Micro-credential program teaches students to see diabetes from patient’s POV

A key experience for students at the Jacobs School of Medicine and Biomedical Sciences is working one-on-one with patients to move beyond theory into hands-on engagement. The Diabetes Mentorship Program offers a unique way for students to acquire knowledge of diabetes and diabetes management and treatment by mentoring — and being mentored by — patients with pre-diabetes and diabetes.

The student-led program began in 2017 and has evolved dramatically since then. Collaborations have taken place with the Greater Buffalo United Accountable Healthcare Network (GBUAHN), with GBUAHN Chief Medical Officer Chet Fox credited as an instrumental contributor to the program’s success. And in spring 2020, the UB Clinical and Translational Science Institute (CTSI) Recruitment and Special Populations Core teamed up with the existing program to serve as a facilitator.

“The program has successfully trained medical students to become diabetes educators and will begin piloting the mentorship component with a local clinic this fall,” says Shanice Guerrier, a fourth-year student at the Jacobs School and past president of the program.

Born and raised in Brooklyn, Guerrier saw her grandmother struggle with the complications of Type 2 diabetes due to difficult experiences with the health care system. She realized that a better understanding of the disease could have prevented many of her grandmother’s difficulties.

“During my first year as a medical student in fall 2018, I was instantly drawn to the Diabetes Mentorship Program,” Guerrier explains, adding that it connected with her aim to improve health literacy in underserved communities in honor of her grandmother.

Guerrier’s belief in the importance of the program led her, with the help of a number of individuals, to restructure the program in fall 2019. “I wanted to create a formal diabetes education curriculum so medical students can feel confident about becoming a diabetes mentor. I also wanted to start a collection of resources medical students can use to improve the understanding and management of diabetes in underserved communities.”

Kim Griswold, professor of family medicine and psychiatry, served as the program’s faculty adviser and mentor. She stresses that in addition to instilling leadership strategies and enhancing knowledge of diabetes, participants gain skills that are very difficult to learn in a classroom or even clinical setting.

“A key feature of this program is the ability of students to reach out into communities — stepping outside those four containing walls of clinics,” Griswold says. “They begin to recognize firsthand the inequities that exist in our systems, and to learn from patients themselves how to advocate for equity, health and well-being for each person, and for their communities.”

Charlotte Starling and Marquessa Henry, both currently in the third year of their rotations at the Jacobs School, served as co-presidents in the fall 2020 and spring 2021 semesters.

“With COVID, we never got the opportunity to mentor any patients, [but] we initiated a discussion series,” Starling says. “We were able to establish a foundation for the program, as well as gather many resources that will help future members.”

In addition to strengthening her knowledge of diabetes, Starling says she learned how to motivationally interview patients and counsel them appropriately. “The program has made me better understand both the disease and the health care disparity that exists behind it. It will make me a more knowledgeable and compassionate physician for my future patients with diabetes.”

Second-year Jacobs School students Olivia Sorci and Olivia Waldman will serve as this year’s co-presidents and hope to make the program’s connections with community organizations even stronger.

“This program stood out to me because it offered an opportunity to build and cultivate a long-term relationship with the community,” Sorci says. “I knew it would be a good learning opportunity to work so closely with patients. They have a wealth of knowledge about their disease and how that intersects with their life.”

“You don't have to be going into endocrinology to want to be a part of the program because you learn how many specialties diabetes impacts,” Waldman says. Sorci adds that “no matter what specialty you’re in, diabetes is something that touches it.”

Even though 2020’s virtual program was challenging, Waldman found it to be a tremendous help, specifically the lessons on motivational interviewing, during which she practiced with other students over Zoom. “The ability to have an honest conversation with patients about their barriers and limitations helps you as a provider, and increases your cultural competency.”

CTSI Recruitment and Special Populations Core Director Teresa Quattrin, UB Distinguished Professor and senior associate dean for research integration in the Jacobs School, says the program “emphasizes looking at a disease model from the outside in, and in a practical way, from the patient's standpoint.” The goal, she says, is to help students learn how to understand the patient’s point of view — even, in a sense, to experience that point of view for themselves.

“That should be what a medical student is taught to do and what we physicians should be doing,” Quattrin says. “We should be ‘jumping’ into the body, the mind and the spirit of people who are going through the experience [in order] to be able to lead them effectively.”

Andy Strohmeier, CTSI integrating special populations coordinator, worked closely with the CTSI’s Workforce Development Core to help secure micro-credential status. A micro-credential is a program that provides students with the opportunity to gain relevant skills that are needed in today’s workforce. Clickable digital badges are awarded to show information such as the date earned and the criteria required to earn the badge. These badges can be added to students’ resumés and curricula vitae to showcase their versatile skills and experiences.

Four virtual sessions were held during 2020-21, and 11 students were awarded micro-credentials after attending each meeting, writing post-meeting reflections and completing a final paper. While it was a successful season, Quattrin says she is excited to be part of the upcoming in-person season. Students will have an opportunity to engage in “a one-to-one interaction of the health care professional with a patient outside of the walls of the health care office.”

This component, she believes, will allow participants to better understand the challenges for individuals with pre-diabetes or diabetes. In addition, it will enhance students’ abilities to make patients’ journeys less difficult and to increase both empathy and understanding.

“We hope this model will help these future physicians to generalize what they have learned [in order to help] all the patients they are seeing,” Quattrin says. “They will still be faced with time limitations in the delivery of their health care, but they might prioritize certain aspects based on what they learned in the program.”

Quattrin stresses that “credit goes to the initiative and vital contributions of the students and our partner, Dr. Chet Fox at GBUAHN.”

Students interested in participating in the program in fall 2021 are encouraged to contact Strohmeier at awstrohm@buffalo.edu or 716-829-2223.