Expert Consensus on Inclusion of the Social Determinants of Health in Undergraduate Medical Education Curricula

Mangold, Karen; Bartell, Tami R.; Doobay-Persaud, Ashti; Adler, Mark; Sheehan, Karen

doi:10.1097/acm.0000000000002593

Cited by 57 publications

(59 citation statements)

References 5 publications

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“…This may reflect that SDH concepts are only now being integrated into medical education and that assessment of these concepts will be developed and disseminated over time. 33,83 Although it rarely appeared in our review, educational research in other fields suggests that critical reflection is a valuable tool for transformation of learner attitudes toward vulnerable populations and structural injustice. 23,32,84,85 True transformative learning, which typically employs both experiential learning and critical reflection, requires a skilled facilitator to teach and assess.…”

Section: Discussionmentioning

confidence: 96%

Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

et al. 2019

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BACKGROUND: To provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients' well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance. OBJECTIVE: This review's objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME). METHODS: In 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics. RESULTS: The authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2). CONCLUSIONS: The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.

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Section: Discussionmentioning

confidence: 96%

Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

et al. 2019

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“…We continue to develop educational strategies for implementation, soliciting learner and educator feedback throughout. While experts agree on quantity, content, and integration throughout undergraduate medical education, few have described a concrete approach [ 10 ].…”

Section: “Tell Us More”mentioning

confidence: 99%

Tuskegee as a History Lesson, Tuskegee as Metaphor: Addressing Discrimination as a Social Determinant of Health in the Classroom

Vijayan

Cortés-Penfield

Harris

2020

Open Forum Infectious Diseases

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While basic science and social medicine are fundamental to the practice of medicine, the former is often prioritized in preclinical medical education at the expense of the latter. In this perspective, we discuss ways to introduce the concept of interpersonal, institutional and structural discrimination as social determinants of health (SDOH) into a preclinical microbiology and infectious diseases medical course. We offer five specific steps to creating a comprehensive curriculum on discrimination as a social determinant of health: define and use standardized terminology; integrate the concept of SDOH throughout the course; encourage critical appraisal of lay and medical resources; encourage student feedback; and provide faculty development supported by key faculty stakeholders that focuses on increasing comfort and facility with teaching such concepts. This approach offers a template for ongoing discussion in the setting of curricular reform.

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“…(3) Despite these concerted calls to action and available guidelines, healthcare disparity education has been described as suboptimal by faculty and students. (4)(5)(6) Effective healthcare disparity education has positive effects for medical schools, including improved recruitment of underrepresented minorities (URM) (those identifying racially or ethnically as African American and/or Black, Hispanic/Latino, Native American). (7) Healthcare disparities curricula create a sense of inclusion for URM students in their learning environments.…”

Section: Physicians the Accreditation Council For Graduate Medical Ementioning

confidence: 99%

Enhancing Existing Medical School Curricula with an Innovative Healthcare Disparities Curriculum

Treacy-Abarca

Aguilar

Vassar

et al. 2020

Preprint

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Background: Effective healthcare disparities curricula are essential to improve care of minority patients. Methods: A cost-neutral, evidence-based curriculum was created by enhancing established medical school lectures at the UCLA David Geffen School of Medicine class of 2021 (n=188). Lectures within an 8-week course were evaluated for “teachable moments” or broad topics suitable to introduce specific healthcare disparities content. A lecture-enhancing curriculum based on Society of General Internal Medicine learning objectives was introduced into the DGSOM learning management system via supplemental PDF documents. Results: A total of 92 of 188 students completed curricular assessments and were stratified into intervention group (“utilized materials” n=52) and comparison (“did not utilize the material” n=40) groups based on self-reported use of materials. Minorities were more likely to utilize the material (41% of the intervention group vs 17% of the comparison group, p<.01). Post-course 16-item knowledge composite scores, and confidence in addressing healthcare disparities improved only in the intervention group (p=0.001), and 96% of respondents described the health disparities curriculum as a valuable learning resource. Conclusions: Enhancing pre-existing lectures by identifying and harnessing “teachable moments” is a cost-neutral and effective strategy to integrate a healthcare disparities curriculum.

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Expert Consensus on Inclusion of the Social Determinants of Health in Undergraduate Medical Education Curricula

Abstract: consensus on inclusion of the social determinants of health in undergraduate medical education curricula. Acad Med.

Cited by 57 publications

References 5 publications

Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

Tuskegee as a History Lesson, Tuskegee as Metaphor: Addressing Discrimination as a Social Determinant of Health in the Classroom

Enhancing Existing Medical School Curricula with an Innovative Healthcare Disparities Curriculum

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