518 - Can Community Service Learning Disrupt Health Inequities?

The Liaison Committee on Medical Education (LCME) requires medical schools to provide curricula that addresses health inequities, but no metrics exist to evaluate the success of a health equity curriculum.  

Objective: To develop a rubric to evaluate the success of a medical student health equity curriculum

Design/Methods:

At our institution, third year medical students participate in community-based participatory research (CBPR) by choosing a health disparity in our community, engaging a community partner to improve the disparity, and presenting a poster of the project’s outcomes. To evaluate the posters, a 16-item survey was developed based on an iterative review by multiple faculty members for validity (Table 1).  This survey was applied by two faculty members to evaluate 24 health equity posters.  Cohen’s kappa was calculated for each question on the rubric to determine interrater reliability.

We convened a series of meetings with multidisciplinary stakeholders from educational administration and curriculum development, health equity researchers, faculty with expertise in CBPR, medical students, administrators of community health systems, and community workers to evaluate health equity outcomes. Stakeholder focus groups developed a rubric using the Kirkpatrick model for evaluation.

Results:

Poster rubric questions with moderate to substantial agreement included questions related to measurement of data.  Rubric questions with poor agreement included questions regarding community impact, community engagement, and health equity outcomes.  (Table 1)

Given that the survey did not reliably assess community impact or health equity, the multidisciplinary stakeholder focus groups identified a goal of engaging community stakeholders in writing a shared critique of the project’s outcomes with the students. Multidisciplinary stakeholders created a health equity rubric (table 2) to evaluate the written shared critiques incorporating valid and reliable survey items.

Conclusion(s):

We describe the process our institution used to develop a health equity rubric.
The question of whether the CBPR projects measured something was a valid and reliable criterion when applied to the posters. Our approach of assembling a multidisciplinary team to create the health equity rubric as well as leveraging community input in the shared written critiques ensures that the success of the health equity curricula are determined not only by medical school faculty but also by communities impacted by health inequity. Future work will focus on examining validity and reliability of the health equity rubric.