Tang Tricia S, Fantone Joseph C, Bozynski Mary Ellen A, Adams Barbara S
Department of Medical Education, University of Michigan Medical School, Ann Arbor 48109, USA.
Acad Med. 2002 Jun;77(6):578-85. doi: 10.1097/00001888-200206000-00019.
To demonstrate an effective model for designing, implementing, and evaluating the Sociocultural Medicine Program (SMP), part of a comprehensive sociocultural medicine curriculum at the University of Michigan Medical School.
This study followed a cross-sectional, pre- and post-intervention survey design. A total of 167 medical students completed a measure of attitudes toward sociocultural issues in medicine prior to and following participation in the SMP. Students' attitudes were assessed in the domains of "exposure to sociocultural issues," "sociocultural factors in clinical scenarios," and "sociocultural background in patient/physician/health status issues."
Paired t-tests of the pre- and post-intervention responses revealed significant positive changes for items in the domain of exposure to sociocultural issues in medicine: experience with sociocultural issues in a clinical setting (p <.01), understanding of relationship among sociocultural background, health, and medicine (p <.001), and importance of sociocultural background in students' future patient populations (p <.01). Significant changes were also found for the impact of sociocultural background in patient/physician/health status issues: physician-patient relationship (p <.001) and patients' health behavior (p <.001).
The SMP had a significant educational impact on students' attitudes towards sociocultural issues in medicine. Students reported greater exposure to these issues conceptually and clinically, and greater influence of sociocultural factors in patients' behaviors and patient- physician relationships. Critical components of this SMP were faculty development, multiple teaching approaches, and pre- and post-intervention evaluation.
展示一种用于设计、实施和评估社会文化医学项目（SMP）的有效模式，该项目是密歇根大学医学院综合社会文化医学课程的一部分。
本研究采用横断面、干预前后调查设计。共有167名医学生在参与SMP之前和之后完成了一项关于对医学中社会文化问题态度的测量。在“接触社会文化问题”、“临床场景中的社会文化因素”以及“患者/医生/健康状况问题中的社会文化背景”等领域评估了学生的态度。
干预前后反应的配对t检验显示，在医学中接触社会文化问题领域的项目有显著的积极变化：在临床环境中接触社会文化问题的经历（p<.01）、对社会文化背景、健康和医学之间关系的理解（p<.001）以及社会文化背景在学生未来患者群体中的重要性（p<.01）。在患者/医生/健康状况问题中社会文化背景的影响方面也发现了显著变化：医患关系（p<.001）和患者的健康行为（p<.001）。
SMP对学生对医学中社会文化问题的态度有显著的教育影响。学生报告说在概念上和临床上更多地接触到这些问题，并且社会文化因素对患者行为和医患关系的影响更大。该SMP的关键组成部分是教师发展、多种教学方法以及干预前后评估。
