Medical Students Knowledge, Attitudes, and Perceptions Regarding the Affordable Care Act and Other Health Policy Issues
Creators: name: Vidwan, Navjyot
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2015

description: ABSTRACT BACKGROUND: Very little is known regarding medical student's attitudes and knowledge on the Affordable Care Act (ACA) and if they are willing to engage in its implementation as part of their future professional obligations. OBJECTIVE: To characterize medical students' views on and knowledge of the ACA and assess correlates of these views. DESIGN: A link to an IRB-approved online survey was emailed directly to students through their university-affiliated email addresses. Cross-sectional survey. PARTICIPANTS: 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 2,761/5,340 [52%]). MAIN MEASURES: We measured students' levels of agreement with 4 questions targeting ACA viewpoints and ability to answer 9 knowledge-based questions regarding the ACA. Students also had the opportunity to answer 2 open-ended questions to give their opinions on positive and negative aspects of the ACA. KEY RESULTS: The majority of respondents indicated understanding of the ACA (75.3%), support for its enactment (62.8%), and a professional obligation to assist with implementation of the ACA (56.1%). The mean number of correct answers on the knowledge-based questions was 6.9±1.3 out of a possible 9 points. Those who anticipated going into a surgical or procedure- based specialty were less likely to support the legislation (OR=0.6 (0.4-0.7), OR=0.4 (0.3-0.6)), less likely to indicate a professional obligation to implement the ACA (OR= 0.7 (0.6-0.9), OR=0.7 (0.5-0.96)), and more likely to have negative expectations (OR=1.9 (1.5-2.6), OR=2.3 (1.6-3.5)) when compared to those who plan to go into a medical or primary care specialty. Those who identified themselves as political moderates, politically liberal, and those with an above average knowledge score were more likely to indicate support for the ACA (OR=5.7 (4.1-7.9), OR= 35.1 (25.4-48.5), OR= 1.7 (1.4-2.1)) and a professional obligation toward implementation of the ACA (OR=1.9 (1.4-2.5), OR=4.7 (3.6-6.0), OR=1.2 (1.02-1.5))1 Positive comments regarding the ACA from the quantitative section, showed themes focused on appreciation for increased access to care, focus on primary care, coverage for pre-existing conditions, and allowing children to stay on parents' insurance plans until 26 years of age. Negative comments focused on lack of tort reform to lessen the burden of malpractice suits on physicians, no identifiable plan to alleviate physician shortage or reduce physicians' educational debt, and concerns about the economic implications of expanding Medicaid provisions. CONCLUSIONS: This study is one of the first national studies addressing medical students' knowledge and views on the ACA. The majority of student respondents support the ACA. We found that support towards the ACA was highest among students who anticipate a future career in a medical specialty, self-identify as political moderates and liberals, or had an above average knowledge score of the ACA. Strong support of the ACA by future physicians suggests they are willing to be involved with health care reform measures and health policy which may lead to improving access to care for many Americans. However, ongoing input from future physicians is critical as many of them have positive and negative opinions or possibly no opinion (lack of interest or knowledge) on the ACA that may ultimately affect individual health care practices. KEYWORDS: Medical students; Health care reform; Affordable Care Act; Survey.