B.R. Taira is health sciences assistant professor of emergency medicine, Olive View-UCLA Medical Center and the UCLA David Geffen School of Medicine, Los Angeles, California, and director, Section of International and Domestic Health Equity and Leadership (IDHEAL), UCLA Department of Emergency Medicine, Sylmar, California; ORCID: https://orcid.org/0000-0002-2510-651X. D. Hsieh is health sciences assistant professor of emergency medicine, Harbor-UCLA Medical Center and UCLA David Geffen School of Medicine, Los Angeles, California, and director, Medical Legal Community Partnerships for Whole Person Care, Los Angeles County Department of Health Services, Torrance, California; ORCID: http://orcid.org/0000-0003-1531-8321.
Acad Med. 2019 Aug;94(8):1094-1098. doi: 10.1097/ACM.0000000000002668.
Calls for integrating the biosocial perspective into medical education are abundant. The core curricula of most of health professions education, however, have yet to fully integrate this concept. In this Invited Commentary, the authors describe barriers to implementation-the lack of a shared vocabulary, core curriculum, and clinical metrics-and propose a framework for implementing curricula in social medicine and structural competence. Advancing the biosocial perspective necessitates concerted efforts to link classroom training in social medicine to the clinical training environment by implementing tools to identify and address structural vulnerability in the clinical setting. Creating clinical metrics that value health outcomes instead of processes will enable educators to model clinical practice that integrates the social determinants of health as a core component. Finally, formalizing and emphasizing social medicine in graduate medical education will reinforce and solidify the importance of the biosocial perspective in the future clinical practice of our trainees.
呼吁将生物社会视角纳入医学教育的呼声不绝于耳。然而，大多数医疗保健专业教育的核心课程尚未充分融入这一概念。在这篇特邀评论中，作者描述了实施这一概念的障碍，即缺乏共享词汇、核心课程和临床指标，并提出了一个在社会医学和结构能力方面实施课程的框架。推进生物社会视角需要通过实施工具，将社会医学课堂培训与临床培训环境联系起来，以确定和解决临床环境中的结构性脆弱性，从而做出协调一致的努力。创建重视健康结果而非流程的临床指标，将使教育工作者能够为整合健康决定因素作为核心组成部分的临床实践树立榜样。最后，在研究生医学教育中使社会医学正式化和得到强调，将加强和巩固生物社会视角在未来学员临床实践中的重要性。
