The Health Promotion-Disease Prevention Project: effect on medical students' attitudes toward practice in medically underserved areas.

BACKGROUND AND OBJECTIVES: Increasing the supply of primary care physicians who will practice in medically underserved areas is a national concern. This study examined the impact of carefully structured, preclinical, and service-oriented learning experiences in underserved areas on medical student participants' attitudes toward practice in such areas.
METHODS: Pre- and post-placement assessments were conducted using a Likert-type scale to measure attitude. Data were obtained from 169 students. A descriptive/interpretational qualitative analysis of participants' final reports of their experiences was conducted to amplify statistical findings.
RESULTS: Results indicated an improvement in attitude from pre-placement to post-placement. Also observed were improved perceptions of the competence of physicians, quality of care, and practice environment in underserved areas, along with an improvement in the students' levels of comfort working with underserved patients.
CONCLUSIONS: The study findings provide some evidence that supports recommendations for reform of undergraduate medical education to promote primary care specialties and to improve access to health care services for the underserved. These recommendations include early exposure to primary care, opportunities to identify primary care role models, service to the community, introduction to community-oriented primary care skills, and community-based experience.