The Crimson Care Collaborative

Abstract

The current shortage of primary care physicians (PCPs), particularly as more individuals obtain health insurance and seek primary care services, is a growing national concern. The Crimson Care Collaborative (CCC) is a joint student-faculty initiative in post-health-care-reform Massachusetts that was started with the explicit goal of attracting medical students to primary care careers. It fills a niche for student-run clinics, providing evening access to primary care services for patients without a PCP and urgent care services for patients of a Massachusetts General Hospital-affiliated internal medicine clinic, with the aim of decreasing emergency department use in both groups. Unlike other student-run clinics, CCC is integrated into the mainstream health care structure of an existing primary care clinic and, because of universal health insurance coverage in Massachusetts, can bill for its services. In addition to the clinical services offered, the student-run research team evaluates the quality of care and the patients' experiences at the clinic. This article describes the creation and development of CCC, including a brief overview of clinic operations, social services, research, laboratory services, student and patient education programs, and finance. In the wake of the Patient Protection and Affordable Care Act of 2010, CCC is an example of how students can aid the transition to universal health care in the United States and how medical schools can expose students early in their training to primary care and clinic operations.

Involving Medical Students in Providing Patient Education for Real Patients: A Scoping Review

“…1 ). In total, five non-randomized controlled trials, 22 , 25 , 34 , 35 , 38 four uncontrolled before-and-after studies, 26 , 30 , 33 , 37 eight post-intervention survey or interview studies, 23 , 24 , 27 – 29 , 31 , 32 , 39 and one case series study 36 were included.

Figure 1 PRISMA flow diagram showing the number of records and studies identified during the search process, screened for relevance, assessed for eligibility and included in the synthesis.

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“…Geographically, 12 studies were performed in the USA, 22 – 24 , 26 – 28 , 30 – 32 , 36 – 38 three in the European Union, 25 , 34 , 39 and one each in Canada, 29 New Zealand, 35 and Singapore. 33 …”

“…The studies described the following: medical students providing patient education during clerkships aimed at learning to provide patient education; 26 – 28 , 31 , 35 medical students providing patient education courses or other types of teaching to patients and family members; 24 , 25 , 29 , 30 , 32 medical students supporting patients in the context of treatment; 22 , 38 , 39 medical students performing patient education to reach underserved communities; 23 , 33 , 37 and medical students providing patient education in a student-run clinic or teaching clinic 34 , 36 (Table 1 ).…”

“…Most involved student participation in providing patient education in primary care. 24 , 26 – 28 , 31 , 36 , 37 Others involved medical students in the community, 23 , 29 , 32 , 33 in the surgical department, 38 , 39 the emergency department, 22 , 25 in psychiatry, 30 , 38 or in rural practice. 35 Specifically, medical students provided patient education with regard to diabetes, 23 , 26 – 28 , 31 – 33 hypertension, 23 , 28 , 32 , 33 , 37 mental illnesses, 28 , 32 arthritis, 28 cardiac arrest, 25 communicating with care professionals, 29 treatment plans and options, 38 surgical procedures, 39 discharge instructions, 22 use of digital tools, 24 medication, 33 , 36 disease-related lifestyle issues, 30 , 32 , 37 and self-care.…”

“…In terms of health-related outcomes, four studies reported a change in patients’ self-reported behavior or attitude toward their disease. 24 , 27 , 29 , 37 Three studies described improved disease management 36 (two studies with significant differences, p < 0.001 and p < 0.03, respectively). 33 , 37 Another study reported improved self-reported medication adherence ( p < 0.01).…”