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对医学生进行健康社会决定因素方面的培训:普恩特斯·德·萨尔ud健康学者项目。

Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud.

作者信息

O'Brien Matthew J, Garland Joseph M, Murphy Katie M, Shuman Sarah J, Whitaker Robert C, Larson Steven C

机构信息

Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA ; Department of Medicine, Section of General Internal Medicine, Temple University of Medicine, Philadelphia, PA, USA ; Department of Public Health, Temple University, Philadelphia, PA, USA ; Puentes de Salud Health Center, Philadelphia, PA, USA.

Puentes de Salud Health Center, Philadelphia, PA, USA ; Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Adv Med Educ Pract. 2014 Sep 23;5:307-14. doi: 10.2147/AMEP.S67480. eCollection 2014.

Abstract

PURPOSE

Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist.

PARTICIPANTS AND METHODS

We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP), was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where students develop, implement, and evaluate an intervention to address a community-defined need.

RESULTS

In our quantitative evaluation, students reported high levels of agreement with the HSP meeting stated course goals, including developing an understanding of the social determinants of health and working effectively with peers to implement community-based projects. Qualitative assessments revealed students' perception of learning more about this topic in the HSP than in their formal medical training and of developing a long-term desire to serve vulnerable communities as a result.

CONCLUSION

Our experience with the HSP suggests that partnerships between academic medical centers and community-based organizations can create a feasible, effective, and sustainable platform for teaching medical students about the social determinants of health. Similar medical education programs in the future should seek to achieve a larger scale and to evaluate both students' educational experiences and community-defined outcomes.

摘要

目的

鉴于社会状况对健康有重大影响,如果医生接受培训以识别和解决影响健康的社会因素,他们可能会更有成效。尽管本科医学教育中对讲授健康的社会决定因素的兴趣日益增加,但相关模式却很少。

参与者与方法

我们为医学及其他健康专业学生开设了一门为期9个月的关于健康社会决定因素的试点课程,该课程以美国宾夕法尼亚州费城的普恩特斯·德·萨卢德社区健康中心为基地,该中心服务于拉丁裔移民群体。这一服务学习课程名为健康学者项目(HSP),由志愿医学和公共卫生教员与社区诊所合作开发并实施。HSP课程将理论教学与在普恩特斯·德·萨卢德的服务经历以及批判性反思机会相结合。HSP课程还包括一个纵向项目,学生在其中制定、实施并评估一项干预措施,以满足社区确定的需求。

结果

在我们的定量评估中,学生报告高度认同HSP达到了既定课程目标,包括对健康的社会决定因素形成理解以及与同龄人有效合作实施社区项目。定性评估显示,学生认为在HSP中学到的关于这个主题的知识比在正规医学培训中学到的更多,并且因此产生了长期为弱势群体服务的愿望。

结论

我们在HSP方面的经验表明,学术医疗中心与社区组织之间的合作可以为向医学生传授健康的社会决定因素创造一个可行、有效且可持续的平台。未来类似的医学教育项目应寻求扩大规模,并评估学生的教育经历和社区确定的成果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a61/4178477/d5afad248d07/amep-5-307Fig1.jpg

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