Training Toward Health Justice: A Review of Community-Engaged Training in Primary Care Residency Programs in the United States.

Purpose: A community-engaged approach to medicine, particularly primary care, is effective for health promotion. There is, however, limited evidence and no consensus on best training practices to ensure that physicians are trained adequately to practice community-engaged medicine. To define and determine how to fill this gap, the authors conducted a systematic review of literature on community-engaged activities in primary care resident training programs. The study sought to evaluate the quality of studied interventions and assess future research needs.

Method: For this systematic review, the study team searched PubMed, MEDLINE, and PsycINFO using key search terms related to graduate medical education, community engagement activities, and potential outcomes. The team selected and reviewed all English-language articles published through December 2024 that described interventions in which primary care residents participated in activities that occurred in community-based settings. The team analyzed studies with quantitative and qualitative results. They assessed study quality using the Medical Education Research Study Quality Instrument (MERSQI) and assessed the quality of the community-engaged educational activity using a novel instrument called the Medical Education Engagement Quality Index (MEEQI).

Results: The study team identified and reviewed the full texts of 29 articles (10 quantitative, 10 qualitative, and 9 quantitative and qualitative articles). Interventions included community engagement activities with varied settings, study length, and learning objectives. Outcomes included a change in attitudes, knowledge, skills, and career choices. The mean MERSQI score was 9.0 (range, 5.5-11.5), and the mean MEEQI score was 6.2 (range, 4.0-10.0).

Conclusions: The authors' findings revealed limited quality and substantial variability of the current literature. Future research should use more rigorous evaluation methods to determine which community-engaged curricular components can most effectively provide primary care resident physicians with the skills needed to provide high-quality primary care, particularly for vulnerable populations.