Enhancing early medical education through mobile health care: An observational survey of medical student volunteers

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Kirsch, Jessica Hane This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7246810/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background In traditional U.S. medical education, preclinical training offers limited exposure to community-based experiences during a critical formative period of career discernment. The absence of early experiential learning may result in missed opportunities to cultivate motivation and sustained enthusiasm to practicing medicine. This observational study aimed to understand the perspectives of preclinical students on their volunteer experiences with the Mobile Health Initiative (MHI), focusing on its perceived impact and role in enhancing their medical education. Methods A survey was disseminated to all MHI volunteers to assess the program’s impact on student engagement and future practice intentions. This survey was emailed out to 179 medical student volunteers during 2025, in which 49 responded (27% response rate). Open-ended survey responses were coded primarily via thematic analysis. We conducted a paired-samples t-test to evaluate the difference in mean scores regarding perceived community connection before and after volunteering with MHI. Results Students defined meaningful experiences as providing healthcare to underserved populations, utilizing cultural understanding to bridge care gaps, and fostering community connections. There was a significant increase in the feeling of connectedness with their community, which helped students rediscover their purpose for pursuing a career in medicine. Some highlights from the survey responses centered on an increased sense of fulfillment and learning to communicate compassionately. In addition, many respondents detailed how MHI events improved their clinical skills through these hands-on experiences and enhanced their clinical judgment in resource-limited settings. Conclusion We identified four main themes that defined meaningful experiences for medical student volunteers: 1) Community Engagement and Connection, 2) Hands-On Clinical Skills Development, 3) Health Equity and Access, and 4) Emotional Fulfillment. There is a strong need for community-based, service-learning programs, such as MHI, to enhance traditional medical education. Mobile health care medical education meaningful experiences wellbeing Background Despite growing recognition of the importance of community-based education, most medical programs offer community engagement opportunities only to self-selected students or as short-term, isolated experiences during the preclinical years ( 1 ). These limited approaches fall short of providing the sustained, longitudinal exposure needed to fully integrate a population health perspective into medical training. There is a need for early curricular adaptations that prepare students not only for the complexities of modern healthcare but also for skills to navigate cultural and societal diversity from a public health and community-integrated care lens ( 2 ). The Geneva Community Health Program (CHP) is a successful initiative that demonstrates an integrated approach to preclinical medical education. By allowing students to repeatedly engage with community health professionals and the public, such initiatives have been shown to promote a multidisciplinary understanding of health and disease, while strengthening their appreciation for health promotion, advocacy, and cultural awareness ( 2 ). This exposure cultivates adaptability and challenges traditional educational models, encouraging institutions to prepare their medical trainees for the ever-changing healthcare environment. As Hunt et al. ( 3 ) proposed, embedding community partnerships within medical education equips students to address both clinical and systemic challenges at the community level, promoting a socially accountable model of training. The Community Health Advocacy Initiative (CHAI) at Northwestern University exemplifies this approach. Through longitudinal, mentored, community-engaged experiences, CHAI enabled all students to acquire practical skills in addressing the social determinants of health, forming lasting partnerships with community organizations, and broadening their perspective on patient health beyond the clinical setting. CHAI’s success demonstrates that sustainable, community-engaged education is both feasible and transformative, offering a model for medical schools aiming to prepare students for a more equitable, community-centered healthcare system ( 4 ). Furthermore, burnout among medical students and residents has increased significantly in recent years, driven by factors such as high work intensity, stressful learning environments, and the shift to remote learning since the COVID-19 pandemic ( 5 , 6 ). Additionally, poor learning experiences during training were found to be predictive of a greater increase in depressive symptoms among internal medicine residents ( 7 ). This increased burnout not only affects personal well-being but also has profound implications for patient care. Residents experiencing burnout are more likely to display racial biases towards Black patients and to regret their specialty choice ( 8 ). As medical students progress in their careers, the prevalence of burnout and depression increases. This emotional exhaustion, as described by the Maslach Burnout Inventory, has been linked to worsening attitudes and an increase in implicit bias ( 9 , 10 ). These findings highlight how burnout and depression can undermine healthcare quality, particularly for historically marginalized groups. In the aftermath of the pandemic, there has been a renewed focus on supporting the well-being of medical trainees. While much research has centered on residents, these issues begin during medical school. A universal solution to improving well-being remains elusive, necessitating a multifaceted approach ( 11 ). Yet, there is a lack of data on how students themselves define wellbeing and meaningful experiences ( 12 ). One of the aims of this study is to bridge that gap by exploring whether volunteering with the Mobile Health Initiative (MHI) is perceived as a meaningful experience and whether it supports wellbeing. Research has shown that meaningful participation and a sense of community belonging contribute to greater well-being among medical students ( 5 ). The University of Minnesota’s MHI, launched in June 2020, offers a unique opportunity for community engagement, with mobile clinics serving as a bridge between clinical care and the communities they support ( 13 ). This study aims to explore how MHI volunteers perceive their experiences, specifically in terms of well-being, community connectedness, clinical skills, and career goals. By gathering these insights, we aim to understand how medical education can incorporate community engagement to enhance both learning and personal resilience. Objective The purpose of this study is to describe the experience of medical students volunteering with MHI and explore how these experiences can supplement medical education. The specific measures we aim to characterize include well-being, community engagement, clinical knowledge and skills, impact on future career, and identifying gaps within the medical school curriculum. Research Question What do medical students find most meaningful about volunteering with MHI, and how does volunteering with MHI enhance medical education? Methods Study Design & Data Collection The qualitative study consists of a Google Forms survey sent to 179 current and past MHI medical student volunteer volunteers, in which 49 completed the survey (27% response rate). While some of the survey recipients are currently in residency programs, this survey only inquired about volunteer experiences during medical school. Volunteers were incentivized with the opportunity to win a gift card for completing the survey. The survey responses remained anonymous. Informed consent for publication of the anonymous data was obtained. Exclusion criteria included any volunteers who were not in medical school at the time of their volunteering. The data collected from the surveys is stored securely and analyzed in a Google spreadsheet. The survey questions consisted of four multiple-choice questions, five "select all that apply" questions, and seven free-response questions. The aim of the survey was to understand how volunteers heard about the program, what motivated them to join, and how they considered it a meaningful experience. Data Analysis Open-ended survey responses were coded primarily via thematic analysis. The authors identified themes in short text responses and aggregated responses under common themes. We created visual representations of relevant questions using Google Spreadsheets, which included pie diagrams and bar charts. To assess the impact of MHI participation on students’ perceived connection to the communities they served, participants rated their connectedness on a 5-point Likert scale both before and after their volunteer experience. We conducted a paired-samples t-test to evaluate the difference in mean scores before and after volunteering. The test assumes that the differences between paired observations are normally distributed, which was considered appropriate for this sample size (n = 48). Statistical significance was set at p < 0.05. We inspected the data for completeness and excluded responses with missing values from the analysis. Results The survey received a total of 49 responses (27.4% response rate). Respondents spanned all years of medical school, with the majority having participated during their first and second preclinical years – 37 students volunteered during their first year, and 27 during their second year. Additionally, 15 students participated during their third year and 6 during their fourth year. The median duration of volunteer involvement was approximately nine months, and notably, 41% of respondents volunteered for greater than one year. Many students indicated they participated in multiple events during their time with MHI and expressed a strong interest in continuing their involvement, underscoring the program’s sustained impact during early medical training. Enhanced Community Connection Community engagement and connection were the primary themes in volunteer responses. Many highlighted how being immersed in the community environment deepened their appreciation for the lived experiences of underserved populations and fostered a greater sense of belonging. One of the most notable outcomes from the survey was a significant increase in students’ perceived connection to the communities they served. There were 48 responses (98% completion rate) to the pre- and post-volunteering community connection questions. Prior to volunteering with MHI, the average self-reported connectedness score was 2.5 on a 5-point Likert scale. This increased to 3.96 following their volunteer experiences, reflecting a 1.46-point improvement. Based on a paired t-test analysis, this increase was found to be statistically significant (mean difference, 1.46; 95% CI, 1.22 to 1.70; p < .0001), indicating a meaningful enhancement in community connection due to the program. CONNECTEDNESS SCORE Mean Score Standard Deviation Sample size (n) Before volunteering 2.5 1.09 48 after volunteering 3.96 0.80 48 Students attributed this score increase to the program’s direct, community-based engagement model, which allowed them to interact with patients outside of traditional clinical settings. "It's helped me appreciate the communities I work with more, and helped me integrate myself better with Minneapolis since I moved here for medical school." "Made me feel more connected with my community." "Getting to work with people and communities and backgrounds I would normally never meet." Clinical Skill Development Medical student volunteers reported substantial growth in their clinical competencies. A 69% response rate was achieved to the survey question regarding how volunteering with MHI enhanced clinical skills and knowledge. Students commonly referenced improved communication skills, particularly in explaining medical information in simple language. Many also reported increased confidence in conducting routine procedures such as blood pressure measurement, HbA1c testing, and vision screening. Several participants described the opportunity to apply didactic knowledge in a practical context as “vastly improving” their early medical education experience. The clinical hands-on practice was frequently cited as a valuable complement to classroom learning, as it reinforced key concepts through real-world application. Some medical students also mentioned gaining experience in interprofessional teamwork and improving their ability to work alongside healthcare providers from different disciplines (internal medicine, pediatrics, family medicine, optometry, pharmacy). "Volunteering with MHI has allowed me to practice my clinical skills in a less formal setting, which I think has vastly improved my didactic education experience." "This has taught me how to speak to patients in ways that are most comfortable and approachable to them." "Learning how to take a BP and do an A1C finger prick was helpful to learn!" Exposure to Social Determinants of Health and Cultural Competency Over one-third of respondents (18 total) highlighted aspects related to delivering healthcare to underserved populations, understanding social and cultural factors in patient care, and utilizing language or cultural skills to bridge care gaps. Students emphasized that serving MHI’s diverse patient population encouraged them to consider cultural, linguistic, and socioeconomic factors in their approach to patient care. Multiple respondents reported that their ability to communicate in Spanish improved patient interactions, serving as a bridge between vulnerable patients and the healthcare system ( 14 ). Furthermore, several participants shared how volunteering with MHI enabled them to engage with healthcare disparities, rather than just learning about them in the classroom. Exposure to these real-world challenges helped medical student volunteers develop a more nuanced understanding of patients’ needs beyond clinical symptoms. "This experience has made me a more compassionate and empathetic listener who takes better account into the patient's community/cultural context when discussing care plans." Learned more about being cognizant of people's conditions and other issues. "Getting real experience with these communities rather than just learning about them in class." Emotional and Motivational Impact Volunteering with MHI had a profoundly personal and uplifting impact on many of the medical students who participated, particularly those who participated during their demanding preclinical years. A total of 39 students (80% of responses) reported that their experiences with MHI brought them greater happiness, a renewed sense of fulfillment, and relief from the burnout that often accompanies early medical training. Volunteering reminded them of why they chose to pursue a career in medicine, helping them reconnect with the values and purpose that initially drew them to the field. "Volunteering with MHI was a reminder of my 'why medicine' during the preclinical years." "Volunteering with MHI has been integral in warding off burnout." "It encourages me to keep pushing during the hard times as a medical school. It gives me a reminder of the various reasons why I decided to become a physician." Career Impact Of the 49 respondents, 15 (32.6% of responses) indicated that participation in MHI influenced their specialty choice or future career goals. Among these, many reported a strengthened interest in primary care, family medicine, or community health. Others expressed a newfound interest in global health, rural medicine, or incorporating outreach initiatives into subspecialty practices. While the remaining respondents did not report a change in specialty interest, several noted that the experience affirmed existing career goals. "Confirmed my interest in primary care/family medicine, meeting people where they're at and providing resources." “Thanks to this experience, I have become more drawn to refugee health and rural medicine." "I would definitely want to help with free clinics and medical camps as a physician. The experiences have made me consider global health as well." Discussion The results demonstrate that volunteering with MHI substantially enriched medical students’ educational experiences by providing early, real-world exposure to community-based healthcare. We identified four main themes that defined meaningful experiences for medical student volunteers: 1) Community Engagement and Connection 2) Hands-On Clinical Skills Development 3) Health Equity and Access 4) Emotional Fulfillment. The statistically significant increase in perceived community connectedness underscores the value of immersive, patient-centered volunteer opportunities offered by programs like MHI. Medical students reported improved communication skills, practical clinical competence, and heightened sensitivity to the social determinants of health – competencies essential to effective, compassionate medical practice. Traditional medical education places a strong emphasis on didactics and often overlooks the complex, relational aspects of modern medicine ( 15 ). These are often referred to as the “soft skills” of medicine, which are currently only being learned in the didactic years through simulations with standardized patients. While these simulation environments are important to medical education, there is an intrinsic difference in developing these provider-patient relationship skills in the real world with a diverse patient population. This sentiment is echoed by students who volunteer at student-run free clinics, who have consistently acknowledged that their community-based experiences provided them with skills that are not emphasized in the formal medical school curriculum ( 16 ). Additionally, there may be a benefit to academic achievement from volunteering at community-based clinics. A study by Vaikunth et al. ( 17 ) found higher Step 2 CK scores in volunteers compared to non-volunteers. There appears to be substantial evidence supporting the incorporation of community-based initiatives, such as MHI, particularly in preclinical years as a supplement to traditional medical education. Due to the well-documented rise in burnout and emotional exhaustion among medical trainees ( 6 , 8 ), the emotional benefits reported by participants in this study are particularly noteworthy. Students consistently described how volunteering with MHI helped them rediscover their initial motivations for pursuing a career in medicine, thereby fostering a renewed sense of purpose. This sense of meaning, derived from real-world patient engagement, contributed to a reduction in feelings of burnout and an increase in emotional resilience. The lack of these critical factors has been associated with compromised patient care and greater implicit biases ( 9 ). In light of evidence that burnout begins during medical school and is associated with downstream effects on patient outcomes and physician satisfaction, early involvement with community-based programs like MHI may be pivotal in fostering a more compassionate healthcare workforce. Therefore, MHI’s role in supporting emotional well-being and reinforcing personal values for medical students demonstrates the program's value in protecting against the rigors of medical training. Moreover, nearly one-third of respondents reported that the experience either shaped their specialty choice or reaffirmed their existing career goals. This aligns with broader efforts to understand how meaningful engagement during medical school can guide students toward career paths. There is some debate in the literature regarding whether medical students who volunteer at community-based or student-led free clinics are more likely to match into a primary care specialty ( 18 , 19 ). While our findings do not support either conclusion, MHI events do provide an opportunity for exposure to primary care and preventive healthcare, with student volunteers emphasizing the desire for more events in the future. Conclusion This study examined the perspectives of medical students on their volunteer experiences with the University of Minnesota’s Mobile Health Initiative (MHI), focusing on its impact and role in complementing traditional medical education. The MHI advances medical education by extending healthcare beyond traditional settings and enabling early clinical and community exposure during a formative time for future physicians. As one of an estimated 2,000 mobile clinics nationwide, MHI mobilizes health professionals, students, and community partners to provide essential services to underserved communities disproportionately impacted by social injustices and other barriers to healthcare. The findings from this study highlight the essential role that community-based initiatives, such as MHI, play in enhancing traditional medical education. Mobile healthcare enriches medical education by offering students firsthand experience in providing care to diverse populations, utilizing cultural understanding to bridge gaps in care, and fostering community connection. In addition, many student volunteers reported being inspired to pursue primary care or work in underserved settings, highlighting the broader potential of such programs to shape the future healthcare workforce. For these reasons, we recommend incorporating community-based service learning into the medical school curriculum. Limitations This study is subject to several limitations. First, the survey response rate was 27%, which may introduce response bias. Volunteers with particularly strong positive or negative experiences might have been more likely to participate. Additionally, the self-reported nature of qualitative data makes it challenging to objectively measure outcomes, such as the impact on emotional well-being and career path discernment. Finally, the results of this study are limited to a single institution and the survey was only sent out to University of Minnesota medical students who had volunteered with the Mobile Health Initiative. Future Research Future research could explore how participation in programs like MHI influences students as they transition into residency. A longitudinal study following medical students into their residency training could assess whether early community-based experiences impact their clinical practice styles, patient interaction approaches, and career satisfaction. Specifically, researchers could investigate whether medical students who participate in community-based programs are more likely to choose residencies with a focus on primary care, community health, or underserved populations. Studies could assess whether MHI participants enter residency with different baseline competencies compared to peers, particularly in areas such as cultural competence, communication skills, and team-based care. Faculty evaluations, self-assessments, and patient feedback could be used to measure these competencies longitudinally. In addition, future research could investigate whether early participation in meaningful, community-based volunteer experiences, such as MHI, contributes to lower rates of burnout later in medical school and during residency. Abbreviations MHI Mobile Health Initiative Declarations Ethics approval and consent to participate IRB ID: STUDY00022977. The IRB reviewed the protocol submission and determined that this study meets the criteria for exemption from IRB review. Jeffrey P Parker, CIP, MLS, the senior IRB analyst at the University of Minnesota Human Research Protection Program provided a letter detailing the reason for exemption from IRB review. This letter is included under “Related Files.” Consent for publication Consent to Publish declaration: not applicable Competing interests The authors declare that they have no competing interests. Funding The authors declare that no financial support was received for the research, authorship, and/or publication of this article. Author Contribution JB wrote the main manuscript text and analyzed/interpreted the data. JB and AA designed the volunteer survey in which the data was derived from. All authors reviewed the manuscript, and contributed to the revision process. Acknowledgement The authors would like to thank Maggie Eckerstorfer, who created the medical student volunteers list for the survey to be emailed out to. In addition, she provided valuable feedback early in the research project and assisted with administrative efforts. We would also like to thank the many community partners, whose invaluable support enables us to deliver care to marginalized populations. Availability of data and materials All data generated or analysed during this study are included in the supplementary information files. References Doobay-Persaud A, Adler MD, Bartell TR, Sheneman NE, Martinez MD, Mangold KA et al. Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7246810","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":539920430,"identity":"37edbc5d-b105-4471-8c92-344148bf9792","order_by":0,"name":"Jameleddine Benhamida","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwElEQVRIiWNgGAWjYBACAwYGNiD5r74fwmcmVkvFAcaZDaRpOXOAccMBYrWYs/cee/Cz7Q6z8Y3stAcMFdaJDYS0WPacSzfsbXvGZnYjd7sBw5l0wloMbuSYSfC2MfMAtWyTYGw7TISW+2/MJP+2MUsYzwBp+UeMlhs8ZtI8Zw4bGEiAtDQQocWyJ8dMWqYiLUHizNttEgnH0o0JajFnP2Mm+cbAJoG/HWjLhxprWYJaUEECacpHwSgYBaNgFOACAJmxP3i1QHMbAAAAAElFTkSuQmCC","orcid":"","institution":"University of Minnesota Medical School","correspondingAuthor":true,"prefix":"","firstName":"Jameleddine","middleName":"","lastName":"Benhamida","suffix":""},{"id":539920431,"identity":"19fe323e-4582-469f-8e5e-53b92d02e7d1","order_by":1,"name":"Aakanksha Angra","email":"","orcid":"","institution":"American Society of Hematology","correspondingAuthor":false,"prefix":"","firstName":"Aakanksha","middleName":"","lastName":"Angra","suffix":""},{"id":539920432,"identity":"4b20bf28-7139-4e4a-9319-e58cfb3dacd7","order_by":2,"name":"Jonathan D. Kirsch","email":"","orcid":"","institution":"University of Minnesota","correspondingAuthor":false,"prefix":"","firstName":"Jonathan","middleName":"D.","lastName":"Kirsch","suffix":""},{"id":539920433,"identity":"64a844d9-3919-4634-8739-0388a7b06c7a","order_by":3,"name":"Jessica Hane","email":"","orcid":"","institution":"University of Minnesota","correspondingAuthor":false,"prefix":"","firstName":"Jessica","middleName":"","lastName":"Hane","suffix":""}],"badges":[],"createdAt":"2025-07-29 21:53:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7246810/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7246810/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95227705,"identity":"2b31cc4f-22f1-462c-aa7b-31139e9fab46","added_by":"auto","created_at":"2025-11-05 16:32:46","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":56602,"visible":true,"origin":"","legend":"","description":"","filename":"MHIStudyFullManuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/8a7e551b5e9149a9130956db.docx"},{"id":95226086,"identity":"1df7fa4b-2bae-42b7-b857-bb653cd43bd3","added_by":"auto","created_at":"2025-11-05 16:26:13","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":6775,"visible":true,"origin":"","legend":"","description":"","filename":"4e051180e67542b8a4809b93ce191f9e.json","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/e7345fd0698c47a2e9a7769c.json"},{"id":95162017,"identity":"f5717c48-211b-4820-958d-86d42a641c03","added_by":"auto","created_at":"2025-11-05 03:43:20","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":137427,"visible":true,"origin":"","legend":"","description":"","filename":"MobileHealthInitiativeVolunteerSurvey.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/812119d9a851e700ceb11072.pdf"},{"id":95226633,"identity":"b00ff769-f834-441f-9b3d-2325ca4147c0","added_by":"auto","created_at":"2025-11-05 16:31:28","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":76497,"visible":true,"origin":"","legend":"","description":"","filename":"4e051180e67542b8a4809b93ce191f9e1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/7b59a2dcec34c1f92e3ed878.xml"},{"id":95162013,"identity":"3af5c411-9046-4ea9-a171-909a9c8716d3","added_by":"auto","created_at":"2025-11-05 03:43:20","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":73034,"visible":true,"origin":"","legend":"","description":"","filename":"4e051180e67542b8a4809b93ce191f9e1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/ff1875de2538cc704ea5297b.xml"},{"id":95162018,"identity":"8252945a-cdae-4dab-ac39-49d9ac4fab31","added_by":"auto","created_at":"2025-11-05 03:43:20","extension":"html","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":84920,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/e4fbc53c7305eb46760a9911.html"},{"id":104882191,"identity":"89230690-896f-47b2-88fa-c16767415d46","added_by":"auto","created_at":"2026-03-18 09:29:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":579617,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/f88e2808-6974-4c69-8e00-f532971dd79b.pdf"},{"id":95226628,"identity":"14bc77fb-e470-4813-b99f-51484b807a25","added_by":"auto","created_at":"2025-11-05 16:31:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":137427,"visible":true,"origin":"","legend":"","description":"","filename":"MobileHealthInitiativeVolunteerSurvey.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7246810/v1/27c58a0931b12d69c6493c8e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Enhancing early medical education through mobile health care: An observational survey of medical student volunteers","fulltext":[{"header":"Background","content":"\u003cp\u003eDespite growing recognition of the importance of community-based education, most medical programs offer community engagement opportunities only to self-selected students or as short-term, isolated experiences during the preclinical years (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). These limited approaches fall short of providing the sustained, longitudinal exposure needed to fully integrate a population health perspective into medical training. There is a need for early curricular adaptations that prepare students not only for the complexities of modern healthcare but also for skills to navigate cultural and societal diversity from a public health and community-integrated care lens (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe Geneva Community Health Program (CHP) is a successful initiative that demonstrates an integrated approach to preclinical medical education. By allowing students to repeatedly engage with community health professionals and the public, such initiatives have been shown to promote a multidisciplinary understanding of health and disease, while strengthening their appreciation for health promotion, advocacy, and cultural awareness (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This exposure cultivates adaptability and challenges traditional educational models, encouraging institutions to prepare their medical trainees for the ever-changing healthcare environment. As Hunt et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) proposed, embedding community partnerships within medical education equips students to address both clinical and systemic challenges at the community level, promoting a socially accountable model of training.\u003c/p\u003e\u003cp\u003eThe Community Health Advocacy Initiative (CHAI) at Northwestern University exemplifies this approach. Through longitudinal, mentored, community-engaged experiences, CHAI enabled all students to acquire practical skills in addressing the social determinants of health, forming lasting partnerships with community organizations, and broadening their perspective on patient health beyond the clinical setting. CHAI\u0026rsquo;s success demonstrates that sustainable, community-engaged education is both feasible and transformative, offering a model for medical schools aiming to prepare students for a more equitable, community-centered healthcare system (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFurthermore, burnout among medical students and residents has increased significantly in recent years, driven by factors such as high work intensity, stressful learning environments, and the shift to remote learning since the COVID-19 pandemic (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Additionally, poor learning experiences during training were found to be predictive of a greater increase in depressive symptoms among internal medicine residents (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This increased burnout not only affects personal well-being but also has profound implications for patient care. Residents experiencing burnout are more likely to display racial biases towards Black patients and to regret their specialty choice (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). As medical students progress in their careers, the prevalence of burnout and depression increases. This emotional exhaustion, as described by the Maslach Burnout Inventory, has been linked to worsening attitudes and an increase in implicit bias (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). These findings highlight how burnout and depression can undermine healthcare quality, particularly for historically marginalized groups.\u003c/p\u003e\u003cp\u003eIn the aftermath of the pandemic, there has been a renewed focus on supporting the well-being of medical trainees. While much research has centered on residents, these issues begin during medical school. A universal solution to improving well-being remains elusive, necessitating a multifaceted approach (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Yet, there is a lack of data on how students themselves define wellbeing and meaningful experiences (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). One of the aims of this study is to bridge that gap by exploring whether volunteering with the Mobile Health Initiative (MHI) is perceived as a meaningful experience and whether it supports wellbeing.\u003c/p\u003e\u003cp\u003eResearch has shown that meaningful participation and a sense of community belonging contribute to greater well-being among medical students (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The University of Minnesota\u0026rsquo;s MHI, launched in June 2020, offers a unique opportunity for community engagement, with mobile clinics serving as a bridge between clinical care and the communities they support (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This study aims to explore how MHI volunteers perceive their experiences, specifically in terms of well-being, community connectedness, clinical skills, and career goals. By gathering these insights, we aim to understand how medical education can incorporate community engagement to enhance both learning and personal resilience.\u003c/p\u003e\n\u003ch3\u003eObjective\u003c/h3\u003e\n\u003cp\u003eThe purpose of this study is to describe the experience of medical students volunteering with MHI and explore how these experiences can supplement medical education. The specific measures we aim to characterize include well-being, community engagement, clinical knowledge and skills, impact on future career, and identifying gaps within the medical school curriculum.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eResearch Question\u003c/h2\u003e\u003cp\u003eWhat do medical students find most meaningful about volunteering with MHI, and how does volunteering with MHI enhance medical education?\u003c/p\u003e\u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design \u0026amp; Data Collection\u003c/h2\u003e\u003cp\u003eThe qualitative study consists of a Google Forms survey sent to 179 current and past MHI medical student volunteer volunteers, in which 49 completed the survey (27% response rate). While some of the survey recipients are currently in residency programs, this survey only inquired about volunteer experiences during medical school. Volunteers were incentivized with the opportunity to win a gift card for completing the survey. The survey responses remained anonymous. Informed consent for publication of the anonymous data was obtained. Exclusion criteria included any volunteers who were not in medical school at the time of their volunteering. The data collected from the surveys is stored securely and analyzed in a Google spreadsheet. The survey questions consisted of four multiple-choice questions, five \"select all that apply\" questions, and seven free-response questions. The aim of the survey was to understand how volunteers heard about the program, what motivated them to join, and how they considered it a meaningful experience.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eOpen-ended survey responses were coded primarily via thematic analysis. The authors identified themes in short text responses and aggregated responses under common themes. We created visual representations of relevant questions using Google Spreadsheets, which included pie diagrams and bar charts. To assess the impact of MHI participation on students\u0026rsquo; perceived connection to the communities they served, participants rated their connectedness on a 5-point Likert scale both before and after their volunteer experience. We conducted a paired-samples t-test to evaluate the difference in mean scores before and after volunteering. The test assumes that the differences between paired observations are normally distributed, which was considered appropriate for this sample size (n\u0026thinsp;=\u0026thinsp;48). Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. We inspected the data for completeness and excluded responses with missing values from the analysis.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe survey received a total of 49 responses (27.4% response rate). Respondents spanned all years of medical school, with the majority having participated during their first and second preclinical years \u0026ndash; 37 students volunteered during their first year, and 27 during their second year. Additionally, 15 students participated during their third year and 6 during their fourth year. The median duration of volunteer involvement was approximately nine months, and notably, 41% of respondents volunteered for greater than one year. Many students indicated they participated in multiple events during their time with MHI and expressed a strong interest in continuing their involvement, underscoring the program\u0026rsquo;s sustained impact during early medical training.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eEnhanced Community Connection\u003c/h2\u003e\u003cp\u003eCommunity engagement and connection were the primary themes in volunteer responses. Many highlighted how being immersed in the community environment deepened their appreciation for the lived experiences of underserved populations and fostered a greater sense of belonging. One of the most notable outcomes from the survey was a significant increase in students\u0026rsquo; perceived connection to the communities they served. There were 48 responses (98% completion rate) to the pre- and post-volunteering community connection questions. Prior to volunteering with MHI, the average self-reported connectedness score was 2.5 on a 5-point Likert scale. This increased to 3.96 following their volunteer experiences, reflecting a 1.46-point improvement. Based on a paired t-test analysis, this increase was found to be statistically significant (mean difference, 1.46; 95% CI, 1.22 to 1.70; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), indicating a meaningful enhancement in community connection due to the program.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCONNECTEDNESS SCORE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean Score\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStandard Deviation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSample size (n)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBefore volunteering\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eafter volunteering\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eStudents attributed this score increase to the program\u0026rsquo;s direct, community-based engagement model, which allowed them to interact with patients outside of traditional clinical settings.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"It's helped me appreciate the communities I work with more, and helped me integrate myself better with Minneapolis since I moved here for medical school.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Made me feel more connected with my community.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Getting to work with people and communities and backgrounds I would normally never meet.\"\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eClinical Skill Development\u003c/h3\u003e\n\u003cp\u003eMedical student volunteers reported substantial growth in their clinical competencies. A 69% response rate was achieved to the survey question regarding how volunteering with MHI enhanced clinical skills and knowledge. Students commonly referenced improved communication skills, particularly in explaining medical information in simple language. Many also reported increased confidence in conducting routine procedures such as blood pressure measurement, HbA1c testing, and vision screening. Several participants described the opportunity to apply didactic knowledge in a practical context as \u0026ldquo;vastly improving\u0026rdquo; their early medical education experience. The clinical hands-on practice was frequently cited as a valuable complement to classroom learning, as it reinforced key concepts through real-world application. Some medical students also mentioned gaining experience in interprofessional teamwork and improving their ability to work alongside healthcare providers from different disciplines (internal medicine, pediatrics, family medicine, optometry, pharmacy).\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\"Volunteering with MHI has allowed me to practice my clinical skills in a less formal setting, which I think has vastly improved my didactic education experience.\"\u003c/p\u003e\u003cp\u003e\"This has taught me how to speak to patients in ways that are most comfortable and approachable to them.\"\u003c/p\u003e\u003cp\u003e\"Learning how to take a BP and do an A1C finger prick was helpful to learn!\"\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eExposure to Social Determinants of Health and Cultural Competency\u003c/h3\u003e\n\u003cp\u003eOver one-third of respondents (18 total) highlighted aspects related to delivering healthcare to underserved populations, understanding social and cultural factors in patient care, and utilizing language or cultural skills to bridge care gaps. Students emphasized that serving MHI\u0026rsquo;s diverse patient population encouraged them to consider cultural, linguistic, and socioeconomic factors in their approach to patient care. Multiple respondents reported that their ability to communicate in Spanish improved patient interactions, serving as a bridge between vulnerable patients and the healthcare system (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Furthermore, several participants shared how volunteering with MHI enabled them to engage with healthcare disparities, rather than just learning about them in the classroom. Exposure to these real-world challenges helped medical student volunteers develop a more nuanced understanding of patients\u0026rsquo; needs beyond clinical symptoms.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"This experience has made me a more compassionate and empathetic listener who takes better account into the patient's community/cultural context when discussing care plans.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003eLearned more about being cognizant of people's conditions and other issues.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Getting real experience with these communities rather than just learning about them in class.\"\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eEmotional and Motivational Impact\u003c/h2\u003e\u003cp\u003eVolunteering with MHI had a profoundly personal and uplifting impact on many of the medical students who participated, particularly those who participated during their demanding preclinical years. A total of 39 students (80% of responses) reported that their experiences with MHI brought them greater happiness, a renewed sense of fulfillment, and relief from the burnout that often accompanies early medical training. Volunteering reminded them of why they chose to pursue a career in medicine, helping them reconnect with the values and purpose that initially drew them to the field.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"Volunteering with MHI was a reminder of my 'why medicine' during the preclinical years.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Volunteering with MHI has been integral in warding off burnout.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"It encourages me to keep pushing during the hard times as a medical school. It gives me a reminder of the various reasons why I decided to become a physician.\"\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eCareer Impact\u003c/h2\u003e\u003cp\u003eOf the 49 respondents, 15 (32.6% of responses) indicated that participation in MHI influenced their specialty choice or future career goals. Among these, many reported a strengthened interest in primary care, family medicine, or community health. Others expressed a newfound interest in global health, rural medicine, or incorporating outreach initiatives into subspecialty practices. While the remaining respondents did not report a change in specialty interest, several noted that the experience affirmed existing career goals.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"Confirmed my interest in primary care/family medicine, meeting people where they're at and providing resources.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Thanks to this experience, I have become more drawn to refugee health and rural medicine.\"\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"I would definitely want to help with free clinics and medical camps as a physician. The experiences have made me consider global health as well.\"\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results demonstrate that volunteering with MHI substantially enriched medical students\u0026rsquo; educational experiences by providing early, real-world exposure to community-based healthcare. We identified four main themes that defined meaningful experiences for medical student volunteers: 1) Community Engagement and Connection 2) Hands-On Clinical Skills Development 3) Health Equity and Access 4) Emotional Fulfillment.\u003c/p\u003e\u003cp\u003eThe statistically significant increase in perceived community connectedness underscores the value of immersive, patient-centered volunteer opportunities offered by programs like MHI. Medical students reported improved communication skills, practical clinical competence, and heightened sensitivity to the social determinants of health \u0026ndash; competencies essential to effective, compassionate medical practice. Traditional medical education places a strong emphasis on didactics and often overlooks the complex, relational aspects of modern medicine (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). These are often referred to as the \u0026ldquo;soft skills\u0026rdquo; of medicine, which are currently only being learned in the didactic years through simulations with standardized patients. While these simulation environments are important to medical education, there is an intrinsic difference in developing these provider-patient relationship skills in the real world with a diverse patient population. This sentiment is echoed by students who volunteer at student-run free clinics, who have consistently acknowledged that their community-based experiences provided them with skills that are not emphasized in the formal medical school curriculum (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Additionally, there may be a benefit to academic achievement from volunteering at community-based clinics. A study by Vaikunth et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) found higher Step 2 CK scores in volunteers compared to non-volunteers. There appears to be substantial evidence supporting the incorporation of community-based initiatives, such as MHI, particularly in preclinical years as a supplement to traditional medical education.\u003c/p\u003e\u003cp\u003eDue to the well-documented rise in burnout and emotional exhaustion among medical trainees (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), the emotional benefits reported by participants in this study are particularly noteworthy. Students consistently described how volunteering with MHI helped them rediscover their initial motivations for pursuing a career in medicine, thereby fostering a renewed sense of purpose. This sense of meaning, derived from real-world patient engagement, contributed to a reduction in feelings of burnout and an increase in emotional resilience. The lack of these critical factors has been associated with compromised patient care and greater implicit biases (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In light of evidence that burnout begins during medical school and is associated with downstream effects on patient outcomes and physician satisfaction, early involvement with community-based programs like MHI may be pivotal in fostering a more compassionate healthcare workforce. Therefore, MHI\u0026rsquo;s role in supporting emotional well-being and reinforcing personal values for medical students demonstrates the program's value in protecting against the rigors of medical training.\u003c/p\u003e\u003cp\u003eMoreover, nearly one-third of respondents reported that the experience either shaped their specialty choice or reaffirmed their existing career goals. This aligns with broader efforts to understand how meaningful engagement during medical school can guide students toward career paths. There is some debate in the literature regarding whether medical students who volunteer at community-based or student-led free clinics are more likely to match into a primary care specialty (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). While our findings do not support either conclusion, MHI events do provide an opportunity for exposure to primary care and preventive healthcare, with student volunteers emphasizing the desire for more events in the future.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study examined the perspectives of medical students on their volunteer experiences with the University of Minnesota\u0026rsquo;s Mobile Health Initiative (MHI), focusing on its impact and role in complementing traditional medical education. The MHI advances medical education by extending healthcare beyond traditional settings and enabling early clinical and community exposure during a formative time for future physicians. As one of an estimated 2,000 mobile clinics nationwide, MHI mobilizes health professionals, students, and community partners to provide essential services to underserved communities disproportionately impacted by social injustices and other barriers to healthcare.\u003c/p\u003e\u003cp\u003eThe findings from this study highlight the essential role that community-based initiatives, such as MHI, play in enhancing traditional medical education. Mobile healthcare enriches medical education by offering students firsthand experience in providing care to diverse populations, utilizing cultural understanding to bridge gaps in care, and fostering community connection. In addition, many student volunteers reported being inspired to pursue primary care or work in underserved settings, highlighting the broader potential of such programs to shape the future healthcare workforce. For these reasons, we recommend incorporating community-based service learning into the medical school curriculum.\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis study is subject to several limitations. First, the survey response rate was 27%, which may introduce response bias. Volunteers with particularly strong positive or negative experiences might have been more likely to participate. Additionally, the self-reported nature of qualitative data makes it challenging to objectively measure outcomes, such as the impact on emotional well-being and career path discernment. Finally, the results of this study are limited to a single institution and the survey was only sent out to University of Minnesota medical students who had volunteered with the Mobile Health Initiative.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eFuture Research\u003c/h2\u003e\u003cp\u003eFuture research could explore how participation in programs like MHI influences students as they transition into residency. A longitudinal study following medical students into their residency training could assess whether early community-based experiences impact their clinical practice styles, patient interaction approaches, and career satisfaction. Specifically, researchers could investigate whether medical students who participate in community-based programs are more likely to choose residencies with a focus on primary care, community health, or underserved populations.\u003c/p\u003e\u003cp\u003eStudies could assess whether MHI participants enter residency with different baseline competencies compared to peers, particularly in areas such as cultural competence, communication skills, and team-based care. Faculty evaluations, self-assessments, and patient feedback could be used to measure these competencies longitudinally.\u003c/p\u003e\u003cp\u003eIn addition, future research could investigate whether early participation in meaningful, community-based volunteer experiences, such as MHI, contributes to lower rates of burnout later in medical school and during residency.\u003c/p\u003e\u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMHI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMobile Health Initiative\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cp\u003eIRB ID: STUDY00022977. The IRB reviewed the protocol submission and determined that this study meets the criteria for exemption from IRB review. Jeffrey P Parker, CIP, MLS, the senior IRB analyst at the University of Minnesota Human Research Protection Program provided a letter detailing the reason for exemption from IRB review. This letter is included under \u0026ldquo;Related Files.\u0026rdquo;\u003c/p\u003e\u003ch2\u003eConsent for publication\u003c/h2\u003e\u003cp\u003eConsent to Publish declaration: not applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThe authors declare that no financial support was received for the research, authorship, and/or publication of this article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJB wrote the main manuscript text and analyzed/interpreted the data. JB and AA designed the volunteer survey in which the data was derived from. All authors reviewed the manuscript, and contributed to the revision process.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank Maggie Eckerstorfer, who created the medical student volunteers list for the survey to be emailed out to. In addition, she provided valuable feedback early in the research project and assisted with administrative efforts. We would also like to thank the many community partners, whose invaluable support enables us to deliver care to marginalized populations.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e\u003cp\u003eAll data generated or analysed during this study are included in the supplementary information files.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDoobay-Persaud A, Adler MD, Bartell TR, Sheneman NE, Martinez MD, Mangold KA et al. 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Front Med. 2021;8:758377.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mobile health care, medical education, meaningful experiences, wellbeing","lastPublishedDoi":"10.21203/rs.3.rs-7246810/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7246810/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eIn traditional U.S. medical education, preclinical training offers limited exposure to community-based experiences during a critical formative period of career discernment. The absence of early experiential learning may result in missed opportunities to cultivate motivation and sustained enthusiasm to practicing medicine. This observational study aimed to understand the perspectives of preclinical students on their volunteer experiences with the Mobile Health Initiative (MHI), focusing on its perceived impact and role in enhancing their medical education.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA survey was disseminated to all MHI volunteers to assess the program\u0026rsquo;s impact on student engagement and future practice intentions. This survey was emailed out to 179 medical student volunteers during 2025, in which 49 responded (27% response rate). Open-ended survey responses were coded primarily via thematic analysis. We conducted a paired-samples t-test to evaluate the difference in mean scores regarding perceived community connection before and after volunteering with MHI.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eStudents defined meaningful experiences as providing healthcare to underserved populations, utilizing cultural understanding to bridge care gaps, and fostering community connections. There was a significant increase in the feeling of connectedness with their community, which helped students rediscover their purpose for pursuing a career in medicine. Some highlights from the survey responses centered on an increased sense of fulfillment and learning to communicate compassionately. In addition, many respondents detailed how MHI events improved their clinical skills through these hands-on experiences and enhanced their clinical judgment in resource-limited settings.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eWe identified four main themes that defined meaningful experiences for medical student volunteers: 1) Community Engagement and Connection, 2) Hands-On Clinical Skills Development, 3) Health Equity and Access, and 4) Emotional Fulfillment. There is a strong need for community-based, service-learning programs, such as MHI, to enhance traditional medical education.\u003c/p\u003e","manuscriptTitle":"Enhancing early medical education through mobile health care: An observational survey of medical student volunteers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-05 03:43:15","doi":"10.21203/rs.3.rs-7246810/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9313671f-5253-4358-8db0-610f0ffe8bae","owner":[],"postedDate":"November 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-18T09:27:36+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-05 03:43:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7246810","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7246810","identity":"rs-7246810","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}