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Purpose: Despite advances in medical technology, health disparities persist and even worsen over time. The education of health care professionals is a contributing factor to this phenomenon. Though students are expected to understand the social and structural determinants of health (SDH) contributing to health disparities, like racism and classism, there is substantial uncertainty regarding standardization and best practices in teaching these concepts. To address this, medical schools have begun adopting social justice curricula (SJC), or courses of study that prioritize health equity as they teach students to recognize SDH and prepare them to address the consequent health disparities. This systematic review sought to evaluate how schools are integrating SJC, what criteria they use to measure success, and to what extent these criteria are being met. Method: Eligible studies reported on longitudinally integrated SJC at U.S. medical schools that comprise more than a single-day training and are intended for all students. Quantitative and qualitative outcomes were synthesized and summarized. Results: Searches of 7 databases identified 3,137 articles; 11 met inclusion criteria. Results demonstrated schools use a variety of teaching methods over a range of 7 to 600 didactic hours to teach SJC concepts. Surveys and objective tests suggest students in SJC are generally satisfied and demonstrate an improvement in knowledge and skills, though changes in attitudes had equivocal findings. Evaluations at graduation and in residency demonstrate students who experienced SJC are more prepared than their peers to work with underserved populations. Conclusions: Overall, these findings suggest SJC are a promising strategy to prepare students to address the root causes of health disparities. Best practices in implementing SJC include addressing the hidden curriculum, considering medical mistrust, and using trained faculty. Future research should consider the long-term influences of these curricula on students, patients, and the community. |
