Tuskegee as a History Lesson, Tuskegee as Metaphor: Addressing Discrimination as a Social Determinant of Health in the Classroom

While basic science and social medicine are fundamental to the practice of medicine, the former is often prioritized in preclinical medical education at the expense of the latter. In this perspective, we discuss ways to introduce the concept of interpersonal, institutional, and structural discrimination as social determinants of health (SDOH) into a preclinical microbiology and infectious diseases medical course. We offer 5 specific steps to creating a comprehensive curriculum on discrimination as a social determinant of health: define and use standardized terminology; integrate the concept of SDOH throughout the course; encourage critical appraisal of lay and medical resources; encourage student feedback; and provide faculty development supported by key faculty stakeholders that focuses on increasing comfort and facility with teaching such concepts. This approach offers a template for ongoing discussion in the setting of curricular reform.

21st Century Problem-Based Learning

An account of 21st century problem-based learning (PBL) in preclinical medical education is provided through a detailed explanation of the overall process, a description of PBL case construction, and a brief consideration of related activities, including case wrap-up sessions and facilitator debriefing meetings. Composition of student PBL groups, the role of the faculty facilitator, and PBL decorum are also explored in this chapter. The implementation of PBL in a new medical school curriculum by rational design is compared to the introduction of PBL into an existing medical school curriculum by retrofit. Advantages and challenges of PBL are enumerated; a brief comparison of PBL with team-based learning (TBL) is also included.