COMSEP 2008 Atlanta Meeting
How Much Self-Reflection is Enough? Evolution of a Curriculum on the Socioeconomic Aspects of Care
Jonathan Gold, Renuka Gera, Ashir Kumar, Elaine Gunn, Colette Gushurst, Melissa Hamp, Raghu Kasetty, & Jeri Weyher, Michigan State University Department of Pediatrics and Human Development
Background: As part of the Contract for Social Responsibility, a longitudinal four-year curriculum designed to produce socially committed physicians at Michigan State University’s College of Human Medicine, the directors of the pediatric clerkship at six campuses designed an exercise in which students explored the effects of a significant medical problem on a child and family with limited socioeconomic resources.
Methods:In the first year of implementation, students were asked to interview the family, do a survey of the child’s medications, meet with a social worker or other care coordinator to discuss community resources available to benefit the patient or family, and write a two to three page essay discussing their findings. A list of questions to discuss with the family was provided as a guideline but no specific criteria were set for passing the exercise. In the second year, a 22-item checklist was provided and each student was required to address at least 18 of the items in their essay in order to pass. Data from both years was collected regarding the types and frequency of problems that were addressed in the narratives.
Results: In the first year, the majority of the students addressed only a portion of the suggested topics. However, the students were more likely to discuss issues or barriers to care not included in the guidelines. By contrast, in the second year the majority of the students addressed nearly all the questions on the checklist, but they were less likely to explore tangential issues in their essays.
Conclusions: A reflective written exercise can be a useful way for students to learn about the impact of limited socioeconomic resources on the family of a child with significant medical problems. A checklist can ensure that students explore a number of important topics but only at the expense of a broader or more creative response to the experience.