A scoping review of social determinants of health curricula in post-graduate medical education

Hunter, Kimberly A.; Thomson, Ben K.A.

doi:10.36834/cmej.61709

Cited by 41 publications

(52 citation statements)

References 16 publications

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“…The only studies that explicitly evaluated the training components of their models were with those that used pediatric residents, [35][36][37][38][39] possibly due to the growing emphasis on SDOH in post-graduate medical education. 96 Future efforts should test and optimize training materials and certification opportunities for nonphysician workers to maximize efficacy.…”

Section: Discussionmentioning

confidence: 99%

Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review

Sandhu

Eisenson

et al. 2021

J Prim Care Community Health

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Objectives While healthcare organizations increasingly aim to address the social determinants of health (SDOH) in the clinic setting, there is little guidance on which staff are best equipped to assume this role. The present study is a scoping review of the peer-reviewed literature to characterize workforce models used to screen for and respond to patients’ unmet social needs in ambulatory settings. Methods Four online databases were used to identify papers published until February 2021. Eligible articles were original research studies or systematic reviews that described the implementation of a standardized assessment for multiple SDOH domains and resulting activities to respond to individual patient needs (eg, referral to community resources) in ambulatory care settings. Results Of the 1569 articles identified, 65 met study eligibility criteria. Majority of studies had observational study designs (11% were randomized control trials). For screening-related activities, more articles reported using traditional healthcare staff (51%), such as medical providers, medical assistants, and front-desk staff, than social care staff (32%), such as social workers and student volunteers. In contrast, for response-related activities, more articles reported using social care staff (88%) than traditional healthcare staff (60%). While we found wide variations in specific team configurations and training for the roles, social care staff generally provided more intensive forms of assistance than traditional healthcare staff. Conclusion While this review demonstrates the breadth of models for building or deploying a workforce to integrate health and social care, it also identifies the need for rigorous research on workforce development, implementation, and effectiveness.

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Section: Discussionmentioning

confidence: 99%

Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review

Sandhu

Eisenson

et al. 2021

J Prim Care Community Health

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“…Health advocacy may consider borrowing from other assessment tools used in medical education by using portfolios, academic benchmarks, such as scholarly projects, publications and successful grant applications, and patient experience outcomes. 123 Several implications for medical educators emerged in designing curricular interventions. First, longitudinal curricula appear to be superior to short, discrete curricula when teaching health advocacy.…”

Section: Discussionmentioning

confidence: 99%

“…Trainee assessment remains challenging and largely limited to micro‐level health advocacy. Health advocacy may consider borrowing from other assessment tools used in medical education by using portfolios, academic benchmarks, such as scholarly projects, publications and successful grant applications, and patient experience outcomes …”

Section: Discussionmentioning

confidence: 99%

The state of health advocacy training in postgraduate medical education: a scoping review

et al. 2019

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Context Health advocacy is an essential component of postgraduate medical education, and is part of many physician competency frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) roles. There is little consensus about how advocacy should be taught and assessed in the postgraduate context. There are no consolidated guides to assist in the design and implementation of postgraduate health advocacy curricula. Objectives This scoping review aims to identify and analyse existing literature pertaining to health advocacy education and assessment in postgraduate medicine. We specifically sought to summarise themes from the literature that may be useful to medical educators to inform further health advocacy curriculum interventions. Methods MEDLINE, Embase and ERIC were searched using MeSH (medical student headings) and non‐MeSH search terms. Additional articles were found using forward snowballing. The grey literature search included Google and relevant stakeholder websites, regulatory bodies, physician associations, government agencies and academic institutions. We followed a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results Of the 123 documents reviewed in full, five major themes emerged: (i) conceptions of health advocacy have evolved towards advocating with rather than for patients, communities and populations; (ii) longitudinal curricula were less common but appeared the most promising, often linked to scholarly or policy objectives; (iii) hands‐on, immersive opportunities build competence and confidence; (iv) community‐identified needs and partnerships are increasingly considered in designing curriculum, and (v) resident‐led and motivated programmes appear to engage residents and allow for achievement of stated outcomes. There remain significant challenges to assessment of health advocacy competencies, and assessment tools for macro‐level health advocacy were notably absent. Conclusions There is considerable heterogeneity in the way health advocacy is taught, assessed and incorporated into postgraduate curricula across programmes and disciplines. We consolidated recommendations from the literature to inform further health advocacy curriculum design, implementation and assessment.

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“…We included 101 studies (See Appendix for a diagram of the inclusion process) 18‐118 . On average 10.1 scoping reviews (SD = 13.1, median = 4, range 0‐42) were published annually (See Appendix ) with the most published in 2019 (n = 42; 41.6%).…”

Section: Resultsmentioning

confidence: 99%

“…Authors put forth, on average, 2.4 research questions or aims per review (SD = 1.0, median = 2, range 0‐5). Similar to their rationales for conducting a scoping review, authors' research questions or aims were attempting to: summarise and disseminate research findings (n = 89; 90.8%) 18‐32,34‐39,41‐69,71‐74,76‐82,84‐88,92‐94,96‐103,105‐107,109‐114,116‐118 ; examine the extent, range and nature of research activity in a given area (n = 86; 87.8%) 18‐30,32,34‐39,41‐57,59‐69,71‐74,76‐82,84‐88,92,94,96,97,99,101‐107,109‐118 ; ...…”

Section: Resultsmentioning

confidence: 99%

Scoping reviews in medical education: A scoping review

et al. 2020

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Objectives Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities. Method The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA‐ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review. Results One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA‐ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal. Conclusions Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised.

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A scoping review of social determinants of health curricula in post-graduate medical education

Cited by 41 publications

References 16 publications

Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review

Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review

The state of health advocacy training in postgraduate medical education: a scoping review

Scoping reviews in medical education: A scoping review

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