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

IntroductionAction on the social determinants of health has been key for improving health and prolonging life in the past, and remains so today. Against this background, WHO’s Commission on Social Determinants of Health has called for increased efforts to create health workforces trained in recognising, understanding and acting on the social determinants of health. However, little is known about the extent to which current medical education systems prepare graduates for this challenge. We, therefore, aim to analyse the extent to which the medical curriculum in Germany incorporates content on the social determinants of health.Methods and analysisWe will conduct a qualitative and quantitative content analysis of four key document groups which influence medical education in Germany: the national medical catalogue of learning objectives; examination content outlines provided by the German Institute for Medical and Pharmaceutical Examination Questions; the online textbook most widely used for final examination preparation and the full set of questions from two national medical licensing examinations. We will analyse these documents based on a coding system, which we derived deductively from the report of WHO’s Commission on Social Determinants of Health as well as other key publications of WHO. We will report quantitative indicators, such as the percentage of text related to social determinants of health for each document type. Moreover, we will conduct a semiqualitative analysis of relevant content.Ethics and disseminationThis study is based on the analysis of existing documents which do not contain personal or otherwise sensitive information. Results from the study will be published in a scientific peer-reviewed journal.

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Taking stock of the social determinants of health: A scoping review

PLoS ONE ◽

10.1371/journal.pone.0177306 ◽

2017 ◽

Vol 12 (5) ◽

pp. e0177306 ◽

Cited By ~ 21

Author(s):

Kelsey Lucyk ◽

Lindsay McLaren

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Scoping Review ◽

Determinants Of Health ◽

The Social

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Transforming our relationship with the social determinants of health: a scoping review of social justice interventions in Canadian Medical Schools

MedEdPublish ◽

10.15694/mep.2020.000191.1 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Nisha Kansal ◽

Brittany Graham ◽

Michael Kruse ◽

Janice Lee ◽

Anvita Kulkarni ◽

...

Keyword(s):

Social Justice ◽

Social Determinants Of Health ◽

Social Determinants ◽

Scoping Review ◽

Medical Schools ◽

Determinants Of Health ◽

The Social

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

Canadian Medical Education Journal ◽

10.36834/cmej.61709 ◽

2019 ◽

Vol 10 (3) ◽

pp. e61-71

Author(s):

Kimberly Anne Hunter ◽

Ben Thomson

Keyword(s):

Medical Education ◽

Social Determinants Of Health ◽

Graduate Medical Education ◽

Social Determinants ◽

Scoping Review ◽

The United States ◽

Course Evaluation ◽

Determinants Of Health ◽

Post Graduate ◽

Graduate Medical

Social determinants of health are responsible for 50% of ill health. The Royal College of Physicians and Surgeons of Canada CanMEDS role of “physician advocate” requires physicians to attain competency in this particular domain, but physician trainees feel this is not well covered in their training programs. This study performed a scoping review of social determinants of health curricula that had been described, implemented and evaluated in post-graduate medical education. A search using MEDLINE(OvidSP) database, with search terms “residency,” ”curriculum,” and “social determinants” with no age, language, and publication date restrictions was done.Researchers identified a total of 12 studies, all from the United States, in internal medicine (n=4), pediatrics (n=4), family medicine (n=2), or multiple (n=2) residency programs. Most curricula (n=8, 67%), were longitudinal, and most contained both patient or community exposure (n=11, 92%) and/or classroom-based components (n=10, 83%). Most (78%) curricula improved participant related outcomes, including exam performance, awareness regarding personal practice, confidence, improved screening for social determinants of health and referral to support services. Program specific outcomes were frequently positive (50%) and included resident satisfaction and high course evaluation scores, high representation of resident and faculty from minority groups, applicability of training to underserviced populations, and improved engagement of marginalized community members. When evaluated, academic outcomes were always positive, and included acceptance of scholarly projects to national conferences, publication of research work, grants earned to support health projects, local or national awards for leadership and community engagement, and curriculum graduates later pursuing related Masters degrees and/or establishing medical practices in underserved areas. Only one study reported a patient-related outcome, with advice provided by health care providers considered by patients to be helpful. Researchers used these results to design recommendations for creation of a post-graduate curriculum to address social determinants of health were provided.

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Teaching the Social Determinants of Health Through Medical Legal Partnerships: A Systematic Review

10.21203/rs.3.rs-130181/v1 ◽

2021 ◽

Author(s):

Benjamin Robinson ◽

Kristian Welch ◽

Michaela Martin ◽

Amy Salerno ◽

Drew Harris

Keyword(s):

Systematic Review ◽

Medical Education ◽

Social Determinants Of Health ◽

Graduate Medical Education ◽

Social Determinants ◽

Determinants Of Health ◽

Systemic Review ◽

Graduate Medical ◽

The Social ◽

Future Practice

Abstract Background: Medical education is increasingly focused on the social determinants of health (SDoH), but questions remain regarding how best to ensure that trainees become empowered to take action on the SDoH in their future practice. The authors conducted a systematic review to better define the impact that educational programs centered on medical legal partnerships (MLP) have on trainees’ knowledge, attitudes and future practice. Methods: The authors sourced data from PubMed, Web of Science, Index to Legal Periodicals, LegalTrac, Google Scholar, Academic Search Complete, Business Source Complete, SocINDEX, SSRN, and Proquest Social Sciences. Selected studies included those centered on Medical Legal Partnerships in graduate medical education and that measured outcomes of the participating trainees. Two abstractors independently extracted information about the study population, setting, design, intervention and outcomes. The literature search was conducted in 2019. Results: Six out of 483 studies met the inclusion criteria. One study highlighted three different MLPs, thus eight total MLP programs were included. Trainees included residents from pediatrics, family medicine and internal medicine. Interventions ranged from didactic sessions, to advocacy projects, to hands-on community-based learning, to poverty simulation trainings. Benefits to trainees were wide in scope but all programs showed improvements in participants’ understanding, comfort, confidence, and/or abilities in identifying and intervening on SDoH in their patients. Conclusion: As undergraduate and graduate medical education is increasingly considering how to effectively teach trainees to understand and address SDoH, the findings in this systemic review suggest that inclusion of Medical-Legal Partnerships into training programs is an effective approach.

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“You Need ID to Get ID”: A Scoping Review of Personal Identification as a Barrier to and Facilitator of the Social Determinants of Health in North America

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124227 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4227

Author(s):

Chris Sanders ◽

Kristin Burnett ◽

Steven Lam ◽

Mehdia Hassan ◽

Kelly Skinner

Keyword(s):

North America ◽

Social Determinants Of Health ◽

Social Services ◽

Social Determinants ◽

Scoping Review ◽

Personal Identification ◽

Determinants Of Health ◽

Access To Health ◽

The Social

Personal identification (PID) is an important, if often overlooked, barrier to accessing the social determinants of health for many marginalized people in society. A scoping review was undertaken to explore the range of research addressing the role of PID in the social determinants of health in North America, barriers to acquiring and maintaining PID, and to identify gaps in the existing research. A systematic search of academic and gray literature was performed, and a thematic analysis of the included studies (n = 31) was conducted. The themes identified were: (1) gaining and retaining identification, (2) access to health and social services, and (3) facilitating identification programs. The findings suggest a paucity of research on PID services and the role of PID in the social determinants of health. We contend that research is urgently required to build a more robust understanding of existing PID service models, particularly in rural contexts, as well as on barriers to accessing and maintaining PID, especially among the most marginalized groups in society.

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