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

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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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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Teaching the social determinants of health through medical legal partnerships: a systematic review

BMC Medical Education ◽

10.1186/s12909-021-02729-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kristian Welch ◽

Benjamin Robinson ◽

Michaela Lieberman Martin ◽

Amy Salerno ◽

Drew Harris

Keyword(s):

Systematic Review ◽

Medical Education ◽

Social Determinants Of Health ◽

Graduate Medical Education ◽

Social Determinants ◽

Determinants Of Health ◽

Graduate Medical ◽

The Social ◽

The Impact ◽

Future Practice

Abstract Background Undergraduate and graduate medical education often includes the social determinants of health, but questions remain regarding how best to ensure that trainees become empowered to take action on the social determinants of health in their future practice. The authors conducted a systematic review to better define the impact that educational programs centered on medical legal partnerships have on trainees’ knowledge, attitudes and future practice. 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 undergraduate or 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. Results Six out of 483 studies met the inclusion criteria. One study highlighted four different MLPs, thus nine total MLP programs were included. Trainees included medical students as well as interns and 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 the social determinants of health in their patients. Conclusion As medical schools and residency programs are increasingly considering how to effectively teach trainees to understand and address the social determinants of health, the findings in this systematic review suggest that inclusion of Medical Legal Partnerships into training programs is an effective approach.

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Exploring civil society leadership to advance action on the social determinants of health

PsycEXTRA Dataset ◽

10.1037/e515722013-001 ◽

2008 ◽

Author(s):

Susan McCunn

Keyword(s):

Civil Society ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

The Social

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Uncovering the social determinants of health

PsycEXTRA Dataset ◽

10.1037/e673532010-001 ◽

2010 ◽

Author(s):

Lydia Buki

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

The Social

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Addressing the Social Determinants of Health

Southern California Quarterly ◽

10.1525/scq.2019.101.4.357 ◽

2019 ◽

Vol 101 (4) ◽

pp. 357-395 ◽

Cited By ~ 1

Author(s):

Saty Satya-Murti ◽

Jennifer Gutierrez

Keyword(s):

Twentieth Century ◽

Los Angeles ◽

Social Determinants Of Health ◽

Social Determinants ◽

Social Activism ◽

Determinants Of Health ◽

Medical Attention ◽

Community Center ◽

Early Twentieth Century ◽

The Social

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.

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