Social Determinants of Health Training in U.S. Primary Care Residency Programs: A Scoping Review

Lauren A. Gard, Jonna Peterson, Corrine Miller, Nilasha Ghosh, Quentin Riggins Youmans, Aashish Didwania, Stephen D. Persell, Muriel Jean-Jacques, Paul Ravenna, Matthew J. O'Brien, Mita Sanghavi Goel*

*Corresponding author for this work

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Purpose Medical training has traditionally focused on the proximate determinants of disease, with little focus on how social conditions influence health. The authors conducted a scoping review of existing curricula to understand the current programs designed to teach primary care residents about the social determinants of health (SDH). Method In January and March 2017, the authors searched seven databases. Eligible articles focused on primary care residents, described a curriculum related to SDH, were published between January 2007 and January 2017, and were based in the United States. Results Of the initial 5,523 articles identified, 43 met study eligibility criteria. Most programs (29; 67%) were in internal medicine. Sixteen studies (37%) described the curriculum development process. Overall, 20 programs (47%) were short or one-time sessions, and 15 (35%) were longitudinal programs lasting at least 6 months. Thirty-two programs (74%) reported teaching SDH content using didactics, 22 (51%) incorporated experiential learning, and many programs (n = 38; 88%) employed both. Most studies reported satisfaction and/or self-perceived changes in knowledge or attitudes. Conclusions The authors identified wide variation in curriculum development, implementation, and evaluation. They highlight curricula that considered community and resident needs, used conceptual frameworks or engaged multiple stakeholders to select content, used multiple delivery methods, and focused evaluation on changes in skills or behaviors. This review highlights the need not only for systematic, standardized approaches to developing and delivering SDH curricula but also for developing rigorous evaluation of the curricula, particularly effects on resident behavior.

Original languageEnglish (US)
Pages (from-to)135-143
Number of pages9
JournalAcademic Medicine
Volume94
Issue number1
DOIs
StatePublished - Jan 1 2019

ASJC Scopus subject areas

  • Education

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