Hansen Helena, Metzl Jonathan M
H. Hansen is assistant professor of anthropology and assistant professor of psychiatry, New York University, New York, New York. J.M. Metzl is Frederick B. Rentschler II Professor of Sociology and Medicine, Health, and Society, and professor of psychiatry, Vanderbilt University, Nashville, Tennessee.
Acad Med. 2017 Mar;92(3):279-281. doi: 10.1097/ACM.0000000000001542.
Structural competency provides a language and theoretical framework to promote institutional-level interventions by clinical practitioners working with community organizations, non-health-sector institutions, and policy makers. The special collection of articles on structural competency in this issue of Academic Medicine addresses the need to move from theory to an appraisal of core educational interventions that operationalize the goals of and foster structural competency. In this Commentary, the authors review the role of clinical practitioners in enhancing population-level health outcomes through collaborations with professionals in fields outside medicine, including the social sciences and law. They describe the core elements of structural competency in preclinical and clinical education, as illustrated by the articles of this special collection: perceiving the structural causes of patients' disease, envisioning structural interventions, and cultivating alliances with non-health-sector agencies that can implement structural interventions. Finally, the authors argue that preparing trainees to form partnerships will empower them to influence the social determinants of their patients' health and reduce health inequalities.
结构胜任力提供了一种语言和理论框架，以促进临床从业者与社区组织、非卫生部门机构及政策制定者合作开展机构层面的干预措施。本期《学术医学》中关于结构胜任力的专题文章集满足了从理论转向对核心教育干预措施进行评估的需求，这些干预措施将结构胜任力的目标付诸实践并促进其发展。在这篇述评中，作者回顾了临床从业者通过与医学以外领域（包括社会科学和法律）的专业人员合作，在改善人群健康结果方面所发挥的作用。他们描述了临床前和临床教育中结构胜任力的核心要素，本专题文章集的文章对此进行了阐释：认识患者疾病的结构成因、设想结构干预措施，以及与能够实施结构干预措施的非卫生部门机构建立联盟。最后，作者认为让受训人员做好建立伙伴关系的准备，将使他们有能力影响患者健康的社会决定因素并减少健康不平等现象。
