The urgency of the problem is difficult to overstate. Firearm injuries have surpassed motor vehicle crashes as the leading cause of death among U.S. children, and the Surgeon General declared firearm violence a public health crisis in 2024. Yet despite these alarming trends, physicians rarely intervene through patient counseling or policy advocacy, likely because few receive any formal training during their education. The OHSU team, led by Dr. Katherine A. Iossi, recognized that if physicians are expected to play a role in preventing firearm injuries, medical schools must equip students with the tools to do so before they enter clinical practice.

The session, developed in collaboration with public health professionals, was integrated into the existing second-year medical student curriculum at OHSU. It comprised three carefully sequenced components: didactic instruction outlining firearm injury epidemiology and evidence-based clinical and policy interventions, facilitated small-group discussions, and role-playing exercises to practice clinical and policy advocacy skills. The design drew on established curriculum development frameworks and incorporated the BulletPoints Project’s 3A’s Framework for firearm safety counseling, along with the structured advocacy pitch model for policy engagement.

The didactic portion grounded students in the epidemiology of firearm injuries, covering the spectrum of harm from suicide and homicide to accidental injury, and presenting evidence-based interventions such as lethal means safety counseling and secure firearm storage. Students then moved into facilitated small-group discussions, where they explored the ethical dimensions of firearm injury prevention and examined the concept of the physician’s “lane,” a reference to the ongoing debate about whether firearm safety falls within the scope of medical practice. The discussions were structured to create psychological safety, allowing students to voice uncertainty and engage with the topic without fear of judgment.

The role-playing component represented the most innovative element of the session. Students practiced clinical counseling scenarios, such as discussing secure firearm storage with a patient at risk for suicide, and rehearsed policy advocacy pitches aimed at translating clinical evidence into legislative action. This experiential approach reflects a growing body of evidence that communication skills are best acquired through deliberate practice rather than passive instruction, and it mirrors the simulation-based methods used to teach other sensitive clinical encounters.

To evaluate the program, the researchers administered a retrospective pre-post survey to participating students, achieving a response rate of 71.4 percent with 105 respondents. The results revealed statistically significant increases in all study variables between the pre- and post-periods, with p-values below 0.001. Students reported meaningful gains in perceived knowledge, confidence, and intention to engage in firearm injury prevention efforts. Approximately half of respondents, 48.6 percent, reported at least some experience with firearms, including having a family or cultural background involving firearms, highlighting the diversity of perspectives students bring to the topic.

Respondents viewed the firearm injury prevention education as timely, educationally valuable, and important to their future practice. The findings suggest that even a brief, well-structured session can shift medical students’ attitudes and self-efficacy in a domain where clinical engagement has historically been low. The researchers note that self-efficacy plays a mediating role in professional identity formation, meaning that early exposure to firearm injury prevention could influence how students see themselves as physicians throughout their careers.

The program’s significance extends beyond a single institution. Prior educational interventions in this domain have been limited and fragmented, ranging from web-based curricula to case-based training for residents, but few have combined clinical counseling with policy advocacy in a single session for preclinical medical students. The OHSU team’s approach, which explicitly frames firearm injury prevention as both a clinical and policy responsibility, addresses consensus-driven priorities for firearm injury education among medical professionals identified by national summits on the topic.

The researchers acknowledge limitations inherent in their evaluation design, including the retrospective self-report method and the single-institution setting. Response bias remains a possibility, and the long-term retention of knowledge and skills was not assessed. Nevertheless, the study provides a replicable template for other medical schools seeking to integrate firearm injury prevention into their curricula, and the de-identified data is available from the corresponding author upon request to facilitate further research.

As the firearm injury epidemic continues to claim tens of thousands of lives annually, the OHSU session offers a concrete example of how medical education can respond. By teaching students to counsel patients on firearm safety and to advocate for evidence-based policies, the program challenges the notion that physicians must remain silent on this issue. The title of the session, “It’s in Our Lane,” captures the researchers’ central message: firearm injury prevention is not a political distraction but a clinical and professional obligation that belongs squarely within the practice of medicine.

Subject of Research: A medical education program training students in firearm injury prevention clinical counseling and policy advocacy skills

Article Title: It’s in Our Lane: A Firearm Injury Prevention Clinical and Policy Advocacy Skill Development Session for Medical Students

Article References: Iossi, K. A., Kane, R. M., Teichman, R., Manley, K., Martinson, T., Carlson, K. F., Carney, P. A., & Burnett, J. R. (2026). It’s in Our Lane: A Firearm Injury Prevention Clinical and Policy Advocacy Skill Development Session for Medical Students. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10716-9

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10716-9

Keywords: firearm injury prevention, medical education, physician advocacy, public health, curriculum development, health policy, communication skills, medical students, Lane, Firearm, Injury, Prevention