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Abstract
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Study Objectives
In 2020, there were more than 45,000 deaths from firearms in the United States. Despite growing evidence that physician counseling can impact firearm safety behaviors, few physicians regularly counsel patients. Medical students are rarely exposed to these topics in their undergraduate medical education. This work sought to address this gap by implementing an educational session for early preclinical medical students. Our objective was to introduce firearm injury epidemiology, risk assessment, and counseling strategies into a required clinical skills course and to evaluate students' perspectives on the session and the inclusion of firearm injury prevention in their curriculum.
Methods
The single session intervention was administered to all first year medical students at Alpert Medical School of Brown University in 2021. The session included pre-session readings, an interactive lecture, and small group practice cases. The session was evaluated using a voluntary post-session feedback survey and two student focus groups. Two study authors independently coded all data using NVIVO software. Coding was completed using a combination of deductive codes generated from an initial literature review and inductive codes that emerged during analysis, with discrepancies resolved through regular meetings and discussions.
Results
The single session was administered to all first year medical students (n=146). 59 of 146 students completed the voluntary post-session survey. Most agreed or strongly agreed that they learned new skills related to firearm safety counseling (89.8%), and that their attitudes about physician counseling relating to firearm injury prevention changed (61%). Students identified the provided example counseling phrasing, concrete patient examples, and practice cases as strengths of the session. Students suggested lengthening the in person session, including more real-world case examples, and adjusting and adding to pre-work resources. Two focus groups were conducted (total n=15) three months following the session. Coded themes indicated that students were receptive to this curriculum, and that the session helped them understand the clinical applications of firearm risk identification and counseling. However, the students noted that the session was only an introduction and felt the topic deserved additional curricular time and integration with other parts of the clinical curriculum. In particular, students were eager to hear from firearm owners, in part due to a perceived lack of cultural competency and fear of coming across as judgemental or politically motivated.
Conclusion
This curriculum fills a critical gap in undergraduate medical education. Our results indicate that most students are interested in this topic, recognize its value, and feel it is an appropriate part of medical school curricula. Students felt that a single session was insufficient to fully address this topic and requested greater integration with other clinical topics and the inclusion of perspectives from firearm owners/users.
Language: en |