mental health. By surveying patients at JayDoc Free Clinic, a student-run free clinic (SRFC) in Kansas City, Kansas, this study sought to as-sess the prevalence of depression and anxiety and compare screening outcomes among various de-mographic groups seeking safety-net care.Methods: From May through November 2022, patients aged 12 and older were offered a Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and demographic survey. Demo-graphic variables included household income, gender, insurance status, and race and ethnicity. GAD-7 and PHQ-9 questionnaire scores were categorized into minimal, mild, moderate, or severe catego-ries. Relationships between demographic variables and scores on screening questionnaires were an-alyzed using multivariable analyses, with linear regression and analysis of variance one-way tests for significance (p-value <0.05).Results: Of 232 participants who consented to the study, 222 completed the GAD-7 and 228 com-pleted the PHQ-9. In comparison to 2019 United States national data, the percentage of respondents experiencing anxiety and depression was greater across all severity classifications. Approximately 18.1% reported symptoms of moderate to severe anxiety and 21.5% reported symptoms of moderate to severe depression, compared to national distributions of 6.1% and 7%, respectively. Of 232 participants, 54 completed the demographic survey. There was no correlation between PHQ-9 scores or GAD-7 scores and gender, household income, insurance status.Conclusion: While no association was identified between screening outcomes and demographic var-iables, the findings that the prevalence of anxiety and depression at JayDoc SRFC is greater than na-tional rates reaffirm the need for accessible mental health services for patients receiving care at SRFCs. This study provides insight into the status of mental health in an SRFC patient population and discusses mental health screening implementation at SRFCs.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"222 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704242","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}

{"title":"Establishing the First Student-Run Clinic to Provide Free Health Care to a South Texas Colonia","authors":"John Nicholas Cauba, Andrew Callan, Joy Alvarado, Beatriz Tapia","doi":"10.59586/jsrc.v10i1.415","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.415","url":null,"abstract":"The University of Texas Rio Grande Valley School of Medicine (UTRGVSoM) opened its student-run clinic (SRC) in March 2018 to provide free health care for the residents of Pueblo de Palmas colonia in Hidalgo County. Located along the United States-Mexico border near some of the country's poorest and most medically underserved communities, UTRGVSoM has the unique opportunity to extend quality primary care to those who otherwise would go without. The physical location of the clinic was determined by a partnership with Proyecto Desarrollo Humano, a nonprofit organization within the Pueblo de Palmas colonia. The free clinic, located in the town’s community center, opens its doors to the public every month on a chosen Saturday. This article hopes to detail the experience of being the first SRC to operate inside a Texas colonia.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"60 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729669","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}

{"title":"Ophthalmology Encounters During the COVID-19 Pandemic in a Student Run Free Clinic","authors":"Anindya Samanta, Alexander Park, Kelly Mitchell","doi":"10.59586/jsrc.v10i1.418","DOIUrl":"https://doi.org/10.59586/jsrc.v10i1.418","url":null,"abstract":"Background: Ophthalmology services at student run free clinics (SRFC) serve an important role for the socioeconomically underserved within a city. The coronavirus disease 2019 (COVID-19) pandemic has worsened gaps in care for ophthalmology tertiary clinics, but its effects on ophthalmology encounters at SRFCs are not known. \u0000Methods: This was a retrospective chart review from a single center that compared patient encounters in the ophthalmology SRFC six months prior to its closure (pre-COVID group) with patient encounters in the ophthalmology SRFC six months after its reopening (post-COVID closure group). \u0000Results: There was a decline (47.3%) in the number of encounters in the post-COVID closure group (n=20) when compared to the pre-COVID group (n=38). While the number of encounters for routine screening stayed about the same in both groups, there was a 90.5% decline in encounters with active disease (21 pre-COVID vs. 2 post-COVID closure). Sub-group analysis of the pre-COVID group showed that patients with active disease tended to have worse vision (-0.33 logMAR, p=0.034 OD; -0.27 logMAR, p=0.048 OS) than those undergoing routine screening. \u0000Conclusions: Patients in West Texas with active eye diseases are not presenting to SRFC after its reopening. Early recognition of this is critical to address the potential gap in care in a vulnerable population.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"96 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249457","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}