We operate a decision support program in a medical center in San Francisco. In this program, postbaccalaureate, premedical interns deliver decision and communication, aids to patients. We asked whether working in this program helped these premedical interns develop key physician competencies. To measure physician competencies, we adopted the standards of the Accreditation Committee on Graduate Medical Education (ACGME), which accredits residency programs in the USA. The ACGME competencies are patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice. We developed a survey for our program alumni to rate themselves on a scale from 0 (none) to 100 (perfect) on each competency, before and after their time in our program. The survey also solicited free-text comments regarding each competency. In June 2012, we e-mailed all 47 alumni a link to our online survey and then analyzed responses received by July 15, 2012. We visually explored the distributions of ratings and compared medians. We selected the most specific and concrete comments from the qualitative responses. Respondents (21/47 or 45 %) reported that their participation in Decision Services increased their competencies across the board. Qualitative comments suggest that this is because students accompanied patients on their clinic journeys (seeing multiple facets of the systems of care) while also actively facilitating patient physician communication. Providing decision support can improve self-ratings of crucial physician competencies. Educators should consider deploying premedical and medical students as decision support coaches to increase competencies through experiential learning.
Premedical interns Health coaches ACGME Competencies Medical education Decision aids Communication aids Shared decision making Patient advocacy
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The authors thank the patients and physicians who have participated in our program over the years. We thank the alumni of our program for participating in this study. The premedical internship program is administered by Meredith Buxton, PhD, with assistance from Natalie Cox, MA. We are very grateful to the staff at the Fishbon Library at UCSF. Thank you to Pat O’Sullivan for suggesting the use of the retrospective pretest design. Dr. Belkora wishes to thank the leaders of the Teaching Scholars Program at UCSF for their mentorship. Thank you to Lauren Stupar who helped to format this manuscript for publication.
We received funding support for this project from the Informed Medical Decisions Foundation, the Boebel Family Leadership Development Program at the UCSF Breast Care Center, and the UCSF School of Medicine. The funders did not otherwise influence the study.
We applied for and received exempt status from the University of California San Francisco Committee on Human Research.
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