title: A framework for evaluating student perceptions of health policy training in medical school.
abstract: OBJECTIVE
  Nearly half of graduating medical students in the United States report that medical school provides inadequate instruction in topics related to health policy. Although most medical schools report some form of policy education, there lacks a standard for teaching core concepts and evaluating student satisfaction.
  
  
  METHODS
  Responses to the Association of American Medical College's Medical School Graduation Questionnaire were obtained for the years 2007-2008 and 2011-2012 and mapped to domains of training in health policy curricula for four domains: systems and principles; value and equity; quality and safety; and politics and law. Chi-square tests were used to test differences among unadjusted temporal trends. Multiple logistic regression models were fit to the outcome variables and adjusted for student characteristics, student preferences, and medical school characteristics.
  
  
  RESULTS
  Compared with 2007-2008, students' perceptions of training in 2011-2012 increased on a relative basis by 11.7% for components within systems and principles, 2.8% for quality and safety, and 6.8% for value and equity. Components within politics and law had a composite decline of 4.8%. Multiple logistic regression models found higher odds of reporting satisfaction with training over time for all components within the domains of systems and principles, quality and safety, and value and equity (P < .01), with the exception of medical economics.
  
  
  CONCLUSIONS
  Medical student perceptions of training in health policy improved over time. Causal factors for these trends require further study. Despite improvement, nearly 40% of graduating medical students still report inadequate instruction in health policy.
authors.affiliation: Dr. Patel is a fellow, Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania, and ambulatory fellow, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania. Dr. Lypson is assistant dean for graduate medical education, professor of internal medicine and learning health sciences, University of Michigan Medical School, and staff physician, Veterans Affairs Healthcare System, Ann Arbor, Michigan. Dr. Miller is dean, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada. Dr. Davis is professor of pediatrics and internal medicine, University of Michigan Health System, member, Institute for Healthcare Policy and Innovation, professor, Gerald R. Ford School of Public Policy, and professor of Health Management and Policy University of Michigan, Ann Arbor, Michigan.
authors.forename: Mitesh S
authors.initials: MS
authors.lastname: Patel
authors.forename: Monica L
authors.initials: ML
authors.lastname: Lypson
authors.forename: D Douglas
authors.initials: DD
authors.lastname: Miller
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
mesh_terms: D000328:Adult; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005260:Female; D006291:Health Policy; D006801:Humans; D016015:Logistic Models; D008297:Male; D011050:Policy Making; D012577:Schools, Medical; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014481:United States