To characterize medical student learning needs regarding rehabilitation and post-acute care.

Clinical post-acute care (PAC) experience (inpatient rehabilitation, long term acute care, skilled nursing) is not uniformly required in United States medical schools. Even in neurology, where many inpatients are discharged to PAC, clerkships seldom include a neurorehabilitation component. Information is lacking about what medical students know and might need to know about rehabilitation/PAC to support patients transitioning from acute to PAC.

In June 2021, 54 second-year medical students from a large urban medical school, rotating at a hospital that discharges patients to all PAC levels, were provided a voluntary survey about rehabilitation/PAC experiences and learning needs. Most students had completed 9 of 12 months of standard required clinical rotations. Data was collected using Qualtrics and analyzed using qualitative grounded theory to identify and quantify responses. The study was exempt from IRB review.

Response rate was 72% (39/54). Among the respondents who had seen patients (37/39;95%), all (37/37;100%) reported discharging at least one patient to PAC. More than half described discharging a patient with neurologic diagnosis to PAC (21/37;57%). All respondents (39/39;100%) reported at least one gap in rehabilitation/PAC knowledge, with responses falling into 8 themes: daily experience of rehabilitation/PAC (17/39;44%); determination of eligibility/screening processes (16/39;41%); distinctions among levels of rehabilitation/PAC (13/39;33%); insurance coverage/equity (12/39;31%); rehabilitation/PAC clinical practice environment (10/39;25%); post-rehabilitation/PAC discharge support (7/39;18%); medical capabilities within PAC settings (6/39;15%); developing rehabilitation goals (6/39;15%). Representative responses were captured.

Despite discharging patients to rehabilitation/PAC settings, medical students lack important knowledge about the process of rehabilitation and recovery, including patient eligibility for and service availability across levels of PAC. Integrating neurorehabilitation education within neurology education could increase awareness of the patient experience and enhance trainee ability to counsel and advocate for patients with neurologic disability through the transition from acute to PAC.