Abstract
BackgroundDespite an abundant literature advocating that social determinants of health (SDH) be taught during undergraduate medical education, there are few detailed descriptions of how to design and implement longitudinal core curricula that is delivered to all students and accomplishes this goal.MethodsIn this paper, we describe the design and implementation of a social medicine curriculum at the University of Vermont’s Larner College of Medicine (UVM Larner). Using Kern’s principles, we designed a longitudinal curriculum that extends through both preclinical and clinical training for all students and focused on integrating SDH material directly into basic science and clinical training.ResultsWe successfully developed and implemented two primary tools, a “Social Medicine Theme of the Week” (SMTW) in preclinical training, and SDH rounds in the clinical setting to deliver SDH content to all learners at UVM Larner.ConclusionsExtensive student-faculty partnerships, robust needs assessment, and focusing on longitudinal and integrated SDH content delivery to all students were key features that contributed to successful design and implementation.
Highlights
Introduction to American healthcareRespect for patient autonomy: medical decision-making, surrogate decision-making and shared decisionmakingGI anatomy and physiology, gross anatomy lab Race and food Racism and foodEthical approaches to race and cultureReproductive system anatomy and physiology Owning bodiesAbortion and values clarificationAbortion, physician assisted death, euthanasia and approaching disagreements about topics in medicineToxicology, lead poisoningHousing and Case studies in environmental health (Flint, Decision support for wise resource waterMichigan, Dakota Access, climate change) allocation Anticoagulants
Goyal et al BMC Medical Education (2021) 21:131 of foundational science material considered necessary for medical training, diverse faculty opinions about the educational utility of teaching social determinants of health (SDH) topics, and stricter average evidentiary standards for incorporation of SDH material into the curriculum compared to what justified the inclusion of traditional foundational science material [18,19,20]
Building on prior publications describing creative means of incorporating SDH into undergraduate medical education [14, 21,22,23,24], and linked to relevant curriculum objectives required by the Liaison Committee on Medicine Education (LCME) such as “Societal Problems” and “Cultural Competence and Health Care Disparities” [25], we describe the design and implementation of a novel longitudinal core curriculum in social medicine at the University of Vermont’s University of Vermont Larner College of Medicine (Larner) College of Medicine (UVM Larner)
Summary
Introduction to American healthcareRespect for patient autonomy: medical decision-making, surrogate decision-making and shared decisionmakingGI anatomy and physiology, gross anatomy lab Race and food Racism and foodEthical approaches to race and cultureReproductive system anatomy and physiology Owning bodiesAbortion and values clarificationAbortion, physician assisted death, euthanasia and approaching disagreements about topics in medicineToxicology, lead poisoningHousing and Case studies in environmental health (Flint, Decision support for wise resource waterMichigan, Dakota Access, climate change) allocation Anticoagulants. Physician educators are motivated to implement SDH as a central feature of undergraduate medical education [6,7,8,9,10,11,12,13,14] This training has the potential to prepare future providers to notice the SDH, to gain tools to address them, and to reduce cognitive dissonance and “betrayals of purpose” [15] whereby SDH may exacerbate burnout through clinical productivity-driven incentives, helplessness about chronic health problems, and lack of insurance coverage [2, 16]. Building on prior publications describing creative means of incorporating SDH into undergraduate medical education [14, 21,22,23,24], and linked to relevant curriculum objectives required by the Liaison Committee on Medicine Education (LCME) such as “Societal Problems” and “Cultural Competence and Health Care Disparities” [25], we describe the design and implementation of a novel longitudinal core curriculum in social medicine at the University of Vermont’s Larner College of Medicine (UVM Larner)
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