Teaching Community Health Needs Assessment to First Year Medical Students: Integrating with Longitudinal Clinical Experience in Rural Communities

Community health education is especially important for physicians who will practice in rural communities. However, the majority of efforts to teach community and population health in medical school appear in later years and focus on non-rural contexts. This article presents data from a formative evaluation of a newly developed curricular component on population health and community health assessment for first year medical students in a rural longitudinal clinical preceptorship. Curricular elements included: a classroom lecture and review of online community health databases, an individual homework assignment and a classroom debriefing session. In a sample of 210 students, pre- and post-course surveys and exam questions assessed gains in awareness and skills over the course period. Analyses of data aggregated over four academic years (2013–2014 to 2016–2017) showed that first year medical students reported significant increases in familiarity with online resources (29.5% pre vs. 94.8% post, p <.001), understanding the importance of community health assessments (67.5% pre vs. 96.7%, p <.001), knowing how to plan a community health assessment (20.0% pre vs. 90.5%, p <.001), and awareness of Affordable Care Act expectations for community health assessments (12.4% pre vs. 82.4% post, p <.001). Further, students performed well on exam questions and reported that this component fit well with the objectives of the rural longitudinal clinical preceptorship course. Later-year education should reinforce early learnings and future studies involving long-term follow-up of physicians could assess the impact of early exposure to community health education on physician behaviors.