The Impact of a Pilot Oncology Summer Internship on Early Medical Students’ Understanding of Oncology and Social Determinants of Health: A Mixed-Methods Study
摘要
As cancer incidence rises globally, there is a growing need for medical schools to engage students in oncology education and how social determinants of health (SDH) influence cancer risk, treatment, and outcomes. Integrating SDH into oncology curricula will prepare students to deliver equitable, patient-centered cancer care. At a U.S. medical school, a four-week pilot Oncology Summer Internship (OSI) was implemented in 2022 and 2023 for rising second-year medical students. In 2024, the OSI was revised to incorporate a stronger focus on SDH. This study used a mixed-methods approach to evaluate the impact of the SDH-focused OSI. Pre- and post-program survey data were collected from thirteen students, including five who participated in the SDH iteration of the internship. Participants rated understandings of oncology with a 5-point Likert scale. Students in the SDH internship were also asked to rate knowledge of SDH in cancer and describe socioeconomic challenges of cancer. Quantitative data was analyzed with Wilcoxon signed rank tests and qualitative data was coded and thematically analyzed. Quantitative analysis demonstrated increased understandings of the field of oncology, such as its training pathways (p = 0.001). Among participants of the SDH-focused program, responses related to SDH did not reveal any significant differences pre- and post-program. Upon qualitative analysis of descriptions of socioeconomic challenges, themes on the importance of SDH in cancer care and reference of SDH factors emerged. Responses revealed an increase in instances that participants mentioned a SDH (14 pre- vs. 22.5 post-survey). Overall, this pilot OSI enhanced students’ understanding of oncology and offered deeper insight into the impact of SDH on cancer care.