The impact of a pilot oncology summer internship on early medical students' understanding of oncology and social determinants of health: A mixed-methods study.

Abstract

e21025 Background: As cancer diagnoses rise, there is an increasing need for medical schools to engage students in oncology. Moreover, given the association of social determinants of health (SDH) with cancer outcomes, students should understand how cancer patients are impacted by SDH. At a U.S. medical school, a four-week pilot oncology summer internship (OSI) for rising second-year medical students was developed in 2022 and 2023 to promote interest and knowledge in oncology. Students participated in multidisciplinary shadowing experiences, facility tours, and faculty mentor lunches. In 2024, the program was updated to emphasize SDH, adding discussion sessions with faculty on SDH topics alongside the previous experiences. This study evaluated the impact of the OSI with a mixed-methods approach. Methods: Pre- and post-program survey data were collected from thirteen students, five of whom participated in the SDH-focused internship. Participants rated understandings of oncology with a 5-point Likert scale and responded to questions about perceptions of oncology. 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. Results: Quantitative analysis showed improvement of students’ knowledge of oncology as a discipline (Table 1). Qualitative analysis on understandings of oncology uncovered themes of cancer treatment and management. In the SDH cohort, quantitative data showed a strong understanding of SDH in oncology unchanged pre- vs. post-program. However, qualitative analysis revealed increased examples of SDH (14 vs. 22.5) and mention of new SDH contributors including zip code and education level. Conclusions: This pilot OSI improved students’ understanding of oncology with potentially deepened insights into impacts of SDH on cancer care and may serve as a framework for other institutions to develop similar programs. Pre- and post-program understandings of oncology as a discipline (reported as median [95% lower confidence limit, upper confidence limit]). Pre-Program Post-Program p-value I have a good understanding of the training pathways I could take to have an oncology-related career. 3 [2.4, 3.6] 5 [4.5, 5.0] 0.001 I have a good understanding of the role of research in oncology. 4 [3.2, 4.0] 5 [4.4, 5.0] 0.002 I have a good understanding of the role of medical oncology in cancer management. 4 [3.0, 3.9] 5 [4.6, 5.1] <0.001 I have a good understanding of the role of radiation oncology in cancer management. 3 [2.7, 3.7] 5 [4.4, 5.0] 0.001 I have a good understanding of the role of surgical oncology in cancer management. 4 [3.1, 4.0] 5 [4.5, 5.0] 0.002 I am aware of non-medical support services for cancer patients. 2 [1.9, 2.9] 5 [4.2, 5.0] <0.001