Abstract:

A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) accepted its first class of students in 2007, and is fully accredited by the AOA’s Commission on Osteopathic College Accreditation. SOMA fulfilled a national need for an innovative medical education program to prepare osteopathic physicians for the unique demands of working within American’s health care safety net—most notably the U.S. Federally Qualified Community Health Centers (CHCs) that serve 22 million patients, regardless of ability to pay.

ATSU-SOMA and the National Association of Community Health Centers (NACHC) developed and maintain a unique relationship, which enables the School to partner with carefully selected CHCs to serve as contextual learning campuses for osteopathic medical students (OMS) in years II-IV. Each community campus has dedicated and fully-equipped classroom space for didactic instruction and clinical skills application. This innovative, distributed, contextual training model affords students early clinical experience and the opportunity to become attitudinally embedded within a healthcare system in order to study the social, economic, and medical needs of patients and communities. Patient panels include a wide array of vulnerable populations, including rural Appalachian farmers, ethnic groups in the low-country of South Carolina, Hawaiian natives, urban homeless, émigrés, those with HIV, and others.

Within the US healthcare system, 3,000 federally qualified CHCs form a strong safety net providing comprehensive value-based primary and other health care services tailored to fit the special needs and priorities of 22 million residents in 9,000 communities. In order to address the ever-burgeoning shortfall of safety net physicians and leaders, the SOMA model embeds trainees in contextual learning campuses that both equip and motivate them to become future agents of change.

SOMA’s unique model includes a variety of curricular innovations necessary to implement a fully-accredited, but decentralized curriculum. All SOMA OMSII (~150 per class) enroll in the Epidemiology and Biostatistics & Preventive Medicine courses. These courses, delivered remotely, teach the fundamentals required for community based participatory research, including how to conduct needs assessments and design/implement community projects addressing the social and economic determinants of health. Students are provided detailed instructions, tools, templates, evaluation rubrics, and continuous support. They work with CHC leadership and community members to develop, execute, and evaluate their own community oriented primary care (COPC) projects. These can be research, quality improvement, or community service projects.

Over the past 10 years, SOMA students developed and delivered a unique and growing library of over 150 COPC projects. We have created a COPC toolkit with detailed instructions for students and grading rubrics for instructors. These projects allow for active learning by students and for significant contributions to vulnerable communities. Using knowledge acquired from the Epidemiology and Biostatistics & Preventive Medicine courses, OMSII students develop, implement and evaluate projects that address social determinants of health.

We will share our methods and detailed toolkit to enable other educators to replicate our methods and empower students to make a difference in their communities. Health professions and undergraduate students can benefit.

Keywords:

Active Learning, Social determinants of health, distance education, vulnerable populations.