Martinez Iveris L, Ilangovan Kumar, Whisenant Ebony B, Pedoussaut Maryse, Lage Onelia G
Associate Professor of Medicine, Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine.
Director of Population Health and Aging, Leon Center on Geriatric Research and Education, Florida International University Herbert Wertheim College of Medicine.
MedEdPORTAL. 2016 Sep 28;12:10471. doi: 10.15766/mep_2374-8265.10471.
While breast cancer incidence rates have remained stable and mortality rates have declined for white women, breast cancer mortality has steadily increased for African American women since the 1950s. It has often been assumed that genetic risks linked to African ancestry are the cause for these disparities. However, a better understanding of the role of stress and social and environmental factors in health lends evidence to the social determinants behind the increasing gaps in breast health outcomes. This resource's goal is to raise awareness among undergraduate medical students about breast cancer disparities, particularly the late-stage diagnoses and the higher mortality rate for African American women.
Our educational session included a lecture on basic epidemiological data and information on breast cancer etiology followed by a case study, which was created with the founder of a local cancer support and resource center serving mainly African American women diagnosed with breast cancer. As part of the case exercise, we utilized concept mapping as a tool to apply learning.
Pre-/postquizzes showed significant improvements in knowledge and confidence in working with patients. Narrative reflections from students indicated an improvement in targeting at-risk populations, educating patients about their risk and options, and understanding the complex role that socioeconomic factors may play in patient outcomes.
By raising awareness and exposing medical students to the socioeconomic and cultural aspects of breast health, we hope to improve medical students' knowledge of risk factors and preventive strategies, as well as their abilities to guide patients through appropriate screening and follow-up.
虽然白人女性的乳腺癌发病率保持稳定，死亡率有所下降，但自20世纪50年代以来，非裔美国女性的乳腺癌死亡率却在稳步上升。人们常常认为，与非洲血统相关的遗传风险是造成这些差异的原因。然而，对压力以及社会和环境因素在健康中的作用有了更深入的了解后，就可以找到乳腺癌健康结果差距不断扩大背后的社会决定因素的证据。本资源的目标是提高本科医学生对乳腺癌差异的认识，特别是非裔美国女性的晚期诊断和较高的死亡率。
我们的教育课程包括一场关于基本流行病学数据和乳腺癌病因信息的讲座，随后是一个案例研究，该案例是与当地一个主要为被诊断患有乳腺癌的非裔美国女性提供癌症支持和资源的中心的创始人共同创建的。作为案例练习的一部分，我们利用概念图作为应用学习的工具。
课前/课后测验显示，在与患者合作的知识和信心方面有显著提高。学生的叙述性反思表明，在针对高危人群、教育患者了解其风险和选择以及理解社会经济因素在患者结果中可能发挥的复杂作用方面有所改进。
通过提高认识并让医学生了解乳腺癌健康的社会经济和文化方面，我们希望提高医学生对风险因素和预防策略的认识，以及他们指导患者进行适当筛查和后续治疗的能力。
