Assistant Professor, Department of Medicine, University of Missouri-Kansas City School of Medicine.
MedEdPORTAL. 2021 Jan 7;17:11060. doi: 10.15766/mep_2374-8265.11060.
Recognizing social determinants of health and addressing barriers to health care are an essential part of medical practice for which students' formal training is inadequate. The majority of medical students feel a professional responsibility to understand health policy, but their knowledge of health care legislation and health insurance is lacking, and their primary information sources are outside the medical education setting. This resource provides an easily implemented tool kit to begin to fill these educational gaps.
During their first inpatient medicine clerkship, fourth-year students in a 6-year BA/MD program participated in a classroom activity that included instruction on taking a comprehensive social history and a lecture regarding government insurance. Through an interactive case-based discussion, students developed a list of specific resources and then compiled information to share with their classmates.
Thirty-seven students participated in this learning activity during a brief pilot period. Comparison of preclass and postclass survey data showed that students increased their knowledge regarding insurance programs. Students also increased their self-perceived skills in identifying barriers and arranging resources for patients. The majority of students (94%) intended to apply these skills and knowledge during future clinical rotations.
This resource provides a tool for introductory, interactive learning about health insurance, social history taking, and addressing barriers to health care, and requires minimal resources. The amount of time devoted to the activity, references, and discussion topics can be customized to fit within a school's specific learning goals and overall curriculum on health disparities.
了解健康的社会决定因素并解决医疗保健障碍是医学实践的重要组成部分，但学生的正规培训对此有所不足。大多数医学生感到有责任了解健康政策，但他们对医疗保健法规和医疗保险的了解不足，其主要信息来源也不在医学教育环境内。本资源提供了一个易于实施的工具包，可用于开始填补这些教育空白。
在为期 6 年的学士/医学博士课程的第一年住院内科实习中，四年级医学生参加了一项课堂活动，其中包括全面社会史记录和政府保险讲座的教学。通过互动案例讨论，学生列出了一系列具体资源，然后汇总信息并与同学分享。
在一个简短的试点期间，有 37 名学生参加了这项学习活动。课前和课后调查数据的比较表明，学生对保险计划的了解有所增加。学生还提高了识别患者障碍和安排资源的自我感知技能。大多数学生（94%）打算在未来的临床轮转中应用这些技能和知识。
本资源提供了一个关于健康保险、社会病史采集和解决医疗保健障碍的入门、互动学习工具，所需资源极少。活动、参考资料和讨论主题的时间投入可以根据学校的具体学习目标和整体健康差异课程进行定制。
