Table 4 Cost awareness knowledge, attitudes, and behaviors by medical student financial stress in intervention cohort pre-intervention, academic year 2020–2021

“I have a good understanding of the following terms: deductibles, co-payment, co-insurance, maximum out of pocket cost”

0.74

Strongly agree or Agree

29 (44.2%)

14 (51.9%)

Neither agree nor disagree, Disagree, or Strongly disagree

23 (55.8%)

13 (48.2%)

“When choosing treatment, doctors should consider costs to the patient”

0.69

Strongly agree or Agree

49 (94.2%)

26 (96.3%)

Neither agree nor disagree, Disagree, or Strongly disagree

3 (5.8%)

1 (3.7%)

“I feel prepared to discuss costs of treatment with patients”

0.62

Strongly agree or Agree

1 (1.9%)

1(3.7%)

Neither agree nor disagree, Disagree, or Strongly disagree

52 (98.1%)

26 (96.3%)

“I feel comfortable discussing costs of treatment with patients”

0.97

Strongly agree or Agree

10 (18.9%)

5 (18.5%)

Neither agree nor disagree, Disagree, or Strongly disagree

43 (81.1%)

22 (81.5%)

“I have easy access to quality resources that assist me in cost discussions with patients”

0.22

Strongly agree or Agree

1 (1.9%)

2 (7.4%)

Neither agree nor disagree, Disagree, or Strongly disagree

52 (98.1%)

25 (92.6%)

Frequency of considering patient out-of-pocket costs when making treatment decisions

0.02

Never or Infrequently

10 (18.9%)

12 (42.9%)

Sometimes, Most of the time, or All the time

43 (81.1%)

16 (57.1%)

Frequency of engaging in cost discussions with patients

0.17

Never or Infrequently

36 (67.9%)

23 (82.1%)

Sometimes, Most of the time, or All the time

17 (32.1%)

5 (17.9%)

Frequency of engaging in cost discussions with medical teams

0.32

Never or Infrequently

26 (49.1%)

17 (60.7%)

Sometimes, Most of the time, or All the time

27 (50.9%)

11 (39.3%)