title: Early learners as health coaches for older adults preparing for surgery.
abstract: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches.
  
  
  
  Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist. A curriculum for health coaching by early learners was developed, implemented, and evaluated in this clinic. Students attended the clinic visit with their patient, reviewed the interdisciplinary care plan, and called patients twice weekly preoperatively and weekly in the first month after discharge. Students logged all calls, completed patient satisfaction surveys 1 wk before surgery and participated in feedback sessions with team members and medical school faculty. Call success rate was calculated, and team communications were recorded and analyzed.
  
  
  
  Median call success rate was 69.2% and was lowest among medical students (P = 0.004). Students and research assistants contacted or facilitated patient contact with their medical team 84 times. Overall, patients were extremely satisfied with the health coach experience, felt better prepared for surgery, and would recommend the program to others.
  
  
  
  Early medical and nurse practitioner students can serve the important function of health coaches for frail patients preparing for surgery. Motivated students benefited from a unique longitudinal experience and gained skills in communication and care coordination. Not all students demonstrated capacity to engage in health coaching this early in their education.
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California. Electronic address: Jenny.Kaplan@ucsf.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Kaplan
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Zabecca
authors.initials: Z
authors.lastname: Brinson
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hofer
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California; Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California; Department of Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Sullivan
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California; Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.affiliation: Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California.
authors.forename: Helen
authors.initials: H
authors.lastname: Horvath
authors.affiliation: Department of Surgical Oncology, U.T.M.D Anderson Cancer Center, Houston, Texas.
authors.forename: George J
authors.initials: GJ
authors.lastname: Chang
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California; Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Emily
authors.initials: E
authors.lastname: Finlayson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D000071252:Mentoring / Q000706:statistics & numerical data*; D009722:Nurse Practitioners; D017060:Patient Satisfaction; D011300:Preoperative Care; D011446:Prospective Studies; D013337:Students, Medical
keywords: Frail older adult; Interprofessional relations; Patient satisfaction; Preoperative care; Undergraduate medical education; Workplace