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SETTING: Task sharing can fill health workforce gaps, improve access to care, and enhance health equity by redistributing health services to providers with less training. We report learnings from a demonstration project designed to assess whether lay student vaccinators can support community immunizations. INTERVENTION: Between July 2022 and February 2023, 27 undergraduate and graduate students were recruited from the University of Toronto Emergency First Responders organization and operated 11 immunization clinics under professional supervision. Medical directives, supported with online and in-person training, enabled lay providers to administer and document vaccinations when supervised by nurses, physicians, or pharmacists. Participants were invited to complete a voluntary online survey to comment on their experience. OUTCOMES: Lay providers administered 293 influenza and COVID-19 vaccines without adverse events. A total of 141 participants (122 patients, 17 lay vaccinators, 1 nurse, and 1 physician) responded to our survey. More than 80% of patients strongly agreed to feeling safe and comfortable with lay providers administering vaccines under supervision, had no concerns with lay vaccinators, and would attend another lay vaccinator clinic. Content and thematic analysis of open-text responses revealed predominantly positive experiences, with themes about excellent vaccinators, organized and efficient clinics, and the importance of training, communication, and access to regulated professionals. The responding providers expressed comfort working in collaborative immunization teams. IMPLICATIONS: Lay student providers can deliver vaccines safely under a medical directive while potentially improving patient experiences. Rather than redeploying scarce professionals, task sharing strategies could position trained lay vaccinators to support immunizations, improve access, and foster community engagement.

RéSUMé: LIEU: Le partage de tâches peut combler les pénuries de personnels de santé et améliorer l'accès aux soins et l'équité en santé en redistribuant les services de santé vers des prestataires ayant moins de formation. Nous rendons compte des enseignements d'un projet de démonstration visant à déterminer si des vaccinateurs étudiants profanes pourraient appuyer l'immunisation communautaire. INTERVENTION: Entre juillet 2022 et février 2023, 27 étudiantes et étudiants de premier cycle et de cycles supérieurs ont été recrutés auprès de l'organisation des secouristes opérationnels de l'Université de Toronto pour gérer 11 cliniques de vaccination sous la supervision de personnel spécialisé. Des directives médicales, appuyées par une formation en ligne et en présentiel, ont permis à ces prestataires profanes d'administrer des vaccins et de les consigner en dossier sous la supervision d'infirmières, de médecins ou de pharmaciens. Les personnes participantes ont été invitées à répondre à un sondage en ligne sur leur expérience. RéSULTATS: Les prestataires profanes ont administré 293 vaccins contre la grippe et la COVID-19 sans manifestations postvaccinales indésirables. En tout, 141 personnes (122 patients, 17 vaccinateurs profanes, 1 infirmière et 1 médecin) ont répondu au sondage. Plus de 80 % des patients ont dit se sentir tout à fait en sécurité et à l'aise de recevoir des vaccins administrés par des prestataires profanes sous supervision, n'avoir aucune inquiétude vis-à-vis des vaccinateurs profanes et être disposés à se présenter à une autre clinique gérée par des vaccinateurs profanes. L'analyse du contenu et des thèmes des réponses aux questions ouvertes a révélé des expériences majoritairement positives, et des thèmes axés sur l'excellence des vaccinateurs, l'organisation et l'efficacité des cliniques, ainsi que l'importance de la formation, des communications et de l'accès à des professionnels réglementés. Les prestataires ayant répondu au sondage se sont dit à l'aise de travailler au sein d'équipes de vaccination collaboratives. CONSéQUENCES: Des prestataires étudiants profanes peuvent administrer des vaccins en toute sécurité en suivant une directive médicale, et cela peut potentiellement améliorer l'expérience des patients. Plutôt que de redéployer des ressources professionnelles limitées, les stratégies de partage de tâches pourraient placer des vaccinateurs profanes formés pour appuyer l'immunisation, améliorer l'accès et favoriser l'engagement communautaire.

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BACKGROUND: Skin disease is a significant contributor to the global disease burden, with dermatologic health disparities adding to this burden. Internists, general practitioners, and other medical professionals often manage skin disease with limited exposure to dermatologic education in medical school. OBJECTIVE: This study evaluated a brief educational intervention for medical students to improve dermatologic knowledge, diagnostic and communication skills, and comfort in performing dermatology-focused physical exams. A secondary focus of the intervention was to promote awareness of skin disease, detection, and prevention for patients with a variety of skin tones. METHODS: Sixty-five first through fourth-year students at Rutgers RWJMS participated in a pre-test-post-test within-subject study. Students described images using open-ended responses followed by multiple-choice identification questions. Students watched a one-hour self-paced module created by a licensed dermatologist and completed a follow-up assessment. RESULTS: At pre-test, descriptions were brief and often inaccurate but significantly improved post-intervention to include descriptors such as primary morphology and demarcation. Accuracy on diagnostic and management questions significantly improved and comfort in advising patients and performing dermatologic exams significantly increased. CONCLUSIONS: A low-cost, brief, self-paced module can augment dermatologic education for medical students while increasing exposure to multiple skin tone presentations of lesions.

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Background: Nutritional recommendations for patients with type 2 diabetes mellitus (T2DM) and hypertension assume high food security. However, food insecurity is estimated to affect 10% of the US population and more so patients at our student-run free clinic (SRFC). The aims of the study were to (1) assess food security in patients with a diagnosis of T2DM, hypertension, or both and (2) examine the relationship between food security and glycated hemoglobin (HbA1C) or blood pressure at an SRFC. Methods: Eligible participants completed a 10-item food security questionnaire and an item addressing perceived barriers. Most recent HbA1C and blood pressure measurements were gathered. Comparisons were made using univariate or multivariate linear regression analysis. Results: Results from 79 participants showed that 25.3% experienced high food security, 29.1% had marginal food security, 13.9% had low food security, and 30.4% had very low food security. No statistically significant association was found between food security category and HbA1C or blood pressure. However, we did find that approximately 73% of patients experienced some degree of food insecurity. Conclusions: Patients at our SRFC are ethnically and racially diverse, most have a high school education or less, and most have food insecurity. No association between food security category and HbA1C or blood pressure control was found. Providers should consider the degree of food insecurity and incorporate a culturally sensitive approach when making nutritional recommendations.

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Hawai'i experiences some of the highest rates of houselessness per capita in the country. COVID-19 has exacerbated these disparities and made it difficult for these individuals to seek medical care. Hawai'i's Houseless Outreach in Medical Education (HOME) clinic is the largest student run free clinic in the state, which provides medical services to this patient population. This article reports the demographics, medical needs, and services provided to patients of Hawai'i's HOME clinic during the era of COVID-19. From September 2020 to 2021, the HOME clinic saw 1198 unique visits with 526 distinct patients. The most common chief complaints included wound care (42.4%), pain (26.9%), and skin complaints (15.7%). A large portion of the population suffered from comorbidities including elevated blood pressure (66%), a formal reported history of hypertension (30.6%), diabetes (11.6%), and psychiatric concerns including schizophrenia (5.2%) and generalized anxiety (5.1%). Additionally, a large portion of patients (57.2%) were substance users including 17.8% of patients endorsing use of alcohol, 48.5% tobacco and 12.5% marijuana. The most common services provided were dispensation of medication (58.7%), wound cleaning/dressing changes (30.7%), and alcohol or other drug cessation counseling (25.2%). This study emphasizes that the houseless are a diverse population with complex, evolving medical needs and a high prevalence of chronic diseases and comorbidities.

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Introduction: Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured population. Methods: In this cross-sectional study, we screened adult patients without health insurance (N = 238) for nine traditional SDOH needs as well as their access to dental and mental health care between October 2021 and October 2022. Patients were surveyed at intervals greater than or equal to 30 days. We assessed correlations between SDOH needs and trends in patient-reported resource usefulness. Results: Access to dental care (64.7%) and health insurance (51.3%) were the most frequently endorsed needs. We found significant correlations (P ≤ 0.05) between various SDOH needs. Notably, mental health access needs significantly correlated with dental (r = 0.41; 95% CI = 0.19, 0.63), medications (r = 0.51; 95% CI = 0.30, 0.72), utilities (r = 0.39; 95% CI = 0.17, 0.61), and food insecurity (r = 0.42; 95% CI = 0.19, 0.64). Food-housing (r = 0.55; 95% CI = 0.32, 0.78), housing-medications (r = 0.58; 95% CI = 0.35, 0.81), and medications-food (r = 0.53; 95% CI = 0.32, 0.74) were significantly correlated with each other. Longitudinal assessment of patient-reported usefulness informed changes in the resources offered. Conclusions: Understanding prominent SDOH needs can inform resource offerings and interventions, addressing root causes that burden under-resourced patients. In this study, patient-reported data about resource usefulness prompted the curation of new resources and volunteer roles. This proof-of-concept study shows how longitudinally tracking SDOH needs at low-resource clinics can inform psychosocial resources.

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Within a small geographic area, Marion County contains a stark spectrum of health outcomes and socioeconomic statuses. The Indiana University Student Outreach Clinic (IUSOC) serves as a safety net provider, offering free health and social services in the Near Eastside neighborhood of Indianapolis. The aim of this study was to characterize the demographics and geographic distribution of the IUSOC's patient population. From January to September 2023, 612 patients visited the IUSOC, and 460 self-identified as Marion County residents. 63.9% of patients were between 45 and 64 years old. 66.8% were Non-Hispanic (NH) Black, and 23.3% were Hispanic. 18.9% spoke Spanish and had limited English proficiency. Based on the Distressed Communities Index (DCI), 58.7% lived in "Distressed" zip codes, indicating economic vulnerability and disparities. The zip code with the greatest number of IUSOC patients had the highest rate of uninsured adults in Marion County. IUSOC patients are primarily middle-aged minorities who live in zip codes with low socioeconomic rankings by DCI. This information can be used to improve community resource referral pathways in the clinic.

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Phenomenon: Student-run free clinics (SRFCs) serve an integral role in most United States (US) medical schools and contribute substantially to literature on the quality of care to uninsured persons. There has been substantial growth over the past decade of scholarly work produced by SRFCs as they have increased in size and number. Research on patient care outcomes informs better care structures for patients, however there is no current synthesis of patient care outcomes research among SRFCs. This article provides an overview of SRFC research on patient outcomes to understand current research domains and to identify gaps in the literature. Approach: We completed a scoping review by searching Scopus, PubMed, and Journal of Student Run Clinics in June 2021. All peer-reviewed, English-language articles focused on patient-centered outcomes at SRFCs in the US were included. Two independent reviewers performed title, abstract, and full-text screening of relevant works, and eight reviewers conducted data extraction. Descriptive data analysis was performed along with relevant content analysis of patient-centered outcomes. Findings: The search strategy identified 784 studies, of which 87 met inclusion criteria. Most studies were published within the last six years (81.6%), located in California, New York, or Florida (43.7%), and intervention based (33.3%). Many studies (46.0%) had a specific disease of focus of which diabetes was the most researched(19.5%). Patient-centered studies were the leading focus of the study aims (40.2%), where key findings demonstrated primarily improved outcomes in clinic metrics post-intervention (36.8%) or equivalent/better clinical performance than national metrics (20.7%). Insights: This review brings to light gaps in the literature reporting research in SRFCs and can be applied to other low-resource settings. Future efforts to expand SRFC outcomes research should focus on community relationship building, understanding institutional support, and ensuring education on best practices for research within SRFCs. Doing so informs patient care improvement as SRFCs continue to operate as safety net clinics for marginalized populations.

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Background: The Student Health Initiative for the Needs of Edmonton (SHINE) dental clinic is a student-volunteer-operated clinic offering free oral care to low-income individuals. However, little is known about how SHINE impacts access to care. Drawing on Penchansky and Thomas' theory of access, this study assessed patient satisfaction to measure access. For further context, patient-reported oral health concerns and alternative oral care options if SHINE were not available were recorded. Methods: The University of Alberta's Research Ethics Board (Pro 00101981) approved the study. Surveys adapted from Penchansky and Thomas were distributed over 12 weeks to all presenting patients. Survey data were triangulated with observations. Data were represented using descriptive statistics, and variables were compared using Chi-squared tests of independence. Results: A response rate of 77% (140/170) was achieved. The survey revealed that patients were generally satisfied with access to SHINE. However, observations revealed physical accessibility barriers. Dissatisfaction was correlated with attending SHINE without receiving treatment. Patients primarily presented to SHINE for pain (55%, 76/139). If SHINE were not available, 38% (46/121) of patients reported they would seek care from an alternative oral health professional, 32% (39/121) through an emergency department or physician, and 27% (33/121) would not attain oral health care at all. Conclusion: SHINE could be seen as addressing the need for access to oral health care services. The remaining barriers to care include long waiting times and clinic capacity to deliver care. A faster triage process may reduce waiting times. However, SHINE cannot provide more oral health care due to clinic capacity. Lastly, access to clinics such as SHINE may reduce visits to emergency departments for oral health care.

Introduction: La clinique dentaire « Student Health Initiative for the Needs of Edmonton (SHINE) ¼ est une clinique dirigée par des étudiants bénévoles qui offre des soins buccodentaires gratuits aux personnes à faible revenu. Néanmoins, on sait peu de choses sur l'incidence de la clinique SHINE sur l'accès aux soins. S'appuyant sur la théorie de l'accès de Penchansky et de Thomas, cette étude a évalué la satisfaction des patients pour mesurer l'accès. Pour plus de clarté, les problèmes de santé buccodentaire déclarés par les patients et les autres options de soins buccodentaires, s'ils n'étaient pas offerts par SHINE, ont été consignés. Méthodes: Le comité d'éthique en recherche de l'Université de l'Alberta a approuvé l'étude (Pro 00101981). Des sondages adaptés de la théorie de Penchansky et de Thomas ont été distribués sur 12 semaines à tous les patients qui se sont présentés. Les résultats ont ensuite été corroborés avec des observations. Les données ont été représentées à l'aide de statistiques descriptives, et les variables ont été comparées à l'aide du test d'indépendance chi carré. Résultats: Le taux de réponse a été de 77 % (140/170). Le sondage a révélé que les patients étaient généralement satisfaits de l'accès à SHINE. Toutefois, les observations ont révélé des obstacles physiques à l'accessibilité. L'insatisfaction était corrélée au fait de faire appel à SHINE sans recevoir de traitement. Les patients ont principalement fait appel à SHINE en raison de douleurs (55 %, 76/139). Si SHINE n'était pas disponible, 38 % (46 sur 121) des patients ont déclaré qu'ils iraient chercher des soins auprès d'un autre professionnel de la santé buccodentaire, 32 % (39 sur 121) par l'entremise d'un service d'urgence ou d'un médecin, et 27 % (33 sur 121) n'obtiendraient pas du tout de soins buccodentaires. Conclusion: La clinique SHINE peut être considéré comme une solution au besoin d'accès aux services de soins de santé buccodentaire. Les autres obstacles aux soins comprennent les longs temps d'attente et la capacité du programme à fournir des soins. Un processus de triage plus rapide pourrait réduire le temps d'attente. Toutefois, SHINE ne peut pas fournir plus de soins buccodentaires en raison de sa capacité d'accueil. Enfin, l'accès à des cliniques comme SHINE peut réduire le nombre de visites aux urgences pour des soins buccodentaires.

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OBJECTIVE: To assess rates of breast and cervical cancer screening at student-run free clinics to understand challenges and strategies for advancing quality and accessibility of women's health screening. METHODS: The authors performed a systematic search of publications in Ovid MEDLINE, PubMed, Web of Science, and Google Scholar databases from database inception to 2020. English-language publications assessing rates of breast and cervical cancer screening in student-run free clinics were included. Structured data extraction was completed for each publication by two reviewers independently. Risk of bias was assessed using a modified Agency for Healthcare Research and Quality checklist. Results were synthesized qualitatively because of study heterogeneity. RESULTS: Of 3634 references identified, 12 references met study inclusion criteria. The proportion of patients up-to-date on breast cancer screening per guidelines ranged from 45% to 94%. The proportion of patients up-to-date on cervical cancer screening per guidelines ranged from 40% to 88%. CONCLUSION: Student-run free clinics can match breast and cervical cancer screening rates among uninsured populations nationally, although more work is required to bridge the gap in care that exists for the underinsured and uninsured.

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The purpose of this study was to gain insight into change in attitudes held by students in oral healthcare about interprofessional learning and collaboration after one year of work in a student-run dental clinic (SRDC). Third- and fourth-year bachelor of dental hygiene students (n = 221) and first- and second-year master of dentistry students (n = 203) participated in baseline and follow-up measurements and completed 570 questionnaires. The Readiness for Interprofessional Learning Scale (RIPLS) was used to measure changes in attitudes toward Interprofessional Education (IPE) during participation in the SRDC. To validate the questionnaire for the setting, professional groups, and wording of RIPLS, we performed exploratory and confirmatory factor analyses. Two modified subscales remained: "Teamwork & Collaboration" and "Negative Professional Identity." Mixed linear models were used to assess relationships between students' attitudes toward IPE and participation in the SRDC. Overall, the students had positive attitudes toward IPE. At baseline, the attitudes of the dental hygiene and dentistry students were almost equally positive. After one year, dental hygiene students demonstrated a significantly more positive attitude toward collaborative learning and teamwork than the dentistry students. Further research should investigate whether the positive attitudes impact behavior in professional practice.

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Student-faculty collaborative clinics, like the Crimson Care Collaborative (CCC), provide primary care access to underserved communities. Affiliated with a community health center, CCC-Chelsea serves a largely immigrant and refugee population. This study aimed to analyze patients' reported ED use before and after they presented to CCC-Chelsea and whether types of insurance affect ED use. We prospectively surveyed 229 patients presenting to CCC-Chelsea between 2013 and 2019. Patients who presented for two or more visits at least one year apart were included in the study. A two-sided Wilcoxon signed rank test was used to compare reported ED use before and after presenting to CCC-Chelsea, and a Kruskal-Wallis test analyzed the association between ED use and insurance status. Most patients (77.7%) presenting to CCC-Chelsea identified as Hispanic, 70.9% were male, 50.6% of patients reported an income of less than $15,000 yearly, and 30.4% had an income between $15,000-$30,000. Most patients (51.9%) did not specify the type of insurance used, followed by public insurance (36.7%), with the remaining having private or no insurance. Results from our survey showed that patients who returned to CCC-Chelsea reported a decrease in the average number of yearly ED visits after attending CCC-Chelsea (pre-CCC 1.544, post-CCC 0.696, p < 0.001 at the 95% CI). There was no difference in reported average number of ED visits yearly and insurance type (p = 0.579). Patients' reported ED utilization after accessing care at CCC-Chelsea decreased. Increased access to student-faculty collaborative clinics could reduce ED use in underserved populations.

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Background and objective Patients' demographics (race, age, gender, and ethnicity) have been determined to affect patients' health status. It has been established that chronic disease prevalence varies by race, age, gender, and ethnicity; however, not much is known about how these demographic factors influence presenting conditions or complaints within a student-run clinic (SRC). This study aimed to investigate how demographic factors in the Apopka community in Florida determine what internal medicine (IM) conditions or complaints patients present with at a student-run free clinic. Methods Electronic medical record (EMR) data for adult patients seen at the clinic from February 2019 to February 2020 were reviewed to collect information on patient demographics, IM presenting conditions or complaints, and body mass index (BMI). Binary logistic regressions were employed to investigate the relationship between demographic factors and presenting conditions or complaints. Results The majority of the patients were female (62.2%), with an almost equal representation of Hispanic (50.3%) and non-Hispanic individuals. About half of the patients visiting the clinic were either overweight or obese. Of the 167 patients, the average age was 44.17 and 44.32 years for males and females respectively. The most common presenting conditions or complaints included cardiac conditions (25.07%), diabetes (9.64%), gastric pain (9.21%), and upper respiratory infection (URI)/allergies (6.15%). Cardiac conditions were further broken down into hypertension (18.94%), dyslipidemia (3.94%), and palpitations (2.19%). Patient age was a contributing factor to the incidence of diabetes (p=0.002), hypertension (p<0.0001), and cardiovascular conditions excluding hypertension (p=0.021). There was a significant relationship between obesity and diabetes (p=0.036) and hypertension (p=<0.001). Conclusion SRCs can make use of the information obtained from this study to advocate for coverage of medications to treat diabetes and hypertension in this undocumented population to prevent morbidity rates. We believe our findings can also provide guidance in terms of instituting screening programs for these illnesses among the broader population and SRCs with different patient makeups.

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Student-run clinics (SRCs) are becoming increasingly popular at medical schools in the United States. These clinics have provided a variety of benefits, including serving disadvantaged populations and providing early clinical exposure for students. There has been no consensus on the impact of SRCs on medical education, specialty selection, and patient care. This review provides a thorough overview of student and patient outcomes as a function of medical students volunteering at SRCs. We queried PubMed for original literature published in English between the years 2000 and 2020. Inclusion criteria included primary research articles evaluating the impact of medical student participation in SRCs on education, specialty selection, and patient care. All articles included in the final review were agreed upon by three reviewers, and the pertinent data were extracted. Of 10,200 initial search results, seven papers were included in this review. These included two studies evaluating medical education, five studies evaluating residency selection, and three studies analyzing patient care. Three studies were included in multiple evaluations. The relationship between volunteering at SRCs and academic performance is unclear. Clinic volunteers had increased retention of empathy compared to non-volunteers. Additionally, clinic volunteers provided satisfactory care as determined by patient-reported outcomes, and were not more likely to pursue primary care specialties. As SRCs are increasing in number, research into the impact on medical students and patients is necessary to understand how these clinics may affect the field of health care. It is important to further evaluate how medical student involvement in SRCs can further improve patient care and outcomes.

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Background: Student-run clinics (SRCs) offer an innovative approach to expand healthcare access and equity and increase clinical placement opportunities for students. However, research on the health benefits and/or outcomes of such clinics is currently fragmented. Methods: An integrative review was conducted to capture and synthesize findings across a range of study types involving varied student disciplines, student delivered intervention types, and health conditions addressed or care areas of focus. Only published and peer reviewed studies were included. Studies needed to report outcomes in a defined study group measured over time, or report SRC data with explicit comparisons to non-SRC settings. Data were analyzed using inductive content analysis to identify major themes and natural clustering of health outcomes measured. Results: Fifty-one articles were selected for review based on the eligibility criteria. Studies were predominantly from the United States, and most (n = 34, 67%) adopted a case review methodology for measuring outcomes. Health outcomes were evaluated in relation to a range of health conditions that, for the purposes of this review, were considered to naturally cluster into eight categories: diabetes, hypertension, functional health/quality of life, depression, hospital utilization, substance use, weight, health screening/vaccinations, and others. Conclusion: This integrative review sought to evaluate the health outcomes accrued by patients in student-run health clinics. Taken as a whole, the literature suggests positive health outcomes resulting from student-run clinics across a range of health conditions. Greater confidence in care-related findings would be achieved from future research utilizing more robust and prospective study designs.

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The Crimson Care Collaborative (CCC) is a network of seven student-faculty clinics in the Greater Boston area that provides primary care services to underserved patient populations and social services to address social determinants of health. Promoting healthy behaviors and health-seeking habits are among the most important focuses in the field of public health and medicine. The main objective of this study is to understand the influence that the student-faculty collaborative clinic in Chelsea has on where patients seek out medical information and if that influence changes with time. To study this phenomenon, a retrospective analysis was conducted for six years of data (2013-2019). The CCC Chelsea patient survey database included 349 surveys for 229 patients. McNemar's test for paired patient survey data showed no significant difference between health information seeking preferences before and after a CCC visit ([2.783], p = 0.093). Chi-square comparing these three visit types is associated with a significant p-value of 0.025 ([Formula: see text] = 7.374). Patients who are at their second visit at CCC are more likely to report favoring reliable sources of medical information, and patients at their third visit are increasingly more likely to report first consulting reliable sources of medical information, including doctors and other healthcare providers. Fisher's test showed no significant difference between health information seeking preferences for patients who last saw a health professional less than 6 months prior to survey administration and greater than 6 months prior to survey administration at a significance level of 0.05 (p = 0.06). Our results suggest that clinic attendance may have an impact on patients' use of reputable sources of medical information in CCC Chelsea, and the positive impact that clinic attendance has on health information seeking habits may be long-standing.

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INTRODUCTION: Changes in society, new public demands for dental care and contemporary educational insights have influenced dental education worldwide and demand a renewed perspective. Following this perspective, an innovative interprofessional dental Master curriculum was developed at Radboud University Nijmegen in the Netherlands. EDUCATIONAL PRINCIPLES: The curriculum is based on five contemporary educational principles and the core of the curriculum consists of a Student Run Dental Clinic that is fully run by students under professional supervision. THE NEW CURRICULUM: In the Student Run Dental Clinic, Master dental students and Bachelor oral hygiene students are responsible for the care of approximately 750 patients. The students work within the same clinic for 3 years and patients receive oral health care from the same students over a long period. The clinic is a longitudinal cross-disciplinary clinic with different dental subdisciplines. Entrustable professional activities (also known as EPAs), to our knowledge not yet widely used in dental education, were introduced to facilitate learning and assessment. Fourteen EPAs have been developed to stimulate interprofessional education and learning. Of these, five EPAs are identical for the dental and oral hygiene curriculum, leading to extended interprofessional education and learning in the Student Run Dental Clinic. DISCUSSION: Preliminary results show that EPAs are generally well received by supervisors and students. CONCLUSION: To monitor and investigate the exact effect of the interventions and underlying mechanisms, a research programme on interprofessional learning, practice-based learning and EPAs and entrustment in dental education was recently set up.

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BACKGROUND: Student-led clinics have gained increasing attention as a mechanism for students across various health professions to gain authentic interprofessional clinical placement experience during their educational programme. PURPOSE: This scoping review is designed to identify and describe experiences relating to student-led clinics in Aotearoa New Zealand. METHODS: The review involved five key steps: 1) identifying the research question; 2) identifying relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results. DISCUSSION: Student-led health clinics present invaluable educational opportunities for authentic collaborative practice and capacity to improve population health and well-being, especially in marginalised and disadvantaged communities. Clinic establishment and operation require consideration of a complex set of factors. CONCLUSION: Community consultation (including with Indigenous populations) should precede establishment of clinics. There is scope for more reporting and objective evaluation to ensure best practice is being determined, developed, and achieved.

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The objective of this study was to describe the frequency that healthcare and social support services offered by JeffHOPE, a student run clinic for people experiencing homelessness in Philadelphia, PA, were utilized by patients. This study also aimed to investigate where patients would seek medical care on a given day had they not been able to access JeffHOPE. This study was conducted via mixed methods consisting of retrospective chart review of patient encounter records and a patient survey conducted weekly throughout 2019, both at a single clinic site, and retrospective chart review of January through March 2020 records at 5 clinic sites. This study found that the frequency of services utilized varied between clinic sites, and that Pharmacy and Procedure committees were the most utilized when examining the combined clinic data. Additionally, the survey found that JeffHOPE provided medical care to those that otherwise would not have sought it. Clinics also served as an alternative to accessing care for non-emergent issues in an Emergency Department (ED) for some patients, but for others it replaced seeing their primary care provider (PCP). This study confirmed that the services offered by JeffHOPE are well-utilized by patients experiencing homelessness in Philadelphia. It also revealed that while the organization's medical services filled care gaps and potentially decreased unnecessary ED visits, they were also sometimes accessed in lieu of a PCP visit. A focused effort on linkage to formal primary care services for all JeffHOPE patients and expanding collection of more granular data to all clinics represent important future endeavors for this student run organization.

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The East Harlem Health Outreach Partnership (EHHOP) is a medical student-run and attending-supervised clinic that provides primary care to predominantly Spanish-speaking, uninsured patients living in East Harlem, New York. In 2010, the clinic launched a Women's Health Clinic (WHC), to offer comprehensive gynecologic and reproductive healthcare under the guidance of faculty gynecologists. In this cross-sectional study, we analyzed WHC data from January 2018 to March 2021. Over this period, 59 individual patients were seen over 39 clinical sessions through a total of 164 clinical encounters staffed by 43 medical students and 19 faculty preceptors from the Department of Obstetrics and Gynecology at Mount Sinai. The most common reasons for referral to the EHHOP WHC were abnormal uterine bleeding, contraception counseling, and management of abnormal Pap smears; the most common procedures performed were Pap smears, long-acting reversible contraception placements and removals, and colposcopies. We discuss the critical role that student-run, physician-supervised reproductive health clinics play in reducing disparities in gynecologic care for uninsured women.

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The successful treatment of depressive disorders critically depends on adherence to prescribed treatment regimens. Despite increasing rates of antidepressant medication prescription, adherence to the full treatment course remains poor. Rates of antidepressant non-adherence are higher for uninsured patients and members of some marginalized racial and ethnic communities due to factors such as inequities in healthcare and access to insurance. Among patients treated in a free, student-run and faculty-supervised clinic serving uninsured patients in a majority Hispanic community in East Harlem, adherence rates are lower than those observed in patients with private or public New York State health insurance coverage. A prior study of adherence in these patients revealed that difficulty in obtaining medications from an off-site hospital pharmacy was a leading factor that patients cited for non-adherence. To alleviate this barrier to obtaining prescriptions, we tested the effectiveness of on-site, in-clinic medication dispensing for improving antidepressant medication adherence rates among uninsured patients. We found that dispensing medications directly to patients in clinic was associated with increased visits at which patients self-reported proper adherence and increased overall adherence rates. Furthermore, we found evidence that higher rates of antidepressant medication adherence were associated with more favorable treatment outcomes. All patients interviewed reported increased satisfaction with on-site dispensing. Overall, this study provides promising evidence that on-site antidepressant dispensing in a resource-limited setting improves medication adherence rates and leads to more favorable treatment outcomes with enhanced patient satisfaction.

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