Song Angela Y, Poythress Edward Lee, Bocchini Claire E, Kass Joseph S
Medical Student, Baylor College of Medicine.
Assistant Dean, Office of Student Affairs, Baylor College of Medicine.
MedEdPORTAL. 2018 Sep 18;14:10752. doi: 10.15766/mep_2374-8265.10752.
Medical students rarely learn about the intersection of socioeconomic and environmental effects on access to health care and maintenance of health. Case-based discussion can cohesively highlight the social determinants of health to complement preclinical education. Our modules can foster future interest in working with vulnerable populations, help students recognize barriers to care, and identify strategies to help these patients.
The Social Determinants of Health Orientation Program (SDHOP) introduced students to the nonbiomedical factors that contribute to patients' health. Key topics were presented in small discussion groups led by faculty facilitators. The subjects addressed included access to care; immigration/language barriers; lesbian, gay, bisexual, and transgender health; human trafficking; race/ethnicity; and women's health.
The SDHOP initiative was integrated into the formal curriculum and successfully implemented in its first year at our institution. Pre- and postsurveys were administered to assess student satisfaction with the course, as well as changes in knowledge and attitude regarding the topics covered. Of the 186 SDHOP participants, 111 medical students responded to both surveys and reported improvements in both knowledge of and comfort level with these topics and specific related terms. Ninety-one percent rated the overall quality of SDHOP and its individual modules as good or excellent.
SDHOP contributes to medical education by providing an all-inclusive model for teaching students about the social determinants of health. Our results suggest that presenting these topics in a small-group discussion model improves medical student cultural competency and comfort level with patients of diverse backgrounds.
医学生很少学习社会经济和环境因素对获得医疗保健及维持健康的影响。基于案例的讨论能够连贯地突出健康的社会决定因素，以补充临床前教育。我们的模块可以培养学生未来与弱势群体合作的兴趣，帮助学生认识到医疗保健的障碍，并确定帮助这些患者的策略。
健康决定因素导向计划（SDHOP）向学生介绍了影响患者健康的非生物医学因素。关键主题在由教员主持的小型讨论小组中进行讲解。涉及的主题包括获得医疗保健的机会；移民/语言障碍；女同性恋、男同性恋、双性恋和跨性别者的健康；人口贩卖；种族/族裔；以及妇女健康。
SDHOP计划被纳入正式课程，并在我校第一年成功实施。我们进行了课前和课后调查，以评估学生对该课程的满意度，以及他们在与所涵盖主题相关的知识和态度方面的变化。在186名参与SDHOP计划的学生中，111名医学生对两项调查都做出了回应，并报告称在这些主题以及特定相关术语的知识和熟悉程度方面都有所提高。91%的学生将SDHOP及其各个模块的整体质量评为良好或优秀。
SDHOP通过为教授学生健康的社会决定因素提供一个全面的模式，为医学教育做出了贡献。我们的结果表明，以小组讨论模式呈现这些主题可以提高医学生的文化能力以及与不同背景患者打交道时的自在程度。
