Caring for the underserved: blending service learning and a web-based curriculum.
BACKGROUND
Recognition of health disparities among underserved individuals, whose demographic, geographic, or economic characteristics impede access to health-related services, has led to calls for the development of medical school curricula that address care for the underserved, but reports of the development and evaluation of such curricula are limited.


METHODS
Two formats of a curriculum addressing care for the underserved were developed and implemented during the 6-week pediatric clerkship for third-year medical students during the 2003-2004 academic year. One format was faculty-led; the other was web-based. Skills for providing care to underserved families were taught through didactic, experiential, and service-learning curriculum components. Novel core curriculum elements included a screening tool for recognizing underserved patients and an independent clinical project through which students linked underserved families with community health resources. Analyses from 2004-2005 compared pre- and post-curriculum knowledge and attitudes of web-based students (n = 29) to those receiving either the faculty-led (n = 36) or the established "readings-only" curriculum (n = 35). Qualitative data from service learning projects were analyzed to assess clinical skills.


RESULTS
Compared to students in the established curriculum, both web-based and faculty-led students demonstrated improved knowledge (p < 0.001) and attitudes (p < 0.05) about caring for the underserved. Both web-based and faculty-led students were successful in recognizing and addressing underserved health issues in the clinical setting.


CONCLUSIONS
Faculty-led and web-based curricula can equally improve student knowledge, attitudes, and skills about caring for the underserved.
Cox
Elizabeth D
ED
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726, USA. Ecox@wisc.edu
Koscik
Rebecca L
RL
Olson
Curtis A
CA
Behrmann
Ann T
AT
Hambrecht
Marijka A
MA
McIntosh
Gwen C
GC
Kokotailo
Patricia K
PK
D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002982:Clinical Clerkship; D002983:Clinical Competence; D003153:Community Health Services; D003194:Computer-Assisted Instruction; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D010372:Pediatrics / Q000193:education*; D017664:Uncompensated Care