King Jalysa, Taylor Jennifer
Department of Family Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Adv Med Educ Pract. 2023 Mar 15;14:237-244. doi: 10.2147/AMEP.S397211. eCollection 2023.
With the ever-growing diversity within our communities, it is imperative that we integrate social determinants of health (SDOH) such as racial disparity, economic instability, lack of transportation, intimate partner violence, and limited social supports, and the importance of health literacy into undergraduate medical education. By incorporating evidence-based curriculum on the disproportionality within healthcare faced by racial and ethnic minorities, we have the opportunity to develop more culturally sensitive providers. The purpose of this study was to assess the impact of a case-based debrief experience on medical students' knowledge about how social determinants of health can impact health and healthcare within a family medicine clinical setting and their intent to practice in an underserved community.
We utilized a retrospective paired-sample -test analysis of program data from 640 third-year medical students who engaged in a family medicine clerkship between July 2020, and April 2022. For inclusion in the study, students must have engaged in a case-based exercise and corresponding small group debrief around the impact of social determinants of health on patient care.
We found a statistically significant improvement in students' reported knowledge about SDOH, as well as the confidence and intent to work with and care for individuals of diverse cultural and socioeconomic backgrounds.
Medical students must have the knowledge and self-efficacy to understand how social determinants of health can impact health and healthcare within a family medicine clinical setting. As a result of integrating more active learning strategies such as the case-base and debrief experience, students may have a more robust medical education experience.
随着我们社区内的多样性不断增加，将健康的社会决定因素（如种族差异、经济不稳定、交通不便、亲密伴侣暴力和社会支持有限）以及健康素养的重要性纳入本科医学教育势在必行。通过纳入关于种族和少数族裔在医疗保健中面临的不均衡问题的循证课程，我们有机会培养出更具文化敏感性的医疗服务提供者。本研究的目的是评估基于案例的汇报经验对医学生关于健康的社会决定因素如何在家庭医学临床环境中影响健康和医疗保健的知识，以及他们在服务不足社区执业意愿的影响。
我们对2020年7月至2022年4月期间参加家庭医学实习的640名三年级医学生的项目数据进行了回顾性配对样本t检验分析。为纳入该研究，学生必须参与了一项基于案例的练习以及围绕健康的社会决定因素对患者护理影响的相应小组汇报。
我们发现学生报告的关于健康的社会决定因素的知识、与不同文化和社会经济背景的个体合作及护理的信心和意愿有统计学上的显著改善。
医学生必须具备知识和自我效能，以理解健康的社会决定因素如何在家庭医学临床环境中影响健康和医疗保健。通过整合更多积极的学习策略，如基于案例的练习和汇报经验，学生可能会有更丰富的医学教育经历。
