title: Medical students as health educators at a student-run free clinic: improving the clinical outcomes of diabetic patients.
abstract: OBJECTIVE
  Student-run free clinics (SRFCs) provide service-learning opportunities for medical students and care to underserved patients. Few published studies, however, support that they provide high-quality care. In this study, the authors examined the clinical impact of a medical student health educator program for diabetic patients at an SRFC.
  
  
  METHODS
  In 2012, the authors retrospectively reviewed the electronic medical records of diabetic patients who established care at Shade Tree Clinic in Nashville, Tennessee, between 2008 and 2011. They compared clinical outcomes at initial presentation to the clinic and 12 months later. They analyzed the relationship between the number of patient-student interactions (touchpoints) and change in hemoglobin A1c values between these two time points and compared the quality of care provided to best-practice benchmarks (process and outcomes measures).
  
  
  RESULTS
  The authors studied data from 45 patients. Mean hemoglobin A1c values improved significantly from 9.6 to 7.9, after a mean of 12.5 ± 1.5 months (P < .0001). A trend emerged between increased number of touchpoints and improvement in A1c values (r = 0.06, P = .10). A high percentage of patients were screened during clinic visits, whereas a low to moderate percentage met benchmarks for A1c, LDL, and blood pressure levels.
  
  
  CONCLUSIONS
  These findings demonstrate that a medical student health educator program at an SRFC can provide high-quality diabetes care and facilitate clinical improvement one year after enrollment, despite inherent difficulties in caring for underserved patients. Future studies should examine the educational and clinical value of care provided at SRFCs.
authors.affiliation: Dr. Gorrindo is a trainee, Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee. Dr. Peltz is a resident physician, Department of Medicine, Boston Children's Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts. Mr. Ladner is a medical student, Vanderbilt University School of Medicine, Nashville, Tennessee. Ms. Reddy is a trainee, Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee. Dr. Bonnie Miller is senior associate dean for health sciences education, Vanderbilt University School of Medicine, Nashville, Tennessee. Dr. Robert Miller is associate professor, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee. Dr. Fowler is assistant professor, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Phillip
authors.initials: P
authors.lastname: Gorrindo
authors.forename: Alon
authors.initials: A
authors.lastname: Peltz
authors.forename: Travis R
authors.initials: TR
authors.lastname: Ladner
authors.forename: India
authors.initials: I
authors.lastname: Reddy
authors.forename: Bonnie M
authors.initials: BM
authors.lastname: Miller
authors.forename: Robert F
authors.initials: RF
authors.lastname: Miller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fowler
mesh_terms: D000553:Ambulatory Care / Q000379:methods*; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D002983:Clinical Competence; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D040441:Health Educators / Q000458:organization & administration*; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011787:Quality of Health Care; D012042:Registries; D012189:Retrospective Studies; D013337:Students, Medical; D016896:Treatment Outcome; D019037:Urban Health Services / Q000458:organization & administration