Diabetes SPECIAL (Students Providing Education on Chronic Illness and Lifestyle): a novel preclinical medical student elective

Abstract

Background Traditional medical student curricula limit substantial clinical experiences until the third and fourth years of medical school. This delay in valuable experiences hinders the ability of some medical students to choose a specialty to pursue, delays the formation of meaningful longitudinal mentorship relationships, and limits the development of important clinical acumen. Furthermore, the use of medical students in preclinical years may help to improve patient care and outcomes. Approach The novel preclinical Diabetes SPECIAL (Students Providing Education on Chronic Illness and Lifestyle) elective was designed to introduce first year medical students to the field of endocrinology, promote the development of a professional identity, improve medical student communication skills, and raise awareness of the complexities of managing patients living with diabetes mellitus. Furthermore, and novel to this experience, was to measure the impact of this elective on patient outcomes. Evaluation Students attended patient appointments, communicated with their assigned patients regularly, relayed important health information to the attending endocrinologist, and attended monthly didactic sessions. The elective outcomes were evaluated via completed surveys by patients, students, and attending physicians as well as medical record review for pre- and post-elective hemoglobin A1C levels. Reflection Students, faculty, and patients who participated in this elective generally reported having a positive experience. Seven out of 10 patients had a reduction in their hemoglobin A1C levels. The outcomes from the pilot of this novel preclinical elective support the importance of early clinical exposure in medical student training and highlight potential positive impacts on both medical student education and patient outcomes.

Adequacy of knowledge of new medical graduates about diagnosis and management of children and adolescents with type 1 diabetes in a developing country

“…Meyers et al evaluated the impact on patient outcomes of a new elective, SPECIAL (Students Providing Education on Chronic Illness and Lifestyle) that was introduced to first year medical students in United States. Patients reported positive experience and most of them had a reduction in their glycated hemoglobin levels, which supports the importance of early introduction to clinical exposure in medical education [ 41 ].…”

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools

“…14 To address this knowledge gap, 1 medical school implemented a novel preclinical elective in which a medical student was paired with an attending endocrinologist for patient care during 1 semester; student performance was assessed by comparing patients' serum hemoglobin A1C levels before and after the student's involvement. 15 The study reported significant improvements in patients' glycemic control and attributed these improvements to the student's involvement in practical diabetes management. 15 In line with this model, identifying endocrine mentors for students early on during the preclinical years may help improve students' understanding of core clinical concepts and potentially spur interest in endocrinology.…”

“…15 The study reported significant improvements in patients' glycemic control and attributed these improvements to the student's involvement in practical diabetes management. 15 In line with this model, identifying endocrine mentors for students early on during the preclinical years may help improve students' understanding of core clinical concepts and potentially spur interest in endocrinology.…”

“…In a study from the State University of New York Upstate Medical University, enthusiasm was observed when the preclinical endocrine elective course partnered first-year medical students with attending endocrinologists and a patient with diabetes mellitus. 15 Another study conducted at the University of Texas Health McGovern Medical School found that resident-led teaching efforts played an important role in increasing student interest in neurology after the third year and decreasing "neurophobia." Although this study assessed the clinical years, the concept of "near-peer" mentorship and teaching could be implemented earlier in the preclinical years, such as through the expanded use of fellows as teachers and mentors.…”