Teaching the Social Determinants of Health in Undergraduate Medical Education

a Scoping Review

Ashti Doobay-Persaud*, Mark D Adler, Tami R. Bartell, Natalie E. Sheneman, Mayra D. Martinez, Karen Ann Mangold, Patricia Smith, Karen M Sheehan

*Corresponding author for this work

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Background: To provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients’ well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance. Objective: This review’s objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME). Methods: In 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics. Results: The authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2). Conclusions: The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.

Original languageEnglish (US)
Pages (from-to)720-730
Number of pages11
JournalJournal of general internal medicine
Volume34
Issue number5
DOIs
StatePublished - May 15 2019

Fingerprint

Undergraduate Medical Education
Social Determinants of Health
Teaching
Medical Education
Students
Problem-Based Learning
Manuscripts
Program Evaluation
Bibliography
Vulnerable Populations
Medical Students
PubMed
Curriculum
Publications
Learning
Databases
Physicians

Keywords

  • health equity
  • scoping review
  • social determinants of health
  • undergraduate medical education

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{31575d28e6a54ac8a9227a7f42cab24a,
title = "Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review",
abstract = "Background: To provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients’ well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance. Objective: This review’s objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME). Methods: In 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics. Results: The authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2). Conclusions: The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.",
keywords = "health equity, scoping review, social determinants of health, undergraduate medical education",
author = "Ashti Doobay-Persaud and Adler, {Mark D} and Bartell, {Tami R.} and Sheneman, {Natalie E.} and Martinez, {Mayra D.} and Mangold, {Karen Ann} and Patricia Smith and Sheehan, {Karen M}",
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doi = "10.1007/s11606-019-04876-0",
language = "English (US)",
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pages = "720--730",
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issn = "0884-8734",
publisher = "Springer New York",
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Teaching the Social Determinants of Health in Undergraduate Medical Education : a Scoping Review. / Doobay-Persaud, Ashti; Adler, Mark D; Bartell, Tami R.; Sheneman, Natalie E.; Martinez, Mayra D.; Mangold, Karen Ann; Smith, Patricia; Sheehan, Karen M.

In: Journal of general internal medicine, Vol. 34, No. 5, 15.05.2019, p. 720-730.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Teaching the Social Determinants of Health in Undergraduate Medical Education

T2 - a Scoping Review

AU - Doobay-Persaud, Ashti

AU - Adler, Mark D

AU - Bartell, Tami R.

AU - Sheneman, Natalie E.

AU - Martinez, Mayra D.

AU - Mangold, Karen Ann

AU - Smith, Patricia

AU - Sheehan, Karen M

PY - 2019/5/15

Y1 - 2019/5/15

N2 - Background: To provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients’ well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance. Objective: This review’s objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME). Methods: In 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics. Results: The authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2). Conclusions: The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.

AB - Background: To provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients’ well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance. Objective: This review’s objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME). Methods: In 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics. Results: The authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2). Conclusions: The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.

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KW - social determinants of health

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