Background: Firearm injury is a leading cause of morbidity and mortality in the U.S., yet research indicates that few clinicians receive formal training in promoting safe firearm storage, and both medical trainees and physicians report low knowledge and comfort about counseling patients. Medical education is an opportunity to address these barriers, yet in 2022, only 27% of U.S. medical schools included firearm-related content.
Purpose: To design and pilot a multi-modal, evidence-informed curriculum that introduces firearm injury epidemiology, culturally sensitive communication strategies, and practical counseling skills to first-year medical students, in order to increase knowledge, self-efficacy, and readiness to discuss firearm safety with patients.
Description: The intervention was developed using Kern’s model of curriculum development. A literature review identified learner needs, gaps in medical training, and consensus guidelines on core content for firearm injury prevention education. Decision-makers, including educational leaders and firearm injury experts, reviewed this content and commented on the scope and feasibility of integration into the curriculum. The intervention was informed by several learning theories, e.g., social cognitive, transformative, and critical pedagogy, to promote skill acquisition, reflective practice, and attitude shifting. The intervention consisted of a 90-minute session integrating the following components: 1. Didactic content discussing firearm injury epidemiology, structural contributors to risk, and consensus recommendations for safety counseling.2. A role play demonstrating how to navigate sensitive discussions regarding firearm ownership and safe storage.3. A panel discussion and Q&A featuring firearm owners and community advocates to expose learners to diverse perspectives and enhance cultural awareness. This session was given in April 2025 as part of the core curriculum required for first-year medical students. Students were asked to complete pre- and post-session surveys, which measured the perceived importance of firearm injury prevention, knowledge of firearm injury epidemiology, knowledge of when to discuss firearms with patients, and comfort discussing firearm injury prevention. Students were also asked to share qualitative reflections.
Conclusions: Among 103 pre-intervention and 37 post-intervention survey respondents, baseline ratings of the importance of firearm injury prevention were high and unchanged. Among the 32 participants with matched pre- and post-intervention responses, significant improvements were observed in knowledge of firearm epidemiology (2.19 vs. 3.03 on a 5-point scale, p< 0.001), knowledge of when to discuss firearms with patients (1.41 vs. 2.81, p< 0.001), and comfort discussing firearm injury prevention (2.25 vs. 3.22, p< 0.001). Qualitative analysis revealed themes of perspective-shifting through exposure to firearm culture; appreciation of epidemiological data; and a desire for more interactive components. This curriculum demonstrates that a brief didactic intervention can meaningfully enhance medical students’ knowledge and comfort with firearm injury prevention counseling. The integration of didactic content, modeled patient interactions, and diverse perspectives is feasible to implement in pre-clinical curricula. Findings support expanding the program and developing longitudinal reinforcement across the medical training and professional development of physicians.