Table 3 Medical student education: Strategies addressing PCMH principles pre- and post-transformation

1. Team-Based Care

• Periodic team-based activities were integrated across the medical student curriculum.

• Team based learning case studies integrated into each pre-clinical course.

• Team-based standardized patient encounters in all system-based courses, which include group history taking, examination, diagnosis and treatment.

• Clinical students participate in weekly “Family Centered Rounds” with a wide variety of healthcare professionals and their patient’s family to gather information and plan next steps.

• Students are required to complete “translational pillars” in between clerkships in which groups work together to solve clinical problems.

2. Patient-Centered Access

• Foundations in Clinical Practice course provided occasional lectures by patient speakers.

• “Meet the Patient” seminars to increase student exposure to the patient perspective.

• Periodic one-on-one standardized patient encounters with a focus on patient care, integrated with feedback from the patient, preceptors, and self-auditing using interactive video capture.

• Students work in both in-patient and out-patient centers that are geographically dispersed in order to facilitate sociodemographic understanding.

• Students rotating through the newborn nursery are tasked with extensive parental education to provide experience in patient instruction.

3. Population Health Management/ Knowing and Managing Your Patients

• Students were introduced to basic concepts within epidemiology and public health in the Foundations in Clinical Practice course.

• “Themes in Medical Education” (TIME) course in the first and second year with structured interactive learning activities focused on epidemiology as well as systemic, state, and community support programs.

• In collaboration with institutional initiatives, students are afforded experiential opportunities to learn about critical public health issues in their local communities.

4. Care Management and Support

• Education in care management and support was reserved for clinical students during “discharge rounds”.

• Standardized patient encounters focused on gauging patient health literacy and delivering patient education during the TIME course.

• Students in the Internal Medicine clerkship participate in weekly “multi-disciplinary care management” rounds.

• Students are assessed on their ability to be active participants on patient rounds to encourage care management competency.

5. Care Coordination and Care Transitions

• Students gained skills in care coordination and care transitions through active participation in clinical clerkships.

• Students gain exposure to multi-disciplinary care through visits to varied community health sites through the TIME course- during which students meet social workers, dietitians, nurses, and other healthcare team members.

• Phase III students are evaluated heavily on their ability to transition from reporter/interpreters of information to managers and educators.

6. Performance Measurement and Quality Improvement

• Students discussed performance measurement and quality improvement in unstructured activities with both clinical and pre-clinical preceptors.

• Activities targeting hospital quality improvement during the TIME course.

• Patient-led discussions surrounding care improvement and critique during the TIME course.

• Clinical students participate in structured chart reviews to assess practice performance.

• Students are required to complete a one-time evaluation of medical school tenets about quality improvement measures and a medical error protocol.