Medical Student Firearm Safety Counseling Follow-Up Study

Summary

The preclinical curriculum related to firearm violence and safety counseling at the UCLA David Geffen School of Medicine (DGSOM) has been expanded for the Class of 2027, informed by the results and conclusions of an initial study of firearm safety counseling by medical students (ClinicalTrials.gov ID: NCT05242627), which was conducted by the present study team. The 1-hour firearm safety counseling training session used in that study will be taught again to first-year medical students in the Class of 2027, but training will be augmented with additional instruction; the Class will receive additional comprehensive instruction on suicide risk assessment and will participate in small group breakout sessions, to facilitate the opportunity for students to discuss issues related to firearm violence as a public health issue and to practice firearm safety counseling with standardized patient actors (SPs). Assessment of access to firearms and firearm safety counseling will be added as a standard component of the Social History that students are taught to obtain from patients during clinical examinations. The goal of the expanded training is to increase the prevalence of medical student counseling when they are conducting a history and physical examination in a simulated patient encounter with an SP 6 months after the initial training session, when compared to results from the initial study. The scenario provided to the SP will be identical to that used in the initial study and is a situation in which firearm safety counseling is warranted.

Students will participate in a survey to ascertain their knowledge of firearm violence and their attitudes about physician counseling about firearm safety, prior to formal instruction. Informed consent will be obtained from students to use their responses in educational research. Following the didactic and small group sessions, students will be asked to complete a post-training survey that is similar to the original survey, as a means of assessing knowledge gained and any change in attitudes about physician counseling. The simulated patient encounter will occur approximately 6 months later, after which students will complete another survey to determine retention of knowledge and their experience during the simulated patient encounter. Students will not be told before the encounter that they will be evaluated regarding firearm safety counseling. The SP will identify which students did and did not raise the issue of firearm safety. Videos recorded of each students' sessions (routinely obtained for grading purposes) will be viewed by investigators for those students who provide informed consent, to determine the quality of counseling, if it was conducted.

Results from this follow-up study will be compared to the results of the initial study as a historical control, to determine whether augmentation of firearm safety counseling training above a 1-hour didactic session increases firearm safety counseling by medical students in a clinical setting and whether it improves retention of knowledge about firearm violence.

Conditions

• Medical Student Knowledge of Firearm Violence Epidemiology
• Medical Student Knowledge About Firearm Safety Procedures
• Medical Student-initiated Clinical Firearm Safety Counseling

Interventions

BEHAVIORAL

Expanded Clinical Firearm Safety Counseling Training

Members of the DGSOM class of 2027 will participate in a mandatory 3.5 hour training session as a part of the regular curriculum that will include: (1) didactic information on firearm violence epidemiology; (2) suicide epidemiology and introduction to lethal means restriction; (3) firearm safety counseling techniques; (4) a panel of firearm violence survivors / trauma interventionists; and (5) a small group session with discussions of the aforementioned topics and a demonstration of a patient encounter using a standardized patient actor depicting a clinical scenario warranting firearm safety counseling. The training will be taught by faculty members, invited subject matter experts, senior medical students, and the DGSOM Standardized Patient Program.

Sponsors & Collaborators

• University of California, Davis

  collaborator OTHER

• University of California, Los Angeles

  lead OTHER

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-08-15

Primary Completion

2024-09-03

Completion

2025-06-01

Countries

• United States

Study Locations