The University of Chicago Pritzker School of Medicine recently launched a new component of its redesigned Phoenix curriculum aimed at transforming early clinical education. Dubbed SHINE (Systems Healthcare Immersion and Navigation Experience), the unique initiative empowers first-year students to directly engage in and contribute to improving patient care in the health system while also learning about social factors that influence health and the importance of interprofessional teamwork.
The SHINE program immerses and engages all first-year students in real-world scenarios as they deal with the practical demands of contemporary health crises.
“Early immersion into the healthcare system provides students with the unique opportunity to integrate and apply concepts learned in the classroom to improve patient care delivery,” said Jeanne Farnan, MD, MHPE, Associate Dean for Undergraduate Medical Education at Pritzker. “It also reinforces the values that are the foundation of the Phoenix Curriculum: clinical care delivery with a systems and equity lens.”
The two programs that comprise SHINE were directly informed by experiences during the COVID-19 pandemic, for which University of Chicago trainees were recognized nationally for their impact on the health system in advancing care.
The first program, OPIATE (Outpatient Principles in Addiction Training and Education), enables first-year medical students to work and learn under the supervision faculty physicians in the University of Chicago Emergency Department to evaluate patients for opioid use disorder and dispense lifesaving medications. The program was first piloted as part of an American Medical Association Accelerating Change in Medical Education grant, and earned an AAMC Curriculum Innovation Award in 2019.
In the second program, VISIT (Value-added for Inpatients by Students and Interdisciplinary Teams), students work under the supervision of physician medical directors on both the medicine and surgical services of University of Chicago Medicine to do a deep dive interview with at-risk patients on social factors that affect health and report what they find to the medical team to advance the care plan. Students have the chance to screen patients for various social determinants that could potentially hinder a smooth, successful discharge process, such as housing instability, food insecurity, and a lack of social support.
Early impressions of VISIT, which is led by Dr. Daniel Aldrich in the Section of Hospital Medicine, indicate students and healthcare professionals alike have quickly recognized the program’s potential.
“I wish I had students who could see all my patients,” one attending physician said.
Added one care coordinator of students’ involvement: “They did an excellent job with their questions to the patient. Very detailed and absolutely loved them identifying the barriers early.”
First-year Pritzker student Gabrielle Sudilovsky participated in VISIT in winter quarter and said she appreciated the opportunity to connect and truly listen to patients.
“I was able to identify barriers to care and actually address them, working with several members of my patient’s care team to connect the patient to resources she didn’t know she was eligible for,” Sudilovsky said. “VISIT reinforced the importance of taking the time to support the entire patient, not just their clinical needs.”
Sudilovsky added that VISIT helped her step outside her comfort zone and take on challenging and empathy-building situations that are difficult to simulate in standardized patient encounters. It also helped her build confidence in the clinical setting early in medical school.
“It is challenging to feel qualified enough to be involved in patient care [as a medical student],” Sudilovsky said. “VISIT helps ease that.”
To design these programs, Pritzker leadership put out a call for letters of intent to collaborate with the Medical School Education team to facilitate the formation of these roles. From the submission of more than a dozen ideas, OPIATE and VISIT were chosen to operationalize as part of SHINE.
Notably, SHINE features a firm commitment to addressing not just the medical but also the societal aspects of healthcare. With an understanding that healthcare transcends the boundaries of hospitals and clinics, the future doctors are empowered to devise innovative solutions, which often involve collaborating with local communities and organizations.
“Empowering students to advocate on behalf of patients is not an abstract concept that can be learned through discussion or lecture; it requires a patient-centered experience,” Farnan said. “Lessons rooted in clinical care are the most impactful, and SHINE embraces that notion, putting students almost immediately onto the healthcare team.
“Additionally, it introduces students to the role and scope of practice of various members of the healthcare team from the outset of their clinical exposure, reinforcing the notion that the patient is the central focus of the team.”
SHINE is made possible through the help of numerous faculty and staff leaders we wish to acknowledge. OPIATE is led by Alejandro Palma, MD from the Section of Emergency Medicine and VISIT is led by Daniel Aldrich, MD from the Section of Hospital Medicine, with Ryan Boudreau from the Section of Trauma and Acute Care Surgery. Both programs are overseen by Clinical Skills Directors Tia Kostas, MD, and Joyce Tang, MD.