Ruth Alissa, SturtzSreetharan Cindi, Brewis Alexandra, Wutich Amber
School of Human Evolution and Social Change, Arizona State University, PO Box 872402, Tempe, AZ 85287-2402 USA.
Med Sci Educ. 2020 Jan 14;30(1):331-337. doi: 10.1007/s40670-019-00909-9. eCollection 2020 Mar.
Scholars within the medical sciences recently have called on undergraduate educators to incorporate the social sciences in order to teach pre-health students structural competencies - or the ability to articulate how social structures produce racial, ethnic, gender, class, and other disparities - in order to better serve these populations medically. Authors used a semester-long course to assess how experiential learning focused on the topic of structural inequities improves structural competency. In Fall 2018, 27 students completed a hands-on, experiential, course focused on structural factors and health disparities. The authors conducted a mixed-methods, pre-/post-test design to solicit data on students' views on the reasons for high rates of obesity, gender pay disparities, and racial/ethnic housing segregation. Using systematic qualitative data analysis and statistical analysis of coded answers, the authors were able to detect pre-/post-test differences in the number of times students identified structural reasons for the disparities. Statistical analysis showed that students were able to identify an average of 4.63 structural reasons at pre-test, and that increased to 5.93 reasons at post-test (statically significant ( = 0.007)), indicating an increase in structural awareness after participation in the course. Qualitative analysis, using systematic methods of coding and a modified constant comparison method, demonstrated that students' ability to articulate structural reasons for inequality greatly improved. This experiential learning course, while relatively short, was found to increase students' ability to identify structural factors and articulate them with deeper understandings. Future curriculum development should consider incorporating experiential learning to promote structural competency, rather than a more traditional passive, content-delivery method of training.
医学领域的学者最近呼吁本科教育工作者将社会科学纳入教学，以便向未来的医科学生传授结构能力，即阐明社会结构如何产生种族、民族、性别、阶级和其他差异的能力，从而在医疗上更好地服务这些人群。作者通过一门为期一学期的课程来评估专注于结构不平等主题的体验式学习如何提高结构能力。2018年秋季，27名学生完成了一门专注于结构因素和健康差异的实践体验课程。作者采用混合方法、前后测试设计，以收集学生对肥胖率高、性别薪酬差距和种族/民族住房隔离原因的看法的数据。通过对编码答案进行系统的定性数据分析和统计分析，作者能够检测出学生在前后测试中识别差异结构原因的次数差异。统计分析表明，学生在测试前平均能够识别4.63个结构原因，测试后增加到5.93个原因（具有统计学显著性（=0.007）），这表明参加课程后学生的结构意识有所提高。定性分析采用系统的编码方法和改进的恒定比较方法，表明学生阐明不平等结构原因的能力有了很大提高。这门体验式学习课程虽然相对较短，但被发现提高了学生识别结构因素并更深入理解地阐明这些因素的能力。未来的课程开发应考虑纳入体验式学习以促进结构能力，而不是采用更传统的被动式内容传授培训方法。
