142nd APHA Annual Meeting and Exposition

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“Healthcare for the Underserved”: A student-designed preclinical elective at Alpert Medical School to address gaps in education about social determinants of health and foster interest in the care of vulnerable populations

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Julius Ho, BS , The Warren Alpert Medical School at Brown University, Providence, RI
Rian Yalamanchili, BA , The Warren Alpert Medical School at Brown University, Providence, RI
Emma Anselin, BA , The Warren Alpert Medical School at Brown University, Providence, RI
Joseph Rabatin, MD , Department of Internal Medicine, The Warren Alpert Medical School at Brown University, Providence, RI
BACKGROUND: There is a growing movement to train physicians in ‘structural competency,’ the ability to recognize and act on the social determinants of health disparities (SDOH). In medical school, discussion often focuses on unequal healthcare access, without attention to the underlying socioeconomic forces that place vulnerable groups at risk for negative health outcomes. Furthermore, students are not taught skills geared towards meeting the complex needs of underserved patients. To address these gaps, we designed a ten-session elective targeting first-year medical students. With approval from the curriculum committee, we implemented the course in Fall 2013. 

OBJECTIVES: Our goals were to: 1) broaden students’ understanding of underserved populations to include SDOH, and 2) foster interest in caring for underserved populations.

METHODS: This course explored five topics related to the intersection of health disparities and social inequality, such as childhood obesity and the built environment. We addressed each topic through case-based learning and skills workshops. Surveys prior to and after the course assessed its impact on students’ attitudes. Students also evaluated the content of each session.

RESULTS: Students (n=18) reported an increase in their understanding of the term “underserved” (pre=3.1, post=3.8; p<0.001; scale: 1-strongly disagree, 4-strongly agree) and desire for more opportunities to engage with underserved populations in medical school (pre=3.2, post=3.6; p=0.02). Students responded positively to the course format, especially the skills workshops.

CONCLUSION: This course provides a model for increasing understanding and interest in SDOH among medical students.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public
Public health or related education

Learning Objectives:
Describe a social determinants-driven model of health disparities education for future healthcare providers. Identify skills that are relevant to providing care for vulnerable populations in the clinical setting.

Keyword(s): Underserved Populations, Public Health Curricula & Competencies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: We the presenters are second-year medical students pursuing scholarly concentrations in Caring for the Underserved and Global Health. Through volunteer work and research, we have interacted with underserved populations in various community and clinic settings. We have also been involved with the design and implementation of the health disparities curriculum at Alpert Medical School.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4191.0: Social Justice & Public Health Student Poster Session