Implementing a Social Determinants of Health Curriculum in Undergraduate Medical Education: A Qualitative Analysis of Faculty Experience.
| Autor: | Bann M; M. Bann is assistant professor, Department of Medicine, University of Washington, Seattle, Washington; ORCID: https://orcid.org/0000-0002-5893-950X ., Larimore S; S. Larimore is a postdoctoral research associate, Department of Sociology, and a postdoctoral affiliate, Center for the Study of Race, Ethnicity & Equity, Washington University in St. Louis, St. Louis, Missouri., Wheeler J; J. Wheeler is a program operations analyst, University of Washington School of Medicine, Seattle, Washington., Olsen LD; L.D. Olsen is assistant professor, Department of Sociology, College of Liberal Arts, Temple University, Philadelphia, Pennsylvania. |
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| Jazyk: | angličtina |
| Zdroj: | Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2022 Nov 01; Vol. 97 (11), pp. 1665-1672. Date of Electronic Publication: 2022 Jul 05. |
| DOI: | 10.1097/ACM.0000000000004804 |
| Abstrakt: | Purpose: Following shifts that broadened the medical profession's conceptualization of the underlying drivers of health, medical schools are required to integrate curricula on health disparities and the social context of medicine into undergraduate medical education. Although previous research has focused on student experiences and outcomes in these curricula, less attention has been paid to the experiences of the physician-faculty involved. This study aimed to capture faculty insights to improve understanding of the challenges and opportunities of implementing this curricular reform. Method: In-depth, semistructured interviews were conducted with 10 faculty members at one U.S. medical school in spring 2019 to capture their experiences designing and teaching a new curriculum related to the social determinants of health and health disparities. Study design, including interview guide development, was informed by the critical pedagogy perspective and social constructionist approaches to curriculum implementation. With the use of a constructivist grounded theory approach, interview transcripts were analyzed using open, thematic, and axial coding techniques. Primary themes were categorized as professional, organizational, interactional, or intrapersonal and organized into the final model. Results: Participants processed their experiences at 4 concentric levels: professional, organizational, interactional, and intrapersonal. Faculty generally embraced the movement to incorporate more discussion of social context as a driver of health outcomes. However, they struggled with the shortcomings of their training and navigating structural constraints within their school when developing and delivering content. When confronted with these limitations, faculty experienced unexpected tension in the classroom setting that catalyzed self-reflection and reconstruction of their teaching approach. Conclusions: Findings highlight the challenges that faculty encounter when integrating social determinants of health and related curricula into undergraduate medical education. They also speak to the need for a broader conceptualization of relevant expertise and have implications for how medical schools select, train, and support medical educators in this work. (Copyright © 2022 by the Association of American Medical Colleges.) |
| Databáze: | MEDLINE |
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