Development and implementation of a pre-clerkship value-added health systems science program

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PROBLEM: Health Systems Science (HSS) is increasingly recognized as a pillar of medical education. Few medical schools, however, have implemented experiential HSS learning opportunities where pre-clerkship medical students contribute value clinically. APPROACH: The Value-added for Inpatients by Students and Interdisciplinary Teams (VISIT) Consult Service, implemented in January 2024, is an HSS program at the Pritzker School of Medicine (PSOM) where first- and second-year medical students manage psychosocial barriers in discharge planning on Hospital Medicine and Trauma Surgery services at UChicago Medicine. The program was evaluated using post-VISIT student and patient surveys assessing student HSS knowledge and attitudes, student communication skills, and patient experience; psychosocial interventions proposed by students and integrated into care plans were categorized and counted. OUTCOMES: First-year students (89/90) in academic year 2023-2024 completed a VISIT consult between January and May 2024. Second-year students (88/88) the following academic year completed a consult between September and December 2024. All students interviewed a patient and documented an electronic health record note for each consult. The student survey response rate was 81% (81/100). All respondents (81/81) rated VISIT as valuable to their education, with 52% (42/81) rating it as "extremely valuable." From September to December, 44 patients participated, of whom 91% (40/44) completed surveys. Patients gave students mean ratings of 3.3 or higher on relational and technical communication skills (4-point scale) and a mean rating of 4.7 for their overall experience (5-point scale). The mean number of student-led interventions per consult from January to December was 5.2 (SD 2.5). The most common interventions were setting up insurance--covered transportation to medical appointments, arranging establish-care primary care follow-up appointments, and providing -substance cessation resources. NEXT STEPS: VISIT demonstrates how we can educate pre-clerkship students in HSS while empowering them to deliver -patient care. Next steps include expanding VISIT to pediatric and outpatient settings and clerkship and post-clerkship phases of -medical school.

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