Advances in Health Sciences Education

, Volume 15, Issue 4, pp 533–545

Students learn systems-based care and facilitate system change as stakeholders in a free clinic experience

  • Colleen Y. Colbert
  • Paul E. Ogden
  • Darla Lowe
  • Michael J. Moffitt
Article

DOI: 10.1007/s10459-009-9216-9

Cite this article as:
Colbert, C.Y., Ogden, P.E., Lowe, D. et al. Adv in Health Sci Educ (2010) 15: 533. doi:10.1007/s10459-009-9216-9

Abstract

Systems-based practice (SBP) is rarely taught or evaluated during medical school, yet is one of the required competencies once students enter residency. We believe Texas A&M College of Medicine students learn about systems issues informally, as they care for patients at a free clinic in Temple, TX. The mandatory free clinic rotation is part of the Internal Medicine clerkship and does not include formal instruction in SBP. During 2008–2009, a sample of students (n = 31) on the IMED clerkship’s free clinic rotation participated in a program evaluation/study regarding their experiences. Focus groups (M = 5 students/group) were held at the end of each outpatient rotation. Students were asked: “Are you aware of any system issues which can affect either the delivery of or access to care at the free clinic?” Data saturation was reached after six focus groups, when investigators noted a repetition of responses. Based upon investigator consensus opinion, data collection was discontinued. Based upon a content analysis, six themes were identified: access to specialists, including OB-GYN, was limited; cost containment; lack of resources affects delivery of care; delays in care due to lack of insurance; understanding of larger healthcare system and free clinic role; and delays in tests due to language barriers. Medical students were able to learn about SBP issues during free clinic rotations. Students experienced how SBP issues affected the health care of uninsured individuals. We believe these findings may be transferable to medical schools with mandatory free clinic rotations.

Keywords

Systems-based practice Systems-based care Competencies Medical students Qualitative research 

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Colleen Y. Colbert
    • 1
    • 2
  • Paul E. Ogden
    • 1
    • 2
  • Darla Lowe
    • 1
    • 2
  • Michael J. Moffitt
    • 1
    • 2
  1. 1.Internal Medicine DepartmentScott & White Memorial HospitalTempleUSA
  2. 2.Texas A&M University System Health Science Center College of MedicineTempleUSA

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