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How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System

Gonzalo, Jed D. MD, MSc; Dekhtyar, Michael; Hawkins, Richard E. MD; Wolpaw, Daniel R. MD

doi: 10.1097/ACM.0000000000001662
Research Reports

Purpose As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education.

Method In 2016, 32 U.S. medical schools in the American Medical Association’s (AMA’s) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes.

Results In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors.

Conclusions These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

J.D. Gonzalo is assistant professor of medicine and public health sciences and associate dean for health systems education, Penn State College of Medicine, Hershey, Pennsylvania.

M. Dekhtyar is research associate, Medical Education Outcomes, American Medical Association, Chicago, Illinois.

R.E. Hawkins is vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois.

D.R. Wolpaw is professor of medicine and humanities, Penn State College of Medicine, Hershey, Pennsylvania.

Funding/Support: The study was performed with financial support from the AMA as part of the Accelerating Change in Medical Education Initiative.

Other disclosures: To the authors’ knowledge, no conflicts of interest, financial or other, exist for any authors. Dr. Richard Hawkins is coeditor of a textbook on the assessment of clinical competence, Drs. Gonzalo and Hawkins are coeditors of a textbook on health systems science, and Dr. Hawkins and Mr. Dekhtyar are employees of the AMA. The views expressed in this article reflect the views of the authors and do not necessarily represent the views of the AMA or other participants in this initiative.

Ethical approval: The University of Illinois at Chicago, the central institutional review board for the Accelerating Change in Medical Education initiative, determined that this study met criteria for exemption.

Correspondence should be addressed to Jed D. Gonzalo, Division of General Internal Medicine, Penn State Hershey Medical Center–HO34, 500 University Dr., Hershey, PA 17033; telephone: (717) 531-8161; e-mail: jgonzalo@pennstatehealth.psu.edu.

© 2017 by the Association of American Medical Colleges