bluuebunny/crossref_metadata_2025_split huggingface dataset:
Student-Run Clinics Adapt to Emerging Changes in Healthcare and Education
Authors: Coburn Brian , Seryak Katie , Lander Jessica 
Published: May 2023

Healthcare and medical education have undergone rapid evolution in the past five years. These changes highlight the flexibility and impact of student-run clinics (SRCs). From the passage of the Affordable Care Act to medical educationâ€™s increasing emphasis on healthcare delivery and experiential learning, the rise of SRCs has placed students on the front lines of progress. During this time, the Society of Student-Run Free Clinics (SSRFC) has worked diligently to help clinics adapt and prosper in this new era. In this article we reflect on the upcoming SSRFC Annual Conference and how SRCs are situated to adapt to these recent changes. We conclude by identifying specific SSRFC goals to help students and clinics continue to grow.
Formula for a Comprehensive Year Four Student-Run Free Clinic Elective
Authors: LaJeunesse Christopher , Bains Ashika , Fisher Rebecca , Chadwell Margit , Binienda Juliann 
Published: May 2023

Many student-run clinics offer electives for professional students. They provide additional clinical experience and exposure to practice management. Since it began five years ago, Wayne State University School of Medicineâ€™s Robert R. Frank Student-Run Free Clinic offers its fourth-year medical students with an innovative and comprehensive elective. Twenty-five students have completed this elective. Four pillars create the foundation of this unique learning environment: clinical care, leadership/mentorship, teaching, and scholarship. We present a blueprint for professional schools to shape their elective to become truly student-run and to give advanced students a rich capstone experience preparing them for future training.
A Chronic Disease Management Program at the Rowan School of Osteopathic Medicineâ€™s Student-Run Free Clinic
Authors: Goldwaser Eric , Bibber Bernadette , Eckert Kathryn , Paglinco Samantha , Leroy Kyley , Alaimo Danielle 
Published: May 2023

In the United States, one out of every four adults is living with at least one chronic disease. Treatment of these chronic conditions accounts for 84% of healthcare spending. Successful treatment of chronic diseases involves support from family, the community, and the healthcare system. In this descriptive report, we outline the beginning steps of implementing a new program aimed at addressing a pervasive chronic disease in the population seen at our student-run clinic. The Rowan University School of Osteopathic Medicineâ€™s Camden Community Health Center in conjunction with the Camden Area Health Education Center gathered information from a community needs assessment and focus group to better direct efforts at optimizing healthcare delivery to the priorities of the community. After collecting the data, a chronic disease management pilot program targeting patients with chronic hypertension was created. The program included a course run over a six-week period, in which a peer-run educational group focused on lifestyle changes and medical management of hypertension. This plan utilized community health workers, a â€œbuddy system,â€ and family support. At the end of the program, participants were provided with a weekly blood pressure log, action plan for their disease management, and specific follow-up appointments. Furthermore, we briefly share preliminary data that allowed us to gauge success of the pilot program and form the basis for a larger, more comprehensive follow-up study.
Understanding the Barriers to Optimal Nutrition in Uninsured and Underserved Adults at the CommunityCare Free Medical Clinic in Toledo, Ohio
Authors: Marino Elizabeth Bedell , Thuppal Hayavadhan , Marino Christopher , Welch Philip John 
Published: May 2023

Background: Healthful eating habits are crucial for obesity prevention and are often lacking among the underserved and uninsured. The CommunityCare Free Medical Clinic (CCFMC) exists to serve the primary and preventive health care needs of uninsured and underserved residents of greater Toledo. The goal this study was to better understand the barriers to achieving optimal nutrition in the CCFMC patient population. Methods: A series of five focus groups of CCFMC patients was conducted in July and August 2015 to better understand the underlying factors resulting in poor nutrition in this population. Participants (n=50) were between ages 18 â€“ 65 and racially diverse. Focus group discussions were recorded, transcribed, and analyzed using the long-table approach. Participants responded to 8 questions pertaining to food insecurity and ranked four factors by level of influence on their food purchasing decisions: cost, taste, nutritional value, and ease of preparation.Results: Several themes emerged, such as shame and embarrassment about not being able to afford nutritious food and the reliance on television personalities for nutritional guidance. Participants shared numerous insights on how to improve nutrition-related interventions at CCFMC. The ranking activity revealed that cost and ease of preparation influenced purchasing decisions more than taste or nutritional value.Conclusions: Based on the focus group findings, we suggest student-run free clinics provide a dedicated website for announcing nutrition programs and events, include clinicians in nutrition conversations with patients, and broadcast informational videos in the clinic lobby to promote nutrition awareness and discourse.
Predictors of Patient Retention at a Student-Run Free Clinic
Authors: Hess Matthew C , Chung Sebastian K , Banos James H , Cockrum Richard H , Van Wagoner Nicholas , Hoesley Craig 
Published: May 2023

Background: Studies of patient retention at student-run free clinics (SRFCs) are lacking. We determined variables associated with clinic retention at Equal Access Birmingham (EAB), an urban SRFC that aims to provide acute care for clients with transitory health needs and longitudinal care for patients with chronic diseases. Methods: We retrospectively analyzed EAB patient data from March 1, 2013 to July 1, 2015, including demographic, social, medical history, and clinical care variables. The primary outcome was retention in care, defined as attendance at a follow-up appointment 6 to 12 months after the initial new patient visit. Potential predictors of retention were examined using stepwise multivariate logistic regression.Results: Patient retention rate was 25.2%. Positive predictors of retention included receipt of medication at the initial visit (odds ratio [OR] 15.40, 95% confidence interval [CI] 1.56-152.82), more kept appointments within 6 months of initial visit (OR 2.00, 95% CI 1.51-2.66), and longer time to follow-up (OR 1.14, 95% CI 1.04-1.26). Negative predictors included receiving only acute care at initial visit (OR 0.10, 95% CI 0.01-0.95), any appointment no-shows (OR 0.33, 95% CI 0.13-0.86), and cancellations (OR 0.29, 95% CI 0.09-0.87) within 6 months of an initial visit.Conclusion: This study is one of the first to analyze predictors of patient retention at a SRFC. Although we analyze a relatively small sample size in a single SRFC, our results inform strategies to better retain SRFC patients who have high rates of chronic illness and are vulnerable to loss to follow-up.
Fighting Health Care Provider Stigma: A Novel Approach to Understanding the Impact of Medical School Exposures
Authors: Brug Aaron Matthew , Nix Linda M. , Fitzgerald Claire B , Jones Catherine E , Counts Catherine R 
Published: May 2023

Background: Attitudes of healthcare professionals towards vulnerable patient populations decline throughout their training, and these negative attitudes have been shown to influence health outcomes and access to care. Little is understood about the factors influencing the development of these attitudes. While service-learning has been a proposed solution, there is heterogeneity in curricula, and it is unknown how varying types of exposures affect providersâ€™ stigma towards vulnerable patients.
Methods: Allopathic medical students completed a survey assessing attitudes towards four vulnerable patient populations: people who suffer from schizophrenia, people who suffer from major depressive disorder, people experiencing homelessness, and people with a history of intravenous drug use. Students also rated their level of exposure to three conditions (mental illness, homelessness, and addiction or injection drug use) in clinical volunteer, nonclinical volunteer, and observational and personal capacities. Analysis was conducted using Chi-squared tests and linear regression to assess for association(s) between the self-reported exposure(s) and attitudes towards the vulnerable populations.
Results: There were 278 survey responses. Clinical and non-clinical volunteer exposures were associated with less stigma towards three of the four patient populations studied. Personal exposures to mental health illnesses as well as addiction or injection drug use were also associated with a reduction in stigma towards vulnerable populations. When controlling for gender, year in school, and race, exposure to persons with a mental illnesses or addiction were each associated with less stigma towards multiple vulnerable populations.
Conclusions: Development of curricula for future health care providers should include, if not emphasize, opportunities for students to volunteer in a clinical capacity with vulnerable populations.
A Tale of Two Sister Clinics: Comparing the Use of Online Scheduling Tools to Reduce Patient Wait Times
Authors: Ku Seul , Liu Monica , Rea Sheridan , Mulumba Kabungo , Chen Annabel , Dutta Ritika , Kakusa Bina , Caceres Wendy , Singh Baldeep , Charon Mina , Montacute Tamara 
Published: May 2023

Background: The Cardinal Free Clinics, Arbor Free Clinic (Arbor) in Menlo Park and Pacific Free Clinic (PFC) in San Jose, are student-run free clinics affiliated with Stanford operating since 1990. Patients are seen on a walk-in basis only, and on average, patients may wait more than an hour to be seen, decreasing patient satisfaction. In this study, we looked at whether we could improve patient wait times by administering a free online self-scheduling tool.
Methods: The free version of Acuity Online Scheduling Tool was used to set up 6 online appointment slots for patients at Arbor and 12 at PFC, and walk-in services were provided concurrently. On clinic days, patients with appointments were given priority over walk-ins. Wait times were calculated from time points collected by hand or through the electronic health record system. The Mann Whitney U test was used to compare wait times between patients with and without appointments in each clinic.
Results: The total number of patients being seen on a given day and whether or not patients had online appointments were significant determinants of wait times. Patients at Arbor with appointments had a median wait time of 35 minutes (N=46) compared to 60 minutes (N=231) without appointments (p<0.05). At PFC, patients with appointments waited 22 minutes (N=123) compared to 26 minutes (N=193) without appointments (p=0.09).
Conclusion: Free online scheduling tools can be customized to significantly decrease patient wait times and spread out patient arrival. Given the lack of resources often available for free clinics, it is important to explore the use of free tools to create a better patient experience.
Assessment of Vaccination Rates among Smokers and Non-Smokers at a Student-Run Free Clinic
Authors: Harnish-Cruz Carissa , Silver Jeremy , Veldheer Susan , Jeong Seong Ho , Reedy-Cooper Alexis 
Published: May 2023

Background: While student-run free clinics (SRFCs) increasingly serve as part of the safety net for the uninsured and underinsured, it is unknown whether SRFCs consistently follow immunization guidelines in patients that smoke. This study characterized the preventative care in our clinic by evaluating the rate of adult immunizations and referrals of patients that smoke to cessation treatment.
Methods: We conducted a retrospective chart review of patients seen in 2016 at the LionCare Free Clinic. Data extracted included tobacco smoking status, desire to quit, smoking cessation treatment referrals, influenza and pneumococcal vaccination status, and demographics. Chi-square tests and Fisher Exact analysis were used to examine differences in influenza and pneumococcal vaccination rates in smokers versus non-smokers. We assessed the rate of interested smokers who received a referral to cessation therapy.
Results: In 2016, 498 patients were evaluated, of whom 67% were smokers. Among smokers, 21% reported receiving the influenza vaccination compared to 20% of non-smokers (p=0.85). Seven percent of patients who smoke received the pneumococcal vaccine compared to 5% of non-smokers. Of the total patients who were vaccinated, a small percentage received the vaccines in the clinic. Although 66% of smokers reported interest in quitting during the first clinic visit, only 3% were referred to a smoking cessation program.
Conclusion: SRFCs face challenges in providing preventative health care for the underserved population. Despite guidelines recommending smokers receive the pneumococcal vaccine before age 65, few patients received it. Quality improvement interventions are needed to improve preventative health services to this vulnerable population.
Increasing Patient Activation at a Student-Run Free Clinic: Effectiveness of a Health Education Intervention
Authors: Dutta Ritika , Shearer Emmy , Garcia Luis , Liu Helen , Swee Joshua , Ku Seul , Lai Cara , Lin Steven , Montacute Tamara , Charon Mina 
Published: May 2023

Background: Free clinics can serve as an important source of health information among underserved populations; however, it is difficult to track the effectiveness of health education interventions for these patients. Thus, the objective of our study was to develop and assess the impact of a health education intervention in a student-run free clinic setting.
Methods: A quality improvement project was implemented in which surveys were used to assess four confidence and knowledge measures among patients who did or did not receive health education from undergraduate volunteers. Statistical significance was determined using studentâ€™s t-tests.
Results: Patients who received health education from undergraduate volunteers during clinic visits reported increased confidence in their ability to manage health conditions (p<0.01), knowledge of their prescribed medications (p<0.05), and ability to manage their symptoms (p<0.05) after clinic visits compared to before their clinic visits.
Discussion: Dedicated health education interventions by undergraduate volunteers during free clinic visits can lead to increased patient confidence and knowledge of their health conditions. Due to their iterative nature and ease of implementation, quality improvement frameworks may be a useful way to track the efficacy of health education programs in the free clinic setting.
Impact of a Checklist on Clinic Flow and Patient Visit Times at a Student-Run Free Clinic
Authors: Scott Alyssa , Patel Dolly , Hughes Alexa , Reedy-Cooper Alexis 
Published: May 2023

Background: While student-run free clinics are a valuable resource to the community, there are limitations leading to challenges with clinic flow. Previous research has identified checklists as a useful intervention in medicine. This project sought to evaluate the efficacy of a checklist on student volunteer accuracy and adherence to clinic flow, and patient visit times.
Methods: From June 2019 to February 2020, volunteers at select clinics received a checklist listing important steps of a patient encounter. The authors sent surveys to volunteers following all clinics and recorded patient visit times. The outcomes measured were: volunteer accuracy (number of steps completed); volunteer adherence (order of steps); perceived helpfulness of the checklist; and patient visit times. The first three outcomes were assessed via self-reported survey data and the last outcome was assessed via collection of time data. Fisherâ€™s exact tests to assess statistical significance (p<0.05).
Results: Thirty-eight student volunteers completed surveys, for a response rate of 67.9%. Eighteen (47%) of those who completed surveys were part of the experimental group (received checklist), while the remaining 53% were part of the control group (did not receive checklist). Nine (50%) of 18 volunteers with a checklist spoke to patient navigation and/or lifestyle educators before presenting to an attending, compared to 1 (5%) of 20 volunteers without checklist (p=0.0025). Of the 18 volunteers who received a checklist, 16 (89%) found the checklist helpful. There was no significant difference between mean visit time pre-checklist (74 minutes, SD= 29.6) and post-checklist (79 minutes; SD=28.3; p=0.46, n=134).
Conclusion: The checklist improved clinic flow by increasing volunteer accuracy and adherence. The checklist was also perceived to be helpful, and did not increase patient visit times.
Improving Student EHR Accuracy: An Analysis of Training Methods to Better Prepare Students to Volunteer at Student-Run Clinics
Authors: Sega Annalisa , Bossan Alexia , Abrams Matthew , Cendan Vincent , Gartland Alexander , Nguyen Dang-Khoa , Simms-Cendan Judith 
Published: May 2023

Background: As many students do not have previous experience with electronic health records (EHRs), the Comprehensive Medical Care Outreach Team at the University of Central Florida repeatedly struggled to maintain an accurate and consistent record of patient visits, despite all volunteers attending a lecture-based training session prior to clinic day. This study evaluated changes in student EHR accuracy at this student-run clinic using alternative training methods. We hypothesized that small-group interactive learning would result in higher EHR accuracy than lecture-style learning.
Methods: This study examined EHR accuracy through one year (2019) of data over four clinic sessions. EHR accuracy was defined as completion and correctness of various EHR parameters, consisting of electronically signing notes, medications, allergies, diagnoses, vital signs triage, and subjective, objective, assessment, and plan notes. For the first two clinics, students were trained using large group lecture-style learning, with a lecturer to volunteer ratio of 1:70. For the latter two clinics, students were trained in small-groups based on clinic role, in rooms with an average lecturer to volunteer ratio of 1:8. In these sessions, students then actively utilized the EHR by annotating a standardized patient case before the clinic.
Results: Data shows significant differences (p<0.05) in EHR accuracy of large-group versus small-group training for 11 of 18 parameters, with all parameters demonstrating an increase in accuracy in the experimental groups.
Conclusions: These results indicate that small-group, interactive learning affords greater EHR accuracy than large group lecture-style learning, suggesting more efficient ways to perform EHR training.
An Evaluation of Hemoglobin A1c Monitoring at a Student-Run Free Clinic in Kansas City, Missouri
Authors: Murali Madhavi , Bodepudi Alaya , Casubhoy Imaima , Kraemer Edwin 
Published: May 2023

Background: The hemoglobin A1c is critical for monitoring and managing type II diabetes and providing clinicians with a framework for a treatment plan. Our study analyzes compliance to the American Diabetes Association (ADA) standards of appropriate A1c monitoring and encourages other clinics to monitor the same information within their own clinics.
Methods: A retrospective chart review was conducted on all patients who visited the Sojourner Health Clinic between January 2017 and November 2019. All patients who had met the criteria for A1c screening based on recommendations from the ADA were included in the study, as well as patients who were charted as diabetic or pre-diabetic. A total of 88 patients met the criteria for this study. Data collected included patient documentation as diabetic or pre-diabetic and patientsâ€™ three most recent A1c values with corresponding dates. Based on this data, these patients were categorized as diabetic, pre-diabetic, or non-diabetic, and were evaluated on whether their A1c was monitored at appropriate intervals.
Results: A total of 21.6% of patients were monitored appropriately for their diabetic status determined by their A1c values. Only 18.2% of diabetic patients were accurately monitored. Patients with an unknown diabetic status had the lowest rate of appropriate monitoring.
Conclusions: Most patients at the Sojourner Health Clinic are not properly monitored for diabetes using the clinic's modified A1c monitoring guidelines. The clinic can make several improvements to strengthen adherence to these guidelines with the implementation of new protocols for better A1c monitoring. Further studies should be made to assess the efficacy of these changes.
Establishing a Model for Free Dental Care for Uninsured Patients Served by a Student-Run Clinic
Authors: Nguyen Eliza , Stewart Heather , Maldonado Marissa , Cook Elizabeth , Arboleda Bianca , Simoneit Elizabeth , Palakurty Sri Harsha , Shahin Alexander , Gonzalez Eduardo 
Published: May 2023

Background: This paper details the establishment of a free dental clinic within the Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Healthcare Clinic, a student-run free clinic, in Hillsborough County, Florida through collaboration with Hope in Health Project (HHP), and local dental volunteers. The purpose of the clinic is to provide general dental service to BRIDGE patients. It notes the patient demographics, procedure types, and total cost of care provided at the first dental clinic.
Methods: Nine dentists, two dental hygienists, and one dental assistant were recruited through HHP as well as 29 local volunteers to participate in the clinic. BRIDGE Clinic patients were contacted via text message informing them of the opportunity to receive dental care. A triage event was held for initial evaluation and to determine services needed. The following week, triaged patients returned to receive dental services. Procedures offered included prophylaxis with fluoride varnish, extractions, and fillings.
Results: 71 patients were triaged and 62 received a procedure. The average age was 49Â±10 years. Of patients triaged, 87% (62) received at least one procedure, 72% (51) received prophylaxis with varnish, 18% (13) received extractions, and 39% (28) received fillings. Total number of procedures completed was 126, which included 51 prophylaxis, 28 extractions, and 47 fillings. The total cost for the services provided was 31,065 United States Dollar (USD) with an average cost per patient of 438 USD.
Conclusion: This project demonstrates the successful implementation of a pilot free dental clinic in the context of an established free, primary healthcare clinic. It provides information on the structure and cost of a free dental clinic and how it can be implemented to provide dental care to uninsured patients.