1. Teaching Medical Students about Patient-Provider Partnerships Through Chronic Condition Self-Management Training
Christine Hur, MD and Joan Ilardo, PhD
Michigan State University, College of Human Medicine
The research reported on this poster was supported by the students and faculty at MSU College of Human Medicine ,
Michigan Partners on the PATH and the Office of Services to the Aging. The investigators retained independence in the conduct of this research.
AAMC Poster v v
Focus Group Quotes
Background v
What is the Michigan Partners on the PATH Program?
On Health Literacy
“Being in medical school sort of pulls you away from society. You get so used to these medical terms that [become] second nature to you. You [actively] have to think of how to say things in a simpler form [that patients will be able to understand].”
On Community Resources
“Knowing that [physicians] can refer these patients out to these community organizations that have a good track record of improving chronic care management means that you can spend more time on acute medical issues. I feel that one of the biggest challenges in primary care is knowing these resources.” On Understanding Patients’ perspectives
“Putting yourself in the position of a patient making action plans and realizing that you are sometimes unable to follow them. From a physician’s perspective, I might think “why aren’t they doing [what is best for their health]” but [by putting myself in the patients’ shoes] it allowed me to realize that ‘well I couldn’t do it either.’ It allows you to face the challenges that everyone faces.”
The management of chronic disease is the biggest concern that health care faces today.
50% of all adults have a chronic disease and 50% of those individuals have two or more chronic diseases.
According to the 2013 AAMC Graduation Questionnaire, 18.6% of medical students students felt inadequately prepared in long-term health care, a stark contrast to the 4.2% of students who felt inadequately trained in the care of hospitalized patients.
With the growing number of complex patients and limited number of health care providers, there has been a push towards a team management approach. Despite this, 24.4% of medical students felt inadequately education in the role of community and social service agencies.
PATH (Personal Action Towards Health) is the evidence-based Stanford chronic disease self management program (CDSMP)
A workshop is given two and a half hours, once a week, for six weeks, in community settings (senior centers, churches, libraries, etc.)
Shown to improve general health, fatigue, disability, social/role activities limitations and communication with physicians. Decreased hospitalizations, hospital stay durations and outpatient visits.
Lead by two trained leaders, one or both whom are non-health care professionals with chronic diseases themselves.
Provides tools that are useful in managing their health, covering topics including creating an action plan, medication and pain management, nutrition and communication.
Hypothesis
By integrating chronic condition self-management programs into medical education, we hypothesize students will be better prepared to manage those with chronic diseases and learn to use readily available community resources. v
Results
Six of the seven medical students participated in the focus group.
Students viewed chronic disease self-management education (CDSME) as a complementary component to their curriculum, finding that it provided a more realistic expectation of patients regarding “compliance with treatment” and gave insight into many aspects of patients’ lives.
Students found that the tools taught are widely applicable and effective regardless of what specialty they were pursuing.
Found it useful to know community resources available for referral.
Methods
Conclusion v
In August of 2013, seven first-year medical students at the College of Human Medicine Michigan State University (MSU) were recruited to participate in a modified PATH leader training.
Five months after the training, medical students participated in a focus group along with Michigan CDSME coordinators and MSU faculty.
Medical students that have gone through CDSMP leader training find that the incorporation of CDSME into medical school curriculum would better prepare their peers to manage individuals with chronic disease and understand the role that community agencies have in patient care.
Resources v
Who are these students and where are they headed now? v
Turner J, Pugh J, Budiani D. “It’s always continuing”: First-year medical students’ perspective on chronic illness and the care of chronically ill patients. Academic Medicine. 2005;80:
Mayer RS, Delateur BJ. Proposal for a required advanced clerkship in chronic disease and disability for medical students. American Journal of Physical Medicine and Rehabilitation. 2008;86:1-6.
Davis BE, Nelson DB, Sahler OJ, Mccurdy FA, Goldberg R, Greenberg L. Do clerkship experiences affect medical students’ attitudes towards chronically ill patients. Academic Medicine. 2001;76:
"Chronic Disease Overview." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Aug Web. 28 Nov [
All 7 students were recruited to participate as 1st year Michigan State University College of Human Medicine students
6 of the 7 students from the original cohort are graduating this spring.
All 6 are staying in the Midwest for their residency training
Half of the students are entering fields that are considered Primary Care Specialties
Specialties:
Pediatric Medicine at The University of Wisconsin
Family Medicine at The University of Michigan
General Surgery at Grand Rapids Medical Education Program
Obstetrics and Gynecology at the Cleveland Clinic Foundation
Emergency Medicine at Beaumont Hospital
Emergency Medicine at The University of Minnesota
5 of the 7 participants were inducted into the Alpha Omega Alpha Honor Fraternity this past November, considered to be one of the most prestigious honors.