March 16, 2021

Accepting the challenge: U-M medical students make an impact during COVID-19 pandemic

Half-dozen U-M Medical School projects featured in American Medical Association publication

AMA Impact Challenge for students, residents and fellows

From supporting patients through a swift transition to virtual care, to connecting the homeless community with needed PPE and other institutional resources, University of Michigan medical students were heavily involved in Michigan Medicine’s COVID-19 response.

A new publication by the American Medical Association (AMA) highlights dozens of learner-led pandemic response projects from across the country, including several spearheaded by U-M medical students. The collection is the result of an annual AMA Impact Challenge for students, residents and fellows, a competition organized by U-M Professor of Obstetrics and Gynecology and Learning Health Sciences Maya Hammoud, M.D., who also serves as the AMA’s senior advisor for medical education and innovation.

“Students from U-M — indeed, students from around the country — stepped forward with innovative ideas and solutions to unprecedented challenges posed by the coronavirus pandemic,” said Hammoud. “It’s important to acknowledge and show how students got involved for their institutions and communities.”

Of the 70 projects highlighted in the publication, six were led or co-led by U-M medical students (only one medical school has more projects included). Many of activities led by UMMS students involved helping Michigan Medicine shift aspects of ambulatory care to the virtual environment in the spring of 2020 as COVID-19 cases began to surge.

Third-year student Cayla Pichan was part of a team working with the Geriatric Psychiatry clinic. Student volunteers telephoned hundreds of patients, first to gauge interest in telehealth visits, and then following up when appropriate to help patients download and practice with the needed teleconferencing software. It was time-intensive work, with calls averaging 20 minutes and some lasting more than an hour.

“This is a population that isn’t necessarily tech-savvy. We offered individualized guidance and that meant taking as much time as needed,” said Pichan. “But making calls was my favorite aspect. They would be so grateful to have this new ability to communicate. One patient was so excited because their friends had been talking to them about Zoom and now they would be able to use it.”

Students were also heavily involved in the Department of Obstetrics and Gynecology’s rapid transition to virtual care. The pandemic upended prenatal care overnight as the traditional, 12-appointment schedule shifted to a new model: an ultrasound and four in-person appointments supplemented by four virtual visits. Medical students drafted materials for the new website announcing the program and then helped phone more than 1,500 patients to explain the change and answer questions.

“The students were a critical part of moving that model forward. They really accelerated our ability to get patients the care they needed during a really chaotic time,” said Ob-Gyn Clinical Lecturer Alex Peahl, M.D. “What is really amazing is that everything we built in that time is going to continue post-pandemic.”

The temporary changes brought on by COVID have evolved into a permanent hybrid-care model that gives patients the option to utilize more virtual visits. In addition, students also helped create a virtual group support program: Stay Home, Stay Connected replaced and expanded on the traditional in-person birthing classes for expecting mothers. Participants are divided into small groups (based on gestational age) for monthly Zoom sessions facilitated by Ob-Gyn faculty along with multidisciplinary student teams.

“Not only is it a convenient way for women to remain connected and feel like they are part of a community throughout their pregnancy, it’s also a great service opportunity for the students involved,” said fourth-year medical student and program organizer Monica Choo. “We are so grateful this is continuing. We just trained and began to hand this off to a new group of student leaders.”

Other initiatives highlighted in the AMA publication include:

  • An effort to create a new interprofessional education course for pre-clinical medical students, social work students, and nursing midwifery students — and then transition the course to the virtual environment because of the pandemic;
  • An initiative through the student-run Wolverine Street Medicine to support the region’s homeless community by organizing sanitizer and PPE donations, volunteering fill in staffing shortages at local shelters, and more; and
  • A Virtual Innovation Bootcamp initiative, led through Harvard with involvement from a U-M medical student, to create new platform for medical students to collaborate online on COVID-related health and health care challenges.

Most are projects or programs that will continue in some form beyond the pandemic, and all are examples of Health Systems Science, said Hammoud. A relatively new field, Health Systems Science (HSS) is the study of how care is delivered across the systems. Hammoud and others at the AMA first created the annual Impact Challenge a few years to emphasize HSS in medical education, but the pandemic put the need in even sharper focus.

“How does the system work – or not work – and how could it be improved? Those questions are more important than ever as we saw during COVID,” Hammoud said. “When I look at what the students did and the differences they made, I’m blown away. And much of it will carry forward for a long time. It makes you so proud.”

Of the 70 projects highlighted in the AMA’s student impact special publication, six were led or co-led by University of Michigan Medical students. Click on the project title below for more information:

GET Access: A Medical Student Volunteer Program to Increase Video Access for Geriatric Telehealth at the Onset of the COVID Pandemic

In response to COVID-19, medical students at the University of Michigan created an initiative to improve access to and comfort with video visits for geriatric patient by providing one-to-one guidance and practice. Providers whose patients worked with our volunteers had a video visit rate of 43% compared to 19.2% prior to participation in the program, ultimately providing a platform for geriatric patients to foster stronger connections with their providers, while increasing Michigan Medicine’s overall proportion of video telehealth visits.

Lead: Cayla Pichan, University of Michigan Medical School 

Teammates: Cassidy Merklen, Clare Anderson and Kinsey Vear

Faculty mentor: Mary C. Blazek, M.D., Clinical Associate Professor Director, Geriatric Psychiatry Clinic, University of Michigan Medical School


COVID-19 Prenatal Support Project

Medical student volunteers, midwives, and physicians from Obstetrics and Gynecology, Maternal-Fetal Medicine, and Family Medicine created a new prenatal care model utilized virtual and in-person visits in order to maintain patient and community safety and quality of care.

Lead: Susan Carlson 

Teammates: Seth Klapman, Jonathan Y. Siden, Allison Powell, Nadine Makki, Chloe Biermann, Annie Minns, Hanna Berlin, Nabeel Salka and Nicole Byl

Faculty mentors: Maya Hammoud, M.D. Professor of Obstetrics and Gynecology, University of Michigan Medical School, and Dr. Alex Peahl, Michigan Medicine, Clinical Lecturer and Director of Outpatient Prenatal Care


Stay Home, Stay Connected — Connecting Pregnant Patients Virtually for Psychosocial Support During the COVID-19 Pandemic and Beyond

Due to COVID-19, many ancillary prenatal support programs such as birthing classes were canceled across Michigan Medicine and the larger community. To provide additional psychosocial support and anticipatory guidance, we created Stay Home, Stay Connected (SHSC), a virtual support group for pregnant and postpartum patients.

Lead: Monica Choo 

Teammates: Chloe Ramirez-Biermann, Yoni Siden, Annie Minns and Kelsey Carman

Faculty mentor: Alex Peahl, M.D., Clinical Lecturer & National Clinician Scholar, Michigan Medicine


Medical Student Support for Homeless Populations: A Community-Oriented Blueprint during the COVID-19 Pandemic

Wolverine Street Medicine (WSM) is a medical student-led organization at U-M Medical School aimed at providing health care to those experiencing homelessness in Detroit and surrounding areas. Since most support systems for this population cannot operate at full capacity due to COVID-19, higher levels of collaboration between all stakeholders became necessary.

Lead: Daniel Yang, University of Michigan Medical School 

Teammates: Claire Garpestad, Ruth Bishop, Molly Fessler, Sarah Jabour, Shannon Cahalan and C. Kenzie Corbin

Faculty mentor: Brent Williams, M.D., MPH, Director, Global Health and Disparities Path of Excellence


COVID-19 Virtual Innovation Bootcamp

During the COVID-19 pandemic, health care problems proliferated while students were relegated to remote learning environments. This Virtual Innovation Bootcamp empowered students across various disciplines to remotely collaborate on COVID-19-related solutions.

Lead: Mario Russo (Harvard Medical School) 

Teammates: Abhinav Appukutty (University of Michigan Medical School) and Andrew Pack (Texas A&M College of Medicine)

Faculty mentor: Jennifer Potter, M.D., Advisory Dean and Director of William Bosworth Castle Society, Harvard Medical School


Using an Interprofessional Educational Approach to Improve Pre-clinical Student Knowledge and Skills in Quality Improvement Methodologies

The U-M medical school, in partnership with other health professional schools, sought to incorporate interprofessional education into its curriculum, exposing pre-clinical medical students to the importance of working together in interprofessional teams. A new course aimed to give students the opportunity to learn the definition of quality improvement and basic tools they could apply to begin practicing quality improvement.

Lead: Nadine Makki 

Teammate: Jamie Lindsay

Faculty mentors: Rosalyn Maben-Feaster, M.D., MPH, Assistant Professor of Obstetrics and Gynecology, Director of Health Systems ScienceCurricular Thread, Michigan Medicine; Jennifer Vredeveld, M.D., Clinical Associate Professor Internal Medicine and Pediatrics, Michigan