Medical students' perceptions of health policy education improving: Study

Study of new teaching framework highlights significant opportunities for continued improvement

Students graduating from U.S. medical schools in 2012 feel they've received a better education in health policy issues than graduates surveyed in 2008, according to a multi-center study led by the Perelman School of Medicine at the University of Pennsylvania, and published online this month in Academic Medicine. The study applied a new framework for teaching and evaluating perceptions of training in health policy, first proposed by the authors in a 2011 perspective published in the New England Journal of Medicine.

"Our prior work found that for nearly a decade, more than 50 percent of graduating medical students were not satisfied with their training in health policy," said lead author Mitesh S. Patel, MD, MBA, MS, a General Internal Medicine physician and a recent graduate of the Robert Wood Johnson Clinical Scholars Program at Penn. "Since the Affordable Care Act was signed into law in 2010, we found new signs of improvement in perceptions in 2011-2012, but 40 percent still report inadequate training. Education in health policy provides future physicians with training in fundamental concepts that will help them to adopt and incorporate new policy changes into their medical-decision making practices that will ultimately impact patient care."

Drawing on data from nearly 53,000 respondents to the Association of American Medical Colleges Medical School Graduation Questionnaire, the study assessed medical students' perceptions of their education in 13 topics assigned to four "domains" of health policy: systems and principles, quality and safety, value and equity, politics and law. Students reported their training in these areas as "appropriate" or "inadequate."

The study found relative improvements in three of the domains: 11.7 percent in appropriate education of "systems and principles," 6.3 percent for education in "value and equity," and a 2.8 percent increase in "quality and safety." The domain "politics and law" had a relative decline of 4.8 percent which was mostly due to perceptions of inadequate training related to medical licensure and regulation.

"We could not assess in this study whether these changes represent improvements in medical school curricula or increased exposure to broader national discussions regarding health policy," said Dr. Patel. "However, it is clear that we have a significant opportunity to impact the training of our future physician workforce by focusing on continuing to improve education in topics related to health policy."