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Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

  • Ashti Doobay-PersaudEmail author
  • Mark D. Adler
  • Tami R. Bartell
  • Natalie E. Sheneman
  • Mayra D. Martinez
  • Karen A. Mangold
  • Patricia Smith
  • Karen M. Sheehan
Article
  • 17 Downloads

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.

KEY WORDS

social determinants of health undergraduate medical education health equity scoping review 

Notes

Funding

This project is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under grant number UH1HP29963, Academic Units for Primary Care Training and Enhancement. This information or content and conclusions are those of the author and should not be construed as the official position or policy of nor should any endorsements be inferred by HRSA, HHS, or the US Government.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_4876_MOESM1_ESM.docx (13 kb)
ESM 1 (DOCX 12 kb)

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Ashti Doobay-Persaud
    • 1
    • 2
    Email author
  • Mark D. Adler
    • 3
    • 4
  • Tami R. Bartell
    • 5
  • Natalie E. Sheneman
    • 2
  • Mayra D. Martinez
    • 2
  • Karen A. Mangold
    • 3
    • 4
  • Patricia Smith
    • 6
  • Karen M. Sheehan
    • 3
  1. 1.Division of Hospital Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Center for Global HealthNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Medical EducationNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy CenterStanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  6. 6.Galter Health Sciences LibraryNorthwestern University Feinberg School of MedicineChicagoUSA

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