Health Equity in Graduate Medical Education: Exploring Internal Medicine Residents' Perspectives on a Social Determinants of Health Curriculum

2020 ◽  
Vol 31 (4S) ◽  
pp. 154-162
Author(s):  
Mobola Campbell ◽  
Aashish Didwania
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Graduate Medical Education ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Health Curriculum ◽  
Graduate Medical ◽  
Internal Medicine Residents

scholarly journals A Faculty Development Graduate Medical Education Retreat to Teach and Address Social Determinants of Health

2020 ◽  
Vol 7 ◽  
pp. 238212052091549
Author(s):  
Johanna Martinez ◽  
Alice Fornari ◽  
Venice VanHuse ◽  
Ethan Fried ◽  
Omolara T Uwemedimo ◽  
...  
Keyword(s):  
Medical Education ◽  
Social Determinants Of Health ◽  
Graduate Medical Education ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Clinical Workflow ◽  
Graduate Medical ◽  
Positive Attitudes ◽  
Faculty Educators ◽  
Program Description

Background: Social determinants of health (SDH) account for a large percentage of health outcomes. Therefore, ensuring providers can address SDH is paramount yet curricula in this area is limited. Aim: The authors aimed to raise awareness, identify learning opportunities, foster positive attitudes, and equip educators to implement SDH curriculum. Setting and participants: This retreat occurred at a large academic institution and had over 130 participants who represented 56 distinct training programs and over 20 disciplines. Program description: The retreat was titled “Social Determinants of Health: Walking in Your Patients’ Shoes.” The retreat was holistic and used a multidimensional approach that included traditional learning, team-based learning, reflective practice, and prompted action. Program evaluation: The evaluation of this retreat included electronic surveys and both qualitative and quantitative data. The retreat’s quality and effectiveness at improving participants’ knowledge and skill in addressing SDH was highly rated and resulted in numerous programs, including surgical and subspecialty programs reporting adopting SDH curricular and clinical workflow changes. Discussion: The retreat was successful and reached a wide and diverse set of faculty educators and can serve as an education model to the graduate medical education community on how to start to develop “physician-citizens.”

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

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.

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

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.

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

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.

scholarly journals Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the wright center for graduate medical education teaching health center curriculum experience

2014 ◽  
Author(s):  
Linda Thomas-Hemak ◽  
Ghanshyam Palamaner Subash Shantha ◽  
Lakshmi Rani Gollamudi ◽  
Jignesh Sheth ◽  
Brian Ebersole ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Health Center ◽  
Graduate Medical Education ◽  
Medical Home ◽  
Statistical Significance ◽  
Patient Centered ◽  
Graduate Medical ◽  
Internal Medicine Residents ◽  
Curricular Innovations

Purpose: Effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes (KSA) in PCMH competency arenas is lacking in the literature. This study aimed to assess impact of PCMH curricular innovations on Internal Medicine residents’ self-reported KSA. Method: Twenty four (24) Internal Medicine residents - 12 Traditional (TR) track and 12 Teaching Health Center (THC) track - began training in academic year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013 covering three years of training. PCMH curricular innovations were applied beginning July 2011 until May 2012 focally to THC residents. These curricular innovations were spread program wide in May 2012. Semi-annual validated PCMH Clinician Assessments assessing PCMH competencies based on self-reported KSA were started in AY2011 and completed by all residents. Results: Mean self-reported KSA scores of TR residents were similar to THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than 2011 and graduating 2009 TR residents for most PCMH competencies. After program wide implementation of PCMH innovations, mean scores of 2011 and 2010 TR residents for all PCMH competencies improved and most equalized to those of 2011 THC residents. Globally improved PCMH competency scores of 2011 THC and TR residents were maintained through May 2014, with majority of improvements above baseline reaching statistical significance. Conclusions: PCMH curricular innovations inspired by HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved Internal Medicine residents’ self-reported KSA of PCMH competencies and improvements were sustained.

scholarly journals Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the wright center for graduate medical education teaching health center curriculum experience

2014 ◽  
Author(s):  
Linda Thomas-Hemak ◽  
Ghanshyam Palamaner Subash Shantha ◽  
Lakshmi Rani Gollamudi ◽  
Jignesh Sheth ◽  
Brian Ebersole ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Health Center ◽  
Graduate Medical Education ◽  
Medical Home ◽  
Statistical Significance ◽  
Patient Centered ◽  
Graduate Medical ◽  
Internal Medicine Residents ◽  
Curricular Innovations

Purpose: Effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes (KSA) in PCMH competency arenas is lacking in the literature. This study aimed to assess impact of PCMH curricular innovations on Internal Medicine residents’ self-reported KSA. Method: Twenty four (24) Internal Medicine residents - 12 Traditional (TR) track and 12 Teaching Health Center (THC) track - began training in academic year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013 covering three years of training. PCMH curricular innovations were applied beginning July 2011 until May 2012 focally to THC residents. These curricular innovations were spread program wide in May 2012. Semi-annual validated PCMH Clinician Assessments assessing PCMH competencies based on self-reported KSA were started in AY2011 and completed by all residents. Results: Mean self-reported KSA scores of TR residents were similar to THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than 2011 and graduating 2009 TR residents for most PCMH competencies. After program wide implementation of PCMH innovations, mean scores of 2011 and 2010 TR residents for all PCMH competencies improved and most equalized to those of 2011 THC residents. Globally improved PCMH competency scores of 2011 THC and TR residents were maintained through May 2014, with majority of improvements above baseline reaching statistical significance. Conclusions: PCMH curricular innovations inspired by HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved Internal Medicine residents’ self-reported KSA of PCMH competencies and improvements were sustained.

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