bluuebunny/crossref_metadata_2025 huggingface dataset:
Asociaciones entre los estereotipos de género tradicionales y los trastornos de la conducta alimentaria durante la adolescencia y juventud. Una revisión sistemática
Authors: Fernández Cassi Candela , Pedrón Valeria Teresa
Published: May 2023

Diversas investigaciones han estudiado la relación entre los roles de género tradicionales presentes en la cultura y el desarrollo de los trastornos de la alimentación. Los trastornos de la conducta alimentaria son una problemática compleja y multicausal que afecta principalmente a les adolescentes y jóvenes. Es por ello que se vuelve importante revisar la bibliografía sobre los estereotipos de género tradicionales y observar cómo se asocian con los indicadores de trastornos alimentarios. Para ello se llevó a cabo una revisión sistemática sobre las investigaciones de las últimas dos décadas (2001-2021) respecto de la contribución de los estereotipos de género tradicionales en el desarrollo de los trastornos alimentarios. Se encontraron 13 estudios que cumplían con los criterios de inclusión y exclusión. Sobre los hallazgos, 11 de los 13 estudios encontrados reportaron que existía una relación entre los estereotipos de género tradicionales y los trastornos de la conducta alimentaria. La mayoría poseía resultados positivos en cuanto a la contribución del estereotipo de género femenino tradicional a la patología alimentaria, sea en mujeres o en hombres. Con respecto a la masculinidad sólo el 23,07% de los estudios la hallaron como un factor protector de los trastornos alimentarios, mientras que otros hallaron que la androginia prevalecía en las personas sin trastorno. Se concluye que es necesario realizar más investigaciones en el contexto latinoamericano, teniendo en cuenta el creciente aumento de las patologías alimentarias.
ԱՇԽԱՏԱՆՔԱՅԻՆ ՊԱՅՄԱՆԱԳՐԻ ԼՈՒԾՈՒՄԸ՝ ԱՇԽԱՏՈՂԻ ԿՈՂՄԻՑ ԶԲԱՂԵՑՐԱԾ ՊԱՇՏՈՆԻՆ ՄԱՍՆԱԳԻՏԱԿԱՆ ՈՒՆԱԿՈՒԹՅՈՒՆՆԵՐԻ ԱՆԲԱՎԱՐԱՐՈՒԹՅԱՆ ՊԱՏՃԱՌՈՎ ՉՀԱՄԱՊԱՏԱՍԽԱՆԵԼՈՒ ՀԻՄՔՈՎ
Authors: KARAPETYAN MANE
Published: May 2023

Employee evaluation in labor relations is an important tool that allows determining whether his/her professionalism, personal and practical qualities meet the requirements of the organization. However, this evaluation must be objective and measurable, otherwise it can target those employees who are honest and suitable for the work they perform. Within the framework of this article, it is proposed at least to ensure that the employee is aware of the requested professional skills, is notified of the evaluation of his/her professional skills within a reasonable time and becomes a participant in this evaluation.
ԲԱՑԱՌՄԱՆ ԿԱՆՈՆԻ ԲԱՑԱՌՈՒԹՅՈՒՆՆԵՐԸ ՈՉ ԻՐԱՎԱՉԱՓ ՁԵՐԲԱԿԱԼՄԱՆ ՀԱՄԱՏԵՔՍՏՈՒՄ
Authors: SHAHINYAN NAIRA
Published: May 2023

The given article is dedicated to the main problem of assessment regarding the admissibility of evidence obtained as a result of an unlawful arrest. The essence of the connection between the causality related to such pieces of evidence and arresting facts was studied in the given article. The issues on the admissibility of the evidence have been discussed, obtained not only as a result of a non-lawful arrest but also by violation within the process of arrest. Foreign experience regarding the admissibility of such kind of evidence is presented.
Songs, Rhymes and Stories as Linguistic Tools for Language Development
Authors:   Department of English Studies, Faculty of Arts, Adekunle Ajasin University, Akungba-Akoko, Ondo State, Nigeria, BAMIGBOLA Esther O.
Published: May 2023

From time immemorial, songs, rhymes, and stories have always been part of human society that portray many aspects of the cultural heritage of many people. Thus, they portend to be important devices in educational development, especially in terms of language acquisition. The linguistic features in these three genres of oral literature make it possible for language to be learnt in a very enjoyable, pedagogical and natural manner. This study was carried out to bring out the peculiar linguistic features in children’s oral literature with the aim of describing how songs, rhymes, and stories aid language acquisition and learning. The data for the study are eight (8) songs, seven (7) rhymes, and two (2) stories randomly selected from some English reading materials. Linguistic Stylistic Model and Halliday’s Systemic Functional Grammar formed the bases for the analysis. The findings of the study show that composers of children songs, rhymes and stories strategically deploy language to enhance children’s skills in spellings, pronunciations, identifications of words, and arrangement of words into meaningful sentences. The study concludes that songs, rhymes, and stories are useful tools to introduce children to a language and to make the acquisition and learning of such a language easy with fun, activity and motivation.
The Place of Grammar in a Stylistic Study: An Analysis of Niyi Osundare’s Open letter to President Goodluck Ebele Jonathan
Authors:   Department of English, Obafemi Awolowo University, Ile-Ife, Nigeria, OYELAKIN Gbenga Samson
Published: May 2023

This study examined the role of Grammar in the Linguistic Stylistic analysis of Niyi Osundare’s Open Letter to President Jonathan. The study identified, analyzed, and related the prominent grammatical components in the letter to its socio-political context. The study employed both primary and secondary sources of data. Additionally, the data were analysed using the purview of the linguistic approach of stylistics. It was discovered that the grammar of the language of the text was deployed in a manner of appealing to President Jonathan to willingly and graciously accept the outcome of the 2015 General Elections in Nigeria. The study equally demonstrated that grammatical devices employed in the letter illuminated the style of language use of Osundare in political discourse. The study concluded that grammar has an important role to play in studying political discourses as it enhances the discovering of their intentions.
Blended Learning: A Nostrum for Effective Teaching and Learning in Post-COVID-19 Africa
Authors:   College of Education, Open, Distance and E-Learning Kampala International University Kampala, Uganda, FAKUADE Olubusayo Victor , AMORAN Olugbenga Bayode ,   Department of Vocational and Technical Education, Ekiti State University, Ado-Ekiti, Nigeria
Published: May 2023

In recent times, one of the major reasons for the promotion and continuous relevance of online learning platforms is to reduce the rapid spread of COVID-19 most especially among the middle age. It is expected to engender continued access to learning anywhere irrespective of time and location. This does not preclude the traditional face-to-face method of teaching from providing an opportunity for robust student-teacher interaction. The combination of these two modes of teaching could be termed blended learning or blended learning, and it is fast becoming a popular approach to teaching in this post-COVID-19 era. Blended learning as an approach to the teaching-learning system is a necessary merging of face-to-face traditional teaching approach and online-based class for actual learning that encourages teacher’s control of class activity in post-COVID-19 time. Notwithstanding, the online method of teaching is characterized by problems occasioned by individualization and a series of other challenges in aftermath of post-COVID-19. Blended learning has therefore been shown to encompass numerous benefits that are lacking in either the online or internet-based teaching methods or the traditional face-to-face method of teaching. These are found in examples such as Flipped learning, Computer Assisted Instruction (CAI), live chat and other e-learning environment techniques that have been reported to boost learning outcomes. It is instructive to note that despite the advancements and seeming benefits, teacher-student interaction which is quintessential to student development has been estranged. This is a strong limitation that may make the sole adoption of learning strategies outside the regular classes (Online Learning) more complicated. It is recommended that the blended learning approach should be encouraged to help synchronize the two teaching strategies to maximize the benefits that can minimize or eradicate the inherent deficiencies.
Exploring the Frontier: The Journal of Student-Run Clinics
Authors: Chen Kevin
Published: May 2023

The Journal of Student-Run Clinics (JSRC) was created to highlight insights and innovations at student-run clinics (SRCs) by featuring quality, relevant media. The inaugural journal issue features three original research articles and one descriptive report. Original studies investigate: how access to an SRC affects reported emergency department usage, patient satisfaction, and perceived access to a physician; hypertension outcomes at an SRC for the uninsured as compared to insured patients; and whether volunteering at an SRC promotes development of certain underrepresented clinical core competencies. The descriptive report details the clinic model of an osteopathic pediatric and obstetric clinic. Many individuals contributed to the production of this first JSRC issue; twenty one different institutions and five distinct health disciplines are represented. In terms of publication statistics, four of ten articles considered for the first issue were published.
The Impact of a Student-Run Free Clinic on Reducing Excess Emergency Department Visits
Authors: Kramer Nick , Harris Jaden , Zoorob Roger
Published: May 2023

Background: Access to primary care directly impacts inappropriate emergency department (ED) utilization. This relationship has been studied in free clinics, but little work has been done regarding the impact of student-run free clinics (SRFCs). This study investigates the effects of an SRFC in Nashville, Tennessee on reported ED utilization patterns, patient satisfaction with healthcare, and primary care access. Methods: The study population included all patients seen at the 12 South Community Clinic from April 2013 to January 2014. A 7-item paper questionnaire, including items on recent ED usage, satisfaction with current level of healthcare, and access to physicians, was distributed to new patients during their first clinic visit; returning patients received a 5-item follow-up questionnaire. New patient survey responses were compared with returning patient survey responses as aggregate data using unpaired t-tests, and descriptive statistics were used to calculate percentages. Results: The response rate was 94.9% (130/137) for new patients and 83.9% (115/137) for returning patients (N=274). The average reported number of ED visits in a three-month period was 0.47 in new patients and 0.24 in returning patients (p=0.0345). Access to the clinic significantly increased the overall level of healthcare satisfaction from 33.3% (35/105) of patients feeling very or completely satisfied prior to their first visit to the free clinic to 71.8% (79/110) of patients feeling very or completely satisfied on return visit (p<0.0001). Since establishing care at the clinic, 98.2% (112/114) of returning patients reported easier access to a physician.Conclusions: The study design was limited by using data from a quality assurance project; identified, individual-level information was not used, and comparison of individual subject responses was not possible. It is unknown how many individuals may have participated in both or only one group or how many individuals may have repeated data points in the returning patient group. Despite these limitations, results suggest that given ongoing primary care access gaps, SRFCs may serve a role in impacting excess ED utilization, patient satisfaction, and access to care in medically underserved and underinsured populations.
Impact of Crisis Prevention Training on Student Confidence in Patient Encounters
Authors: Carlson Sarah , Dresow Ben , Murugappan Meena , Sieling Emma , Srnec Jason , Levy Allison , Westra Ruth , Christensen Raymond , Stratton Tim
Published: May 2023

Background: The Health of People Everywhere (HOPE) Clinic is a student-run free triage and urgent care clinic that has operated in a Duluth, Minnesota homeless shelter since 2008.  More than 100 University of Minnesota medical and pharmacy students volunteer at the clinic annually. The unpredictable nature of clinical interactions have highlighted the need to better prepare students on preventing escalation of difficult patient situations to crises.   Methods: HOPE Clinic student leaders developed a Crisis Prevention Training Module around the themes of drug-seeking behavior, suicidal ideation and sexual harassment. A didactic presentation was followed by role-playing scenarios utilizing Theater Arts students as patients. A pre-training email survey was sent out to all 120 medical students and 180 pharmacy students on campus to evaluate studentsâ€™ confidence to handle difficult patients. Medical students (n=60) and pharmacy students (n=116) who volunteer at the free clinic then had the chance to participate in crisis prevention training through the school. A post-training survey was sent out to all medical and pharmacy students on campus to compare the change in student confidence among students who participated in the training and students who did not.  Results: On the pre-training survey, 40% of medical students and 17% of pharmacy students reported receiving previous crisis-prevention training (p=0.023). ANOVA of post-training survey results revealed a significant increase in student confidence to prevent a crisis compared to the pre-training survey among pharmacy students (p=0.001), but not among medical students.  Conclusions: Pharmacy students perceived that crisis-prevention training increased their confidence to prevent uncomfortable patient interactions from escalating to a crisis.
An Organizational Model and Growth of a Free-Standing Physical Therapy Student-Run Clinic
Authors: Rayson Nicole , Weiss Shelby , Bellizio Jonathan
Published: May 2023

Student-run medical free clinics are becoming a way for students to engage and serve their local communities while improving and growing their own professional skills. Widener University has become one of these institutions of higher education in which their professional programs have embraced service-learning and community engagement into their curriculum. The Institute for Physical Therapy Education at Widener University has added to the institutionâ€™s civil mission by opening the Chester Community Physical Therapy Clinic on September 15, 2009. The clinic is completely student-run and follows an organizational model that implements a student board, which with the help of faculty, oversees the daily function of the clinic. Over the last six years, the student board has striven to develop the organizational model to provide the most competent, professional, and consistent care to the clinicâ€™s clients. We hope that this descriptive article can serve as a guide for others who wish to begin or improve upon their own student-run clinics that serve their respective communities.
Patient Expectations and Satisfaction When Using a Student-Run Health Clinic
Authors: Mischell Stephanie , Yegya-Raman Nikhil , Frenchu Kiersten , Lin Karen
Published: May 2023

Background: Promise Clinic, a student-run continuity-based free health clinic affiliated with Rutgers Robert Wood Johnson Medical School, serves the uninsured and low-income population in New Brunswick, New Jersey. Though it has been operating for over ten years, Promise Clinic does not yet have a formalized system for evaluating quality of care from a patientâ€™s perspective. The purpose of this study was to investigate patient satisfaction and expectations at Promise Clinic. Methods: Over a two-month span, we interviewed 21 patients at Promise Clinic. The interview addressed a variety of factors, including patient satisfaction with student doctors, health education and awareness, and understanding of and access to community health options. Furthermore, we elicited open-ended feedback from patients, allowing them to express opinions regarding their healthcare and reasons for attending Promise Clinic over other low-income healthcare providers. Results: We found that while patients were highly satisfied with their overall experience and student doctor teams, there were some concerns about wait times, the timing of clinic, and student doctor preparedness. Patient health education was strong in many, but not all, areas. Of eligible patients, 40.0% reported receiving regular cancer screenings and 33.3% were unaware of other healthcare options. Conclusions: Overall, this study provides a patient-centered assessment of the clinic. Insight obtained has helped medical students and faculty administrators at Promise Clinic address chief patient concerns and improve upon the patient experience. We hope that patient interviews will continue to be a part of quality improvement processes at Promise Clinic and other similar clinics.
Examination of Demographics and Chronic Health Condition Management in an Underserved Population at a Pro Bono Physical Therapy Clinic
Authors: Creps James , Kaartinen Mia , Diebold Kayla
Published: May 2023

Background: The purpose of this study was to identify and describe the demographic information of the patient population at a student-run physical therapy pro bono clinic. We hypothesized this patient population would present with more chronic health conditions that are either unmanaged or under-managed compared with Genesee County, Michigan. Methods: New patients were asked to complete a 47-question survey on demographic information, past medical history, and social history. Vital signs were also recorded. Frequency tables were run to determine the health needs in this patient population. Self-report of hypertension, diabetes, and depression was compared to self-reported medications to determine medical management of the conditions. Results: Some patients report taking medications for these conditions, but many individuals are not medically managing these conditions. Conclusions: With this information, clinicians can better create programs that meet the specific needs of this patient population including fitness programs, chronic disease management education, and pain management programs.
Investigating the Motivators, Barriers and Facilitators to Volunteering at a Student-Run Physical Therapy Clinic
Authors: Cassidy Andrew , Yorke Amy
Published: May 2023

Background: Student-run free clinics (SRFCs) provide opportunities for student physical therapists (SPTs) to develop their clinical skills while serving the community. However, the frequency of volunteering is not consistent amongst students. The purpose of this report is to investigate motivators, barriers, and facilitators to volunteering as a SPT at an SRFC.Methods: A mixed methods study was completed in two parts. First, an electronic survey was sent to Year 1 and Year 2 SPTs. Second, focus group interviews were completed with two groups: high frequency SPTs (4+ times volunteered) and low frequency SPTs (0-3 times volunteered).Results: The survey was sent to 119 students, with a response rate of 39.5% (n=47). Top motivators were practicing intervention techniques (78.7%, n=37), improving examination skills (68.1%, n=32), and community service (63.8%, n=30). The top barrier was clinic hours (66%, n=31). The top potential facilitator was extra credit (61.7%, n=29). Focus groups substantiated that developing clinical skills and serving the community were top motivators, while time constraints were the largest barrier to volunteering.Conclusions: SRFCs can encourage additional students to volunteer as physical therapists by promoting benefits such as improved clinical skills, opportunity to serve the community, and potential for improved student confidence. Integrating volunteering through course credit or faculty encouragement may also increase the number of students who participate. Operating hours of SRFC should be scheduled to minimize interference with other time commitments of SPTs.
A Roadmap to Clinic Expansion: Meeting the Needs of an Underserved Community
Authors: Stubbs Chivon , Duvernay Danielle , Omole Folashade
Published: May 2023

In todayâ€™s medical education, student-run clinics play an integral role in helping to prepare students at all levels in their medical training. The Morehouse School of Medicine Health Equity for All Lives (MSM-HEAL) student-run clinic was established in 2011 as a place dedicated to meeting the needs of Atlantaâ€™s underserved population. Today, the MSM-HEAL Clinic has grown in three areas: clinical sites, interdisciplinary leadership and volunteer teams, and community outreach initiatives. The purpose of this descriptive report is to demonstrate the roadmap to a clinic expansion to meet the needs of a community and how the MSM-HEAL Clinic grew in one year, marshaling financial and community resources and establishing a community outreach initiative. The MSM-HEAL Clinic has served over 1,400 individuals as of December 2017. With the expansion came the demand for funding clinic operations and patient care. A grant proposal was submitted to a community nonprofit organization. In one year, over $20,000 was raised to support MSM-HEAL. These funds made healthcare access possible by providing transportation to patients for their appointments, medication assistance, supplies for medical screenings, and seasonal community vaccination initiatives. During this one-year period the MSM-HEAL Clinic provided services to an increased number of patients and greater education for the interdisciplinary student volunteers, creating a shared benefit. The free clinic will continue to benefit the community by providing no-cost services for uninsured and underinsured patients and improve professional student clinical education while upholding the core values of family medicine.
A Logic Model for Planning, Implementing, and Evaluating a Student-Run Free Clinic
Authors: McAndrew Rose , Kaskutas Vicki
Published: May 2023

Student-run free clinics (SRFCs) are an important part of the American healthcare system, providing free services to many individuals in need. Patients report improvements after care in an SRFC, and students develop skills requisite for practice. Current literature describes outcomes at SRFCs for patients and students but fails to provide a solid model to guide planning, implementation, and evaluation of SRFCsâ€™ success. This paper presents the SRFC logic model, a contextually based model that is useful throughout the life of an SRFC. The SRFC logic model utilizes a backward design process for planning a new SRFC. The same five components examined in the planning process are performed in reverse order during the implementation and evaluation phases. The planning phase begins by identifying the impact that the SRFC hopes to make, followed by defining the measurable outcomes the SRFC expects to achieve. Outputs are projected to examine the reach of the SRFC. Specific activities to produce the desired output and outcomes are defined. Lastly, the inputs needed to complete the activities are identified. Implementation of the SRFC addresses the same components in a forward direction. Evaluation is performed iteratively, allowing for adjustments to ensure that the SRFC is achieving its targeted outcomes. The logic model described in this paper can be used across healthcare disciplines and settings to plan, implement, and evaluate an SRFC and to demonstrate its significance to all stakeholders.
Using Time Limits to Improve Patient Visits & Clinic Flow at a Student-Run Free Clinic
Authors: Stephens Dylan , Ramedani Shayann , Tupinio Maegan , Lambert Kristin , Artrip Rick
Published: May 2023

Background: Student-run free clinics often have difficulties with long visits, which are associated with patient dissatisfaction. LionCare, a free clinic run by Pennsylvania State University College of Medicine medical and physician assistant students, experiences similar difficulties. This study sought to gather baseline data on the duration of each step of a patient visit and to evaluate whether implementing a time limit on the longest step would improve clinic flow and affect patient satisfaction.

Methods: Data was collected from LionCareâ€™s General and Neurology clinics. Each step of a patientâ€™s visit was recorded, including Time of Arrival and Departure as well as duration of Waiting Room; Vitals; History and Physical (H&P); Presentation to Physician; Seeing Patient with Physician; Medications, Vaccines, Tests, Other. In order to gauge patient satisfaction, short surveys based on select Press Ganey questions were administered at the end of each visit before and during the intervention.

Results: Five months of baseline data from 44 visits indicated that H&Ps took the longest of all the steps of a patient visit at 30 minutes. Over 19 visits, a time limit of 25 minutes reduced H&P duration by 10 minutes (p<0.001); duration of Presentation to Physician by 6 minutes (p=0.002); Medications, Vaccines, Tests, Other by 4.5 minutes (p=0.03); and Total Patient Visit by 20 minutes (p=0.002). Patient Satisfaction remained stable before (n=10) and after (n=13).

Conclusions: A 25-minute time limit reduced the duration of H&Ps, subsequent steps in the visit, and the overall visit more than expected, thus improving clinic flow. Importantly, patient satisfaction scores remained steady. Thus, at LionCare, placing a time limit on H&Ps was an effective way to improve clinic flow without sacrificing quality.
Ability of an Appointment Complexity Categorization System Applied by Non-Medical Personnel to Discriminate Between Patient Categories
Authors: Brain Charity , Allison Lauren , Fernandez Candace , Kreisler Rachael
Published: May 2023

Background: The Midwestern University College of Veterinary Medicine hosts student-run free clinics through the campus-wide interprofessional program, Health Outreach through Medicine and Education. Veterinary students, attending veterinarians, and non-medical volunteers conduct clinics on a first-come-first-served basis. Patients are declined once estimated capacity is reached. Historically, capacity was based on the number of patients, but clinic end-time was found to be highly variable. An appointment complexity categorization system based on presenting complaint (used as a proxy for appointment duration) was implemented in an attempt to maximize patients seen while allowing for an on-time clinic conclusion.

Methods: A rubric was constructed based on prior clinical experience and provided to non-medical personnel assisting with check-in to determine a point value (1-3) for each patient, with lower point value appointments being simpler, and higher point appointments being more complex. Clinic capacity was set at 24 points. Appointment duration for each point category was analyzed via Kruskal-Wallis equality of populations rank test and Dunn's test of multiple comparisons.

Results: Median duration was the same for 1- and 2-point appointments (24 minutes), but longer for 3-point appointments (62 minutes). Duration of 3-point appointments was significantly different than 1-point (p=0.0071) and 2-point (p=0.0201) appointments, while duration between 1- and 2-point appointments was not different.

Conclusions: Non-medical personnel using a rubric were able to discriminate between simple (1-point) and complex (3-point) appointments but were unable to discriminate between simple and complicated (2-point) appointments. However, this utility of this in clinical practice was minimal.
Emergency Department Use and Barriers to Health Care Among Homeless and Uninsured Patients at a Student-Run Free Clinic
Authors: Bhathena Shayan , Moczygemba Leticia , Lawson Kenneth
Published: May 2023

Background: Free clinics often provide healthcare to homeless individuals who face barriers to accessing primary care and other healthcare services. This study aimed to assess: (1) barriers to healthcare experienced by uninsured and homeless patients at a student-run free clinic; (2) patient perceptions of helpfulness of social service resources; and (3) relationships between barriers and emergency department (ED) use and health status.

Methods: In 2017, patient interviews were conducted at a student-run free clinic in central Texas. A structured questionnaire was used to collect demographics, perceived health status, ED usage, and ratings of barriers to healthcare and helpfulness of social service resources. Data analysis included descriptive and bivariate analyses, used to examine the relationship between barriers to healthcare services and ED use, and between barriers to healthcare services and health status.

Results: In total, 48 patients participated. The highest-rated barrier to receiving medical care was cost of healthcare, followed by lack of transportation and lack of insurance. Of the top 5 most utilized resources, Medicaid was rated as most helpful, followed by a medical assistance program and caseworkers. Reported ED use was significantly associated with higher ratings of lack of transportation as a barrier (p=0.03), use of a local mental health services program (p=0.01), and having insurance coverage through a local medical assistance program, Medicaid, or Medicare (p=0.01). No significant relationship was found between any healthcare barrier and health status.

Conclusions: This study found that the highest barrier to medical care was cost of healthcare and that lack of transportation was significantly related to ED usage. In the future, this clinic might consider introducing a resource that addresses the barrier of transportation for its patients.
Impact of Adverse Childhood Experiences in a Student-Run Free Clinic Population
Authors: Mills Weston , Griffin Rachel , Jin Jing , Halverson Melissa , Huitt Tiffany
Published: May 2023

Background: Adverse childhood experiences (ACEs) correlate with development of chronic disease and early death. High ACEs are more common in underserved populations. The objective is examining how ACE scores correlate to the presence and severity of chronic diseases in student-run free clinic (SRFC) populations.Methods: This study took place at the University of Arkansas for Medical Sciences (UAMS) 12th Street Health and Wellness Center, an SRFC in Little Rock, Arkansas. Included were patients diagnosed with at least one of the following: hypertension, diabetes, depression, chronic headaches, and chronic obstructive pulmonary disease. Surveys were administered to determine the amount and type of ACEs, and scores were calculated. Relative risks for effects of ACE exposure were assessed on chronic disease. Univariate and multivariate analyses for ACE and chronic disease association was conducted. Results: A total of 75 patients completed the survey. Prevalence of ACEs >1 among UAMS patients was 61 (81.3) and more common in women and non-smokers. Exposure to physical abuse showed 55% higher risk of more than one chronic disease than without exposure. Patients reporting 3-4 or >5 ACEs had 2.00 or 1.69 times the risk of having more than one chronic disease compared to no ACEs in an adjusted analysis, respectively.Conclusions: ACEs were more prevalent in this SRFC than the general public. Exposure to more ACEs was associated with an increased risk for having one or more chronic disease. The study provides novel evidence of the increased risk this SRFC population has for ACEs and identifies a possible need for additional resources.
Implementation of an Evidence-Based Health Equity Curriculum for Reducing Implicit Bias at a Student-Run Free Clinic
Authors: Gururangan Kapil , Hooda Charisma , Osterberg Lars
Published: May 2023

Healthcare providersâ€™ implicit biases negatively impact the quality of patient care. Education to promote bias awareness is the first step to mitigating this negative effect. Implicit bias education is particularly relevant to volunteers at student-run free clinics, where patients often belong to underserved populations who are most vulnerable to providersâ€™ implicit bias. No prior studies have reported the development and evaluation of an implicit bias curriculum in this setting. We developed an evidence-based health equity curriculum for undergraduate student volunteers at a student-run free clinic and report preliminary results of a pilot study. The training program was regarded as highly informative and relevant to clinical practice by students, and their qualitative feedback was organized thematically. Our data suggest that volunteers experienced increases in empathy after participating in this implicit bias training, despite not demonstrating a significant change in implicit biases. Further study of educational interventions to modify unconscious bias and provider empathy is warranted to augment the efficacy of these interventions and their benefit to patient care.
Implementation of an Education Empowerment Team to Promote Education-Focused Conversations in a Student-Run Free Clinic: A Reproducible Model
Authors: Jager Shannon , Hentz Emily , Pairitz MacKenzie , Jansen Shae , Sevilla-Martir Javier
Published: May 2023

Lack of time dedicated to patient education is a barrier to motivational, empathetic conversations in the setting of high patient volume at the Indiana University Student Outreach Clinic (IUSOC). The Education Empowerment Team (EET) was created to: (1) empower patients through educational conversations and (2) empower a cohort of graduate and health professional students to grow in the skills of motivational interviewing (MI) and patient education. The purpose of this study is to detail the EET implementation model and evaluate the successes and barriers encountered by team members during its first three months of implementation. Fifteen EET members were selected and completed three training sessions. A survey was dispersed to members of the EET after three months of implementation. Thematic analysis of the teamâ€™s qualitative perception of their role, as well as quantitative evaluation of encountered barriers and training session utilization was completed. McNemarâ€™s test was implemented to determine significance. EET members found the MI pre-clinical training to be most utilized (p=0.02) and requested a second, â€˜refresherâ€™ MI training later in the year, as well as role-play training scenarios. Members found the public setting of EET encounters to be the largest barrier to effective patient-volunteer relationships. The EET was successfully implemented at the IUSOC from January to March 2020 when COVID-19 restrictions forced clinic closure. The shortened duration of the EET was the largest limitation of the study; yet, the reproducible EET implementation model serves as an effective starting point for the implementation of education-focused teams at student-run free clinics. Future steps involve modifying the EET model, expanding interdisciplinary heterogeneity of the team, and evaluating the impact of EET on patient health outcomes objectively by disease progress and subjectively by patientsâ€™ assessments.
Evaluation of a Diabetes Prevention Program Implementation in a Student-Run Free Clinic Setting
Authors: Huszagh Meredith , Hatcher Jeremy , Grimaldi Carolina Gomez , Kloosterman Nicole , Carranza-Leon Daniel , Li Xuanyi , Sulieman Lina , Chakkalakal Rosette , Niswender Kevin
Published: May 2023

Introduction: The Diabetes Prevention Program (DPP) can prevent or delay the development of type 2 diabetes in at-risk individuals. Although low-resource and minority communities have higher rates of type 2 diabetes, these communities often have limited DPP participation due to cost and program accessibility. We evaluated whether a high-fidelity, reduced-cost 16-week DPP could feasibly be implemented by student volunteers and be effective in facilitating the target 5% weight loss goal among participants. 

Methods: Uninsured, Spanish-speaking participants and their invited guests were recruited from Vanderbilt University Medical Center’s student-run clinic. Weekly DPP sessions were conducted using the CDC’s Prevent T2 curriculum in Spanish, delivered in-person for 6 weeks and virtually for the remaining 10 weeks due to the Coronavirus Disease 2019 pandemic. Participant attendance and weight data were collected. Pre- and post-program health-related quality of life was assessed using the EuroQoL 5D5L tool, and qualitative program feedback surveys were administered. Changes in weight and quality of life as a function of program session attendance and patient demographics were determined primarily using Wilcoxon tests.

Results: Of the 17 participants actively engaged in the student-led DPP, 13 were clinic patients and 4 were invited guests. The median weight loss achieved by participants was 5.90% of their total body weight. 13 of the 17 participants (76.50%) achieved the 5% weight loss goal. Age, sex, pre-program body mass index, and English proficiency were not associated with the achievement of the 5% weight loss goal. Though not statistically significant, patients’ average self-scored general health rating (0-100) improved from 72.30 to 81.50 (p=0.12), and the greatest reductions in health limitations were reported with regards to pain (1.94 to 1.70, p=0.28) and daily activities (1.53 to 1.35, p=0.36).

Conclusion: A student-run DPP implementation among low-resource participants is feasible and appears capable of achieving the target 5% weight loss.
A Retrospective Study on the Influence of Participation at a Student-Run Free Clinic on Medical Specialty Choice
Authors: Tang Cynthia , Win George , Unangst Samantha , Haynes Tricia , Pendergraft Brittany , Weisenberger Kaystin , Ohler Adrienne , Long Natalie , Young-Walker Laine
Published: May 2023

Background: The MedZou Community Health Clinic at the University of Missouri School of Medicine is a student-run free clinic (SRFC) providing primary care and specialty services to uninsured patients of Missouri. Little is published about the relationship of volunteerism in SRFCs and residency match results. This study evaluated the association of SRFC volunteering on residency placement. We hy-pothesized that there would be an increased likelihood of medical students matching into specialties correlating with specialty clinics they volunteered with as students. 

Methods: We analyzed data on volunteers who graduated from the University of Missouri School of Medicine between 2010-2019 in this retrospective study. Selection criteria included students who per-mitted publishing their residency match results publicly and actively volunteered for MedZou (at least five volunteer shifts). Odds ratios (OR) were calculated with Fisher exact tests using a confidence in-terval (CI) of 95% to assess whether volunteering in a specialty clinic was associated with matching in that specialty. Clinics with at least five volunteers during the study period were analyzed (Dermatol-ogy, Musculoskeletal [MSK], and Neurology). 

Results: Twenty-nine percent of the MedZou volunteers that fit the inclusion criteria volunteered for the Dermatology, MSK, or Neurology Clinic. We found significant associations between those who volunteered in a specialty clinic and those who matched in a related specialty for Dermatology (OR = 4.25, 95% CI = 1.37, 12.13), Musculoskeletal (OR = 3.49, 95% CI = 1.45, 7.98), and Neurology Clinics (OR = 10.89, CI = 1.71, 50.39). Additionally, 51% of MedZou volunteers that fit inclusion criteria volunteered for Primary Care Clinic. These students were also found to have a significant association with matching into a related primary care specialty (OR= 2.01, CI= 1.14, 3.62). 

Conclusions: The results of this study indicated that clinical exposure at a SRFC specialty clinic was associated with residency match into related specialties.
Implementing Health Behavior Change Consultations for Adult Patients in a Free Student-Led Interprofessional Community Clinic
Authors: Kumar Esha , Konsor Madeline , Sampson Jessica , Schneider Kristin
Published: May 2023

In 2018, the behavioral health clinic within the Interprofessional Community Clinic, a student-led free clinic in Lake County, Illinois, expanded its mental health services by implementing health behavior change consultations (HBCCs) during primary care appointments. HBCCs are conducted by psychology graduate students and are designed to help patients implement behavior and lifestyle changes to improve overall health. Consults are requested by the medical team to assist patients with developing strategies for reasons such as weight management, increasing physical activity, and medication adherence. An HBCC consultant discusses current lifestyle behaviors, identifies motivations and barriers to making change, and assists the patient with goal-setting. Follow-up with patients often occurs during their subsequent medical appointments to monitor progress, reassess goals, and troubleshoot barriers. Since 2018, the utilization of HBCCs increased to an average of one out of six patients receiving an HBCC per clinic day. This descriptive report describes the implementation of HBCCs, a patient case example of an HBCC, and strategies to help student-led clinics implement similar services. Integrating behavior change appointments in student-led clinics through the use of HBCC can help reduce some of the burden on primary care providers and help patients better manage their health conditions.
Incorporation of Standard Operating Procedures for Leadership and Volunteer Transitions in a Student-Run Free Clinic
Authors: Jagadish Ishitha , Modi Neal
Published: May 2023

At the Saint Louis University Health Resource Center, all student leadership roles transition yearly, requiring a robust method to maintain institutional knowledge. Standard operating procedures (SOPs) are written documents containing detailed instructions for the completion of functions within a greater organization. SOPs are utilized in clinical settings and may be useful for student-run free clinics (SRFCs). This project sought to formally establish clinic procedures into centralized documents and assess the utility of these documents. We created SOPs for all leader and volunteer positions which were then assembled into Leadership and Volunteer Handbooks for increased accessibility. Two surveys, one for leaders and one for volunteers, were distributed after the 2020-2021 leadership transition period to investigate the utility of the SOPs. Although the response rates were insufficient, results suggest that leader and volunteer respondents found confidence in utilizing the SOPs during the transition period and beyond. SOPs allow our volunteers and leaders to enhance the performance of their roles despite frequent turnover of positions. Per constructive feedback from survey respondents, we plan to improve awareness of SOPs and increase the frequency of updating SOPs to reflect current clinic operations. Future research should evaluate the utility and efficacy of SOPs in other SRFCs through multiple transition cycles of active leaders and volunteers.
Exploring the Influence of an Interprofessional Student-Run Clinic on Matriculation to Health Professional School: A Retrospective Cross-Sectional Study
Authors: Vanstrum Erik , Mohan Sukriti , Yue Janis , Veloria Daniella , Quon Justin , Lee Renee , Knox Kevin , Fung Cha Chi
Published: May 2023

Background: Projected demographic trends in the United States suggest increasing racial and ethnic diversity. It is important that the healthcare workforce reflects these trends to reduce healthcare disparities among underserved populations. For example, concordant backgrounds between patients and providers improve communication and increase probability that patients seek and receive healthcare among marginalized populations. Building in curricular opportunities to connect with the underserved community is one way to recruit students from diverse backgrounds into this pipeline that will lead to a diverse workforce in healthcare. The objective of this study was to assess the influence of an interdisciplinary student-run clinic (SRC), which focuses on caring for underserved and vulnerable populations, on students’ decisions to matriculate in four health professional programs (medical, occupational therapy, pharmacy, and physician assistant) at a single institution.

Methods: In this retrospective cross-sectional survey study, we examined factors influencing first-year students’ decisions to attend a private university in a large metropolitan area. The primary outcome was students’ self-reported ratings of the university’s SRC as a factor in their matriculation decisions.  Two-tailed Mann-Whitney-U tests was applied to compare the relative importance of SRC on matriculation. Free response data were evaluated by a qualitative content approach.

Results: A total of 419 students completed the survey (73% completion rate) across the 4 programs. We found that underrepresented minorities in medicine (URM) (p < 0.05) and first-generation (p < 0.01) students rated the importance of an SRC on their matriculation decision significantly higher than non-URM and non-first-generation students.

Conclusions: Our findings suggest that the presence of an SRC may positively impact matriculation decisions and diversification of the student body across certain health professional disciplines.
Why Do Physicians Volunteer at Student-Run Free Clinics? A Look into What Drives or Hinders Their Participation
Authors: Greni Susan , Radil Stephanie , McIntire Benjamin , Menning Melanie
Published: May 2023

Background: Student-run free clinics (SRFCs) provide students space to join and lead the care of patients who may not have access to care elsewhere. This is done under supervision of a physician preceptor who ensures safety and quality care while fostering a learning environment for students. The SRFC cannot function without physician preceptors. Concerns about retention and participation at the Student Health Alliance Reaching Indigent Needy Groups (SHARING) Clinic, a SRFC at University of Nebraska Medical Center (UNMC), fueled the investigation into motivations and barriers of physician volunteerism. This study aims to find why physicians volunteer and to propose meaningful strategies to increase retention rates at our institution and other SRFCs.

Methods: An anonymous electronic survey was emailed to 348 physicians from various departments at UNMC. The survey assessed frequency of volunteerism, motivations and barriers, preceptor experiences, demographic information, and free form questions with respect to volunteering at the university associated SRFC. 

Results: Of the 348 survey recipients, 49 (13.5%) physicians responded. The most common barriers to physician volunteerism are work (n=23, 59%) and family obligations (n=23, 59%). The most common motivations are the ability to mentor students (n=14, 36%) and help patients in need (n=12, 31%). Of the respondents, 25 (61%) had never previously volunteered at SHARING. Of those who had volunteered, 7 (44%) reported volunteering at SHARING Clinic on average once or less per year over multiple years. Additionally, 13 (81%) volunteers report that they agree or strongly agree that they were satisfied with the experience and that it helped them improve their mentoring relationships with students.

Conclusions: Collectively, the results indicate that the physicians sampled feel it is valuable to volunteer at the SRFC but are often impeded by other obligations. SRFCs may implement our proposed strategies to enhance motivations and mitigate barriers to physician volunteering.
Designing an Interprofessional, Student-Led Clinic with the Patient-Centered Medical Home (PCMH) Model
Authors: Leighton Claire , Jackson Grayson , Israel Tanner , Chyu Joanna , Jeon Dayoung , Garcia Christopher
Published: May 2023

Students and faculty at the University of Texas Medical Branch (UTMB) embarked on the novel undertaking of establishing a comprehensive, interprofessional clinic treating underserved, uninsured residents of Galveston County, Texas, and the surrounding area, modeled after the patient-centered medical home (PCMH). The need for such a community clinic is evident in relevant literature and patients’ suggestions, in addition to local demographic data. The comprehensive nature of this approach to clinic design is apparent in the intricate planning and documents produced by the steering committee, which outline a unique operational structure that optimizes clinic flow. This paper describes the planning, implementation, and future directions of an interprofessional, student-led free clinic operating under the PCMH model that offers a framework for other clinics.