TY - JOUR
T1 - Addressing the social determinants of health in undergraduate medical education curricula
T2 - A survey report
AU - Lewis, Joy H.
AU - Lage, Onelia G.
AU - Kay Grant, B.
AU - Rajasekaran, Senthil K.
AU - Gemeda, Mekbib
AU - Like, Robert C.
AU - Santen, Sally
AU - Dekhtyar, Michael
N1 - Funding Information:
The authors would like to thank all the members of the consortium’s social determinants of health interest group for their expertise in developing the survey instrument. The authors would also like to thank Debosree Roy, PhD, for her help with preparation of the manuscript and Curt Bay, PhD for statistical analysis. The project was performed with financial support from the American Medical Association as part of the Accelerating Change in Medical Education Initiative.
Publisher Copyright:
© 2020 Lewis et al.
PY - 2020
Y1 - 2020
N2 - Purpose: Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/ goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH. Methods: A team from the American Medical Association’s Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate. Results: Twenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/ goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations. Conclusion: Despite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multi-tude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional “preclinical” years, indicates curricular areas in need of attention.
AB - Purpose: Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/ goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH. Methods: A team from the American Medical Association’s Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate. Results: Twenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/ goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations. Conclusion: Despite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multi-tude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional “preclinical” years, indicates curricular areas in need of attention.
KW - Barriers to teaching
KW - Health system science
KW - Social factors
KW - Teaching strategies
UR - http://www.scopus.com/inward/record.url?scp=85097834869&partnerID=8YFLogxK
U2 - 10.2147/AMEP.S243827
DO - 10.2147/AMEP.S243827
M3 - Article
AN - SCOPUS:85097834869
SN - 1179-7258
VL - 11
SP - 369
EP - 377
JO - Advances in Medical Education and Practice
JF - Advances in Medical Education and Practice
ER -