Medical students’ experiences of health inequalities and inclusion health education

Abstract

Background Inclusion health groups experience a significantly larger burden of morbidity and mortality than the general public. Despite this, undergraduate medical education is often limited in its approach to inclusion health curricula, leaving students disengaged and lacking understanding. Methods We conducted two research studies to explore medical students’ experiences of inclusion health education. All participants were studying medicine at the University of Leeds at the time of data collection. We gathered experiences of both compulsory and elective inclusion health education via semi‐structured interviews. Interview responses were audio‐recorded, transcribed and analysed thematically. Findings We identified several key findings across the two studies. Firstly, medical students felt unprepared to work with inclusion health groups. Further to this, medical students have a preference for interactive teaching and learning in inclusion health education. Finally, encountering inclusion health groups by chance (on placement) or choice (optional initiatives) present different opportunities. Discussion and Conclusion Our research suggests that simply being exposed to inclusion health groups through lectures and on placement is not considered sufficient by medical students, and in fact can lead to the perpetuation of misinformation and stigma. Participants perceived that optional initiatives or ‘choice encounters’ had profoundly positive impacts on attitudes and interest, particularly when there were opportunities to learn directly from individuals with lived experience of exclusion. We suggest that a flipped classroom approach to inclusion health education along with integrated experiential learning would provide medical students with comprehensive and patient‐focused learning opportunities.

Using medical education as a tool to train doctors as social innovators

“…Fortunately, widening participation initiatives are helping more students from diverse backgrounds, including those with lived experience of mental health to be admitted into medical school 23. Medical students, we discovered, are also eager to pursue an agenda of addressing inequalities and promoting social justice 24. However, the ambition of medical students as nascent social innovators is made difficult through the institution of a hospital-based education and socialisation together with a health service configuration which makes health delivery partnerships with community groups difficult 25.…”

Health professional’s implicit bias of adult patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review protocol

“…Our view is augmented by a wide range of evidence from different contexts, which indicates that healthcare professionals often make subconscious assumptions and exhibit implicit bias based on their own perceptions about another person because of their sexual orientation, perceived race, culture, religion or wealth. [52][53][54][55] Therefore, we contend that it is apposite to include papers with discrete measures that may be limited in their utility as proxy measures of SES in this scoping review, because they provide an important insight into factors relating to healthcare implicit SES-related bias(es) and how they affect HPs decision-making about different facets of patient care in the reality of everyday practice. In other words, we feel that excluding papers that use discrete measures would diminish the scope of the review, by limiting and/or failing to map the extent of this problem, in a manner which best reflects the praxis of modern healthcare.…”

Developing a tool for the measurement of social exclusion in healthcare settings

“…It also recognised that social inclusion (SI) and social exclusion were on a continuum, greatly influenced by access to resources, the ability to realise one’s rights and the capabilities of people to put those rights and resources to use. Groups that are frequently mentioned in the context of SE and health include people who have experienced homelessness, people who have addiction issues, people who engage in sex work, people from the Roma and Traveller communities and others [ 15 – 17 ]. The 2008 WHO World Health Report advised that making primary healthcare universal would ensure that “health systems contribute to health equity, social justice and the end of exclusion” [ 18 ].…”