Social Determinants of Health Education Within Family Medicine Clerkships: A CERA Study.

Abstract

Social determinants of health (SDoH) education has gained popularity in undergraduate medical education; however, emphasis varies, and the curricula or assessment methods are not uniform. This study sought to examine the current SDoH teaching and assessment methods within family medicine clerkships and to identify characteristics associated with SDoH curriculum with multicomponent (two or more) teaching strategies and higher Kirkpatrick levels of assessment (Level 3-behavior change and Level 4-results). An online survey was conducted through the 2023 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors Survey. The survey response rate was 56.8% (96/169). The degree of SDoH emphasis in the medical school was positively associated with the number of teaching strategies (r=0.48; P<.001). We found a trend toward degree of SDoH emphasis being associated with higher Kirkpatrick levels of assessment (H[3]=7.83; P=.05). Having an SDoH faculty champion was associated with more teaching strategies (F[1,77]=8.73; P=.004), more types of assessments (F[1,78]=5.88; P=.018), and higher Kirkpatrick levels of assessment (H[1]=4.46; P=.035). Underrepresented in medicine clerkship director identity was not associated with the number of teaching strategies or higher Kirkpatrick levels of assessment. Greater degrees of SDoH emphasis and having a faculty champion were associated, or trended toward association, with multicomponent teaching strategies and higher Kirkpatrick levels of assessment, which prepare students to provide SDoH responsive care that could lead to reduction in health inequities.