The Power of a Virtual Community
S-CORPS Uses Telehealth to Connect with Patients
Spring Break during a pandemic was always going to be strange, but a group of medical students and Stanford physicians, including second-year medical students Lydia Tam and Mike Dacre, found a way to turn it into an opportunity. Tam and Dacre, along with others including Drs. Marcie Levine, Erika Schillinger, Tamara Montacute, and Olivia Jee, used their spring break to create and launch what became S-CORPS, an initiative matching medical students with doctors to help reach out virtually to patients during the COVID-19 crisis.
A Quick Beginning
S-CORPS (Stanford Student Community Outreach and Physician Support) pairs medical students with doctors and Stanford faculty. The medical students are assigned patients by their doctor mentors and the students then reach out to these patients, either on the phone or in some cases via Zoom, to check in on their physical, emotional, and mental wellbeing.
The idea grew out of the Walk With Me course, which is part of a larger Patient and Family Engaged Medical Education program. Jee, a family physician, details how the program got its start: in the early days of California’s shelter-in-place order, she explains, a provider and medical director of a primary care clinic reached out to Walk With Me leadership “to see if we could mobilize these pre-clinical students to provide needed phone check-ins.”
Many medical students were primed to help. They felt restless during the pandemic, since all their hands-on experience at hospitals had been curtailed or canceled. “We all wanted a way to participate in patient care that didn't involve going to the hospital,” says Tam, a second year medical student, adding that many students were also interested in learning the “intricacies of telemedicine and how to effectively provide patient care when we're not face to face with a patient.”
Dacre agrees: “S-CORPS was born out of a sense of frustration among students (myself included), who wanted to be of help to those in need, doctors, and a wonderful social worker (Jordan Chavez) who saw an opportunity for medical students to be able to help vulnerable patients.” They started by recruiting medical students from the Walk With Me program, and then reached out to a wider group, where they were impressed by the quick and enthusiastic response.
Week by Week
The program quickly took shape. A group of interested students was assembled, and a program and accompanying medical course, FAMMED208, was set up.
The spring course had 17 students and two TAs (Tam and Dacre), each of whom was paired with a faculty member. Class sessions included a weekly group debrief with a short lecture and breakout rooms.
Each student and physician pair also had a weekly check-in, to set an agenda for patient care and address the students’ questions and needs. Then the students reached out to their patients for calls that lasted anywhere from five minutes to an hour.
The content of these calls differs from person to person. Some are highly medically complicated, involving students asking detailed questions about a patient’s response to medication or treatment. Others are more about emotional support. “We have some students calling patients in nursing homes, and these patients are just really lonely, especially during this time, and it's nice to have someone to talk to that's consistent. So those conversations can be really long,” Tam says.
"Being able to be there and talk with patients and just listen to them has been so valuable to me.
Learning from the Unexpected
The calls have proven truly helpful for everyone involved. For the students, they were excellent learning opportunities. “Being able to be there and talk with patients and just listen to them has been so valuable to me,” Dacre says. “It’s also been great for my education.” He adds that the patients’ questions for their doctors also help him learn “so much about the management of these often very complicated patients.”
For the faculty, it was a chance to see students blossom. “I was surprised by how much the students got out of this experience,” Jee says. “As part of the course, we held weekly didactic sessions on high-yield patient-care topics as well as discussion groups. The students asked such sophisticated questions from their interactions on topics that most providers learn only through years of experience in practice, such as boundary setting, agenda setting, difficult conversations.”
Dacre reflects on the value of these didactic sessions and discussion groups: “I was struggling with how to broach the subject of mental health with my patients early on,” he says. “I was worried about upsetting them or ruining their mood, but then I had help from my physician mentor Dr. Schillinger and a class from our social worker Jordan Chavez about how to do just that, and my calls with patients dramatically improved, and continued improving.”
The S-CORPS team was initially concerned that the program might cause more work for the doctors by adding another person into the treatment process. But interestingly, that hasn’t been the case. Tam says she’s heard from multiple doctors who are grateful for the extra help the medical students provide, and in some cases they’ve actually learned vital information about their patients from the medical students.
And of course the patients themselves are benefiting from this level of care. “Part of me was worried that patients would be annoyed by the intrusion or just want to talk to their doctor,” Dacre says. “But that wasn’t the case at all. Some patients are happy just having a short conversation, but others really needed someone to talk to and were so grateful.” He concludes, “What surprised me was how much value we brought to patients.”
Jee describes herself as “so happy” with the results of the course. “Much of the feedback we got from patients was how helpful it was to have a trusted source to talk to, check-in and follow up with them. We also heard it was a great relief to have a more accessible connection to their healthcare team especially during this difficult time.”
The Future of S-CORPS
S-CORPS is already looking to the future. In the immediate future, FAMMED208 will be offered in the summer, and Dacre drafted and posted online guidelines gleaned from the course so that people in other institutions would have access to S-CORPS knowledge. They’re also collecting data from patient, doctor, and student surveys to help design the course more efficiently and make sure that programs like it are useful to everyone involved.
In the longer term, they’re envisioning the role of the course post-pandemic. “We're hoping that this could be integrated into the Stanford curriculum,” Tam says.
Jee agrees, “Our plan is to continue this course as a means for preclinical students to continue to develop practical skills and start to develop the softer skills for medicine earlier in their career.”
She adds, “I'm really proud that we were able to put this program together so quickly and hope we can continue to develop it to fulfill the learning needs and development of our preclinical students here at Stanford, to provide them with an early opportunity for patient interaction and learning!”
Dacre agrees: “I really ended up valuing the synergy of the course: students helping patients, patients teaching students, students assisting physicians, and physicians mentoring students. It ended up being a wonderful program.”