Barriers to Care Encounter: A Model That Empowers Underserved Populations and Promotes Cross-Cultural Preparedness in Medical Students

Introduction While identifying and interacting with patients adversely impacted by social determinants of health (SDoH) and related barriers to care is essential in medical education, current educational models lack meaningful patient involvement and feedback. This project aims to implement an activity focused on barriers to care that incorporates and empowers representative standardized patients (SPs) to share their lived experiences with students. Methods Forty-five first- and second-year preclinical medical students participated in a 90-minute intervention including a lecture; a prebrief; a simulated clinical encounter with a patient who was nonadherent to treatment because of a financial, social, or cultural barrier; and a debrief. All SPs had personal experiences with barriers to care. This intervention was implemented in January and October of 2024 and evaluated via analysis of pre- and postencounter Likert surveys that were administered to students. Results In January, statistical analysis of pre- and postsurveys indicated a significant increase in participants' reported ability to elicit a comprehensive history and enhance patient adherence ( P < .05). After content revision, analysis of the October cohort demonstrated significant increases in reported ability to describe historical and systemic impacts, elicit a comprehensive history, enhance adherence, and understand own biases ( P < .05). Discussion The Barriers to Care Encounter was effective in increasing student knowledge, skills, and attitudes on addressing SDoH in clinical practice while allowing medical students to engage with representative patient populations. Future directions include performing qualitative analyses of SP feedback and comparing impact of representative SP encounters to nonrepresentative SP encounters.