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Chang RS, Kloosterman N, Ukwuani S, Carpenter HL, Miller B. The Social Mission Committee: Establishing a Student-Based Organization to Advance Awareness of Socially Conscious Medicine. Acad Med 2021; 96:S179-S180. [PMID: 34705677 DOI: 10.1097/acm.0000000000004301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Rachel S Chang
- Author affiliations: R.S. Chang, N. Kloosterman, S. Ukwuani, H.L. Carpenter, B. Miller, Vanderbilt University School of Medicine
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Afolabi T, Borowsky HM, Cordero DM, Paul DW, Said JT, Sandoval RS, Davis D, Ölveczky D, Chatterjee A. Student-Led Efforts to Advance Anti-Racist Medical Education. Acad Med 2021; 96:802-807. [PMID: 33711839 DOI: 10.1097/acm.0000000000004043] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Over the past decade, medical schools across the United States have increasingly dedicated resources to advancing racial and social justice, such as by supporting diversity and inclusion efforts and by incorporating social medicine into the traditional medical curricula. While these changes are promising, the academic medicine community must apply an anti-racist lens to every aspect of medical education to equip trainees to recognize and address structural inequities. Notably, organizing and scholarly work led by medical students has been critical in advancing anti-racist curricula. In this article, the authors illustrate how student activism has reshaped medical education by highlighting examples of student-led efforts to advance anti-racist curricula at Harvard Medical School (HMS) and at the University of California, San Francisco (UCSF) School of Medicine. HMS students collaborated with faculty to address aspects of existing clinical practice that perpetuate racism, such as the racial correction factor in determining kidney function. They also responded to the existing curricula by noting missed opportunities to discuss structural racism, and they planned supplemental sessions to address these gaps. At UCSF, students identified specific avenues to improve the rigor of social medicine courses and developed new curricula to equip students with skills to confront and work to dismantle racism. The authors describe how HMS students, in an effort to improve the learning environment, developed a workshop to assist students in navigating microaggressions and discrimination in the clinical setting. At UCSF, students partnered with faculty and administration to advocate pass/fail grading for clerkships after university data revealed racial disparities in students' clerkship assessments. In reviewing these examples of students' advocacy to improve their own curricula and learning environments, the authors aim to provide support for students and faculty pursuing anti-racist curricular changes at their own institutions.
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Affiliation(s)
- Titilayo Afolabi
- T. Afolabi is a fourth-year student, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-1273-2183
| | - Hannah M Borowsky
- H.M. Borowsky is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0001-8779-7873
| | - Daniella M Cordero
- D.M. Cordero is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0003-4207-5708
| | - Dereck W Paul
- D.W. Paul Jr is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0001-6099-5933
| | - Jordan Taylor Said
- J.T. Said is a fourth-year student, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0002-0357-6916
| | - Raquel Sofia Sandoval
- R.S. Sandoval is a fourth-year student, Harvard Medical School and Harvard Kennedy School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-0770-4030
| | - Denise Davis
- D. Davis is a clinical professor of medicine, University of California, San Francisco, specialist for diversity, University of California, San Francisco, and vice president, Diversity, Equity, and Inclusion, Academy of Communication in Healthcare, San Francisco, California
| | - Daniele Ölveczky
- D. Ölveczky is a physician, Department of Medicine, Beth Israel Deaconess Medical Center (BIDMC), inclusion officer, Department of Medicine, BIDMC, and assistant professor, Department of Medicine, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-8972-4483
| | - Avik Chatterjee
- A. Chatterjee is a physician, Boston Health Care for the Homeless Program, assistant professor, Boston University School of Medicine and Boston Medical Center, part-time lecturer, Harvard Medical School, associate epidemiologist, Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, and faculty supervisor, the Racial Justice Coalition, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-8437-6774
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Amutah C, Greenidge K, Mante A, Munyikwa M, Surya SL, Higginbotham E, Jones DS, Lavizzo-Mourey R, Roberts D, Tsai J, Aysola J. Misrepresenting Race - The Role of Medical Schools in Propagating Physician Bias. N Engl J Med 2021; 384:872-878. [PMID: 33406326 DOI: 10.1056/nejmms2025768] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Amutah
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Kaliya Greenidge
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Adjoa Mante
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Michelle Munyikwa
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Sanjna L Surya
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Eve Higginbotham
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - David S Jones
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Risa Lavizzo-Mourey
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Dorothy Roberts
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Jennifer Tsai
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
| | - Jaya Aysola
- From the Perelman School of Medicine (C.A., A.M., M.M., S.L.S., E.H., R.L.-M., J.A.), School of Arts and Sciences (K.G., D.R.), the Penn Medicine Center for Health Equity Advancement (K.G., J.A.), the Leonard Davis Institute of Health Economics (E.H., R.L.-M., J.A.), Carey Law School (D.R.), and the Penn Program on Race, Science, and Society (D.R.), University of Pennsylvania, Philadelphia; Harvard Medical School, Boston (D.S.J.); the Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (J.T.); and the Warren Alpert Medical School of Brown University, Providence, RI (J.T.)
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Manca A, Gormley GJ, Johnston JL, Hart ND. Honoring Medicine's Social Contract: A Scoping Review of Critical Consciousness in Medical Education. Acad Med 2020; 95:958-967. [PMID: 31688036 DOI: 10.1097/acm.0000000000003059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE To explore how the construct of critical consciousness has been conceptualized within the medical education literature and identify the main elements of critical consciousness in medical education so as to inform educational strategies to foster socially conscious physicians. METHOD In March 2019, the authors conducted a literature search of 4 databases and Google Scholar, seeking articles discussing critical consciousness in medical education published any time after 1970. Three of the authors screened articles for eligibility. Two transcribed data using a data extraction form and identified preliminary emerging themes, which were then discussed by the whole research team to ensure agreement. RESULTS Of the initial 317 articles identified, 20 met study inclusion criteria. The publication of academic articles around critical consciousness in medical education has expanded substantially since 2017. Critical consciousness has been conceptualized in the medical education literature through 4 overlapping themes: (1) social awareness, (2) cultural awareness, (3) political awareness, and (4) awareness of educational dynamics. CONCLUSIONS Critical consciousness has been conceptualized in medical education as an intellectual construct to foster a reflexive awareness of professional power in health care, to unearth the values and biases legitimizing medicine as currently practiced, and to foster transformation and social accountability. Scholars highlighted its potential to improve sociocultural responsibility and to foster compassion in doctors. Adopting a critical pedagogy approach in medical education can help uphold its social accountability through an intrinsic orientation to action, but any enterprise working toward embedding critical pedagogy within curricula must acknowledge and challenge the current structure and culture of medical education itself.
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Affiliation(s)
- Annalisa Manca
- A. Manca is a PhD candidate in medical education, Centre for Medical Education, Queen's University Belfast, Belfast, Northern Ireland; ORCID: http://orcid.org/0000-0001-5494-4267. G.J. Gormley is clinical professor of education, Centre for Medical Education, Queen's University Belfast, Belfast, Northern Ireland; ORCID: https://orcid.org/0000-0002-1701-7920. J.L. Johnston is clinical senior lecturer in education, Centre for Medical Education, Queen's University Belfast, Belfast, Northern Ireland; ORCID: https://orcid.org/0000-0002-3999-8774. N.D. Hart is clinical senior lecturer in education, Centre for Medical Education, Queen's University Belfast, Belfast, Northern Ireland; ORCID: https://orcid.org/0000-0002-8168-1746
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Holmes SM, Hansen H, Jenks A, Stonington SD, Morse M, Greene JA, Wailoo KA, Marmot MG, Farmer PE. Misdiagnosis, Mistreatment, and Harm - When Medical Care Ignores Social Forces. N Engl J Med 2020; 382:1083-1086. [PMID: 32187466 DOI: 10.1056/nejmp1916269] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Seth M Holmes
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Helena Hansen
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Angela Jenks
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Scott D Stonington
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Michelle Morse
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Jeremy A Greene
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Keith A Wailoo
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Michael G Marmot
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
| | - Paul E Farmer
- From the University of California Berkeley, Berkeley, and the University of California San Francisco, San Francisco (S.M.H.); New York University, New York (H.H.); the University of California Irvine, Irvine (A.J.); the University of Michigan, Ann Arbor (S.D.S.); Brigham and Women's Hospital and Harvard Medical School - both in Boston (M.M., P.E.F.); Johns Hopkins University, Baltimore (J.A.G.); Princeton University, Princeton, NJ (K.A.W.); and University College London, London (M.G.M.)
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Boroumand S, Stein MJ, Jay M, Shen JW, Hirsh M, Dharamsi S. Addressing the health advocate role in medical education. BMC Med Educ 2020; 20:28. [PMID: 32000759 PMCID: PMC6993364 DOI: 10.1186/s12909-020-1938-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/16/2020] [Indexed: 05/24/2023]
Abstract
The health advocate role is an essential and underappreciated component of the CanMEDs competency framework. It is tied to the concept of social accountability and its application to medical schools for preparing future physicians who will work to ensure an equitable healthcare system. Student involvement in health advocacy throughout medical school can inspire a long-term commitment to address health disparities. The Social Medicine Network (SMN) provides an online platform for medical trainees to seek opportunities to address health disparities, with the goal of bridging the gap between the social determinants of health and clinical medicine. This online platform provides a list of health advocacy related opportunities for addressing issues that impede health equity, whether through research, community engagement, or clinical care.First implemented at the University of British Columbia, the SMN has since expanded to other medical schools across Canada. At the University of Ottawa, the SMN is being used to augment didactic teachings of health advocacy and social accountability. This article reports on the development and application of the SMN as a resource for medical trainees seeking meaningful and actionable opportunities to enact their role as health advocates.
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Affiliation(s)
| | - Michael J Stein
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Mohammad Jay
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Julia W Shen
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael Hirsh
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shafik Dharamsi
- College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
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Taira BR, Hsieh D. Advancing the Biosocial Perspective in the Clinical Training Environment: Surmounting the Barriers and Constructing the Framework. Acad Med 2019; 94:1094-1098. [PMID: 30801271 DOI: 10.1097/acm.0000000000002668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Calls for integrating the biosocial perspective into medical education are abundant. The core curricula of most of health professions education, however, have yet to fully integrate this concept. In this Invited Commentary, the authors describe barriers to implementation-the lack of a shared vocabulary, core curriculum, and clinical metrics-and propose a framework for implementing curricula in social medicine and structural competence. Advancing the biosocial perspective necessitates concerted efforts to link classroom training in social medicine to the clinical training environment by implementing tools to identify and address structural vulnerability in the clinical setting. Creating clinical metrics that value health outcomes instead of processes will enable educators to model clinical practice that integrates the social determinants of health as a core component. Finally, formalizing and emphasizing social medicine in graduate medical education will reinforce and solidify the importance of the biosocial perspective in the future clinical practice of our trainees.
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Affiliation(s)
- Breena R Taira
- B.R. Taira is health sciences assistant professor of emergency medicine, Olive View-UCLA Medical Center and the UCLA David Geffen School of Medicine, Los Angeles, California, and director, Section of International and Domestic Health Equity and Leadership (IDHEAL), UCLA Department of Emergency Medicine, Sylmar, California; ORCID: https://orcid.org/0000-0002-2510-651X. D. Hsieh is health sciences assistant professor of emergency medicine, Harbor-UCLA Medical Center and UCLA David Geffen School of Medicine, Los Angeles, California, and director, Medical Legal Community Partnerships for Whole Person Care, Los Angeles County Department of Health Services, Torrance, California; ORCID: http://orcid.org/0000-0003-1531-8321
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Stonington SD, Holmes SM, Hansen H, Greene JA, Wailoo KA, Malina D, Morrissey S, Farmer PE, Marmot MG. Case Studies in Social Medicine - Attending to Structural Forces in Clinical Practice. N Engl J Med 2018; 379:1958-1961. [PMID: 30428284 DOI: 10.1056/nejmms1814262] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Scott D Stonington
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Seth M Holmes
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Helena Hansen
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Jeremy A Greene
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Keith A Wailoo
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Debra Malina
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Stephen Morrissey
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Paul E Farmer
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
| | - Michael G Marmot
- From the Departments of Anthropology and Internal Medicine, University of Michigan, Ann Arbor (S.D.S.); the Division of Society and Environment, Joint Program in Medical Anthropology, Berkeley Center for Social Medicine, University of California Berkeley, Berkeley, and the Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco (S.M.H.); the Departments of Psychiatry and Anthropology, New York University, New York (H.H.); the Departments of Medicine and History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.); the Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (K.A.W.); the Department of Global Health and Social Medicine, Harvard Medical School, and the Division of Global Health Equity, Brigham and Women's Hospital - both in Boston (P.E.F.); the Commission on Social Determinants of Health, World Health Organization, Geneva (M.G.M.); and University College London, London (M.G.M.)
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Halldin J, Ågren G, Svanström L, Åberg J. [Reintroduce clinical social medicine]. Lakartidningen 2017; 114:EMEW. [PMID: 28463385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Basu G, Pels RJ, Stark RL, Jain P, Bor DH, McCormick D. Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum. Acad Med 2017; 92:515-520. [PMID: 28145945 DOI: 10.1097/acm.0000000000001580] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PROBLEM Health disparities are pervasive worldwide. Physicians have a unique vantage point from which they can observe the ways social, economic, and political factors impact health outcomes and can be effective advocates for enhanced health outcomes and health equity. However, social medicine and health advocacy curricula are uncommon in postgraduate medical education. APPROACH In academic year (AY) 2012, the Cambridge Health Alliance internal medicine residency program transformed an elective into a required social medicine and research-based health advocacy curriculum. The course has three major innovations: it has a yearlong longitudinal curriculum, it is required for all residents, and all residents complete a group research-based health advocacy project within the curricular year. The authors describe the structure, content, and goals of this curriculum. OUTCOMES Over the last four years (AYs 2012-2015), residents (17/32; 53%) have rated the overall quality of the course highly (mean = 5.2, where 6 = outstanding; standard deviation = 0.64). In each year since the new course has been implemented, all scholarly work from the course has been presented at conferences by 31 resident presenters and/or coauthors. The course seems to enhance the residency program's capacity to recruit high-caliber residents and faculty members. NEXT STEPS The authors are collecting qualitative and quantitative data on the impact of the course. They will use their findings to advocate for a national health advocacy competency framework. Recommendations about how to initiate or further develop social medicine and health advocacy curricula are offered.
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Affiliation(s)
- Gaurab Basu
- G. Basu is instructor in medicine, Harvard Medical School, and course director, Social Medicine and Health Advocacy Curriculum, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. R.J. Pels is assistant professor of medicine, Harvard Medical School, and residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. R.L. Stark is instructor in medicine, Harvard Medical School, and associate residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. P. Jain is instructor in medicine, Harvard Medical School, and associate residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. D.H. Bor is Charles S. Davidson Associate Professor of Medicine, Harvard Medical School, and chief academic officer, Cambridge Health Alliance, Cambridge, Massachusetts. D. McCormick is associate professor of medicine, Harvard Medical School, and course director, Social Medicine and Health Advocacy Curriculum, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
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Axelson Fisk S. [The forgotten (?) social medicine]. Lakartidningen 2016; 113:D64H. [PMID: 27505850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Kasper J, Greene JA, Farmer PE, Jones DS. All Health Is Global Health, All Medicine Is Social Medicine: Integrating the Social Sciences Into the Preclinical Curriculum. Acad Med 2016; 91:628-32. [PMID: 26703416 DOI: 10.1097/acm.0000000000001054] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
As physicians work to achieve optimal health outcomes for their patients, they often struggle to address the issues that arise outside the clinic. Social, economic, and political factors influence patients' burden of disease, access to treatment, and health outcomes. This challenge has motivated recent calls for increased attention to the social determinants of health. At the same time, advocates have called for increased attention to global health. Each year, more U.S. medical students participate in global health experiences. Yet, the global health training that is available varies widely. The discipline of social medicine, which attends to the social determinants of disease, social meanings of disease, and social responses to disease, offers a solution to both challenges. The analyses and techniques of social medicine provide an invaluable toolkit for providing health care in the United States and abroad.In 2007, Harvard Medical School implemented a new course, required for all first-year students, that teaches social medicine in a way that integrates global health. In this article, the authors argue for the importance of including social medicine and global health in the preclinical curriculum; describe Harvard Medical School's innovative, integrated approach to teaching these disciplines, which can be used at other medical schools; and explore the barriers that educators may face in implementing such a curriculum, including resistance from students. Such a course can equip medical students with the knowledge and tools that they will need to address complex health problems in the United States and abroad.
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Affiliation(s)
- Jennifer Kasper
- J. Kasper is assistant professor and chair, Faculty Advisory Committee on Global Health, Harvard Medical School, and faculty member, Division of Global Health, Massachusetts General Hospital for Children, Boston, Massachusetts. J.A. Greene is associate professor of medicine and of the history of medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. P.E. Farmer is Kolokotrones University Professor of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts. D.S. Jones is A. Bernard Ackerman Professor of the Culture of Medicine, Faculty of Medicine, Harvard Medical School, Boston, Massachusetts, and Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts
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Vanderbilt AA, Baugh RF, Hogue PA, Brennan JA, Ali II. Curricular integration of social medicine: a prospective for medical educators. Med Educ Online 2016; 21:30586. [PMID: 26782722 PMCID: PMC4716551 DOI: 10.3402/meo.v21.30586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/22/2015] [Indexed: 05/05/2023]
Abstract
In the United States, the health of a community falls on a continuum ranging from healthy to unhealthy and fluctuates based on several variables. Research policy and public health practice literature report substantial disparities in life expectancy, morbidity, risk factors, and quality of life, as well as persistence of these disparities among segments of the population. One such way to close this gap is to streamline medical education to better prepare our future physicians for our patients in underserved communities. Medical schools have the potential to close the gap when training future physicians by providing them with the principles of social medicine that can contribute to the reduction of health disparities. Curriculum reform and systematic formative assessment and evaluative measures can be developed to match social medicine and health disparities curricula for individual medical schools, thus assuring that future physicians are being properly prepared for residency and the workforce to decrease health inequities in the United States. We propose that curriculum reform includes an ongoing social medicine component for medical students. Continued exposure, practice, and education related to social medicine across medical school will enhance the awareness and knowledge for our students. This will result in better preparation for the zero mile stone residency set forth by the Accreditation Council of Graduate Medical Education and will eventually lead to the outcome of higher quality physicians in the United States to treat diverse populations.
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Affiliation(s)
- Allison A Vanderbilt
- Department of Family Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA;
| | - Reginald F Baugh
- Department of Surgery, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Patricia A Hogue
- Department of Physician Assistant Studies, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Julie A Brennan
- Family Medicine and Division, Adult Psychiatry, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Imran I Ali
- Department of Neurology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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Abstract
INTRODUCTION Medical education based on the principles of social medicine can contribute toward reducing health disparities through the "creation" of doctors who are more involved in community programs. PURPOSE This study compared the social medicine orientation of graduates from various medical schools in Israel. METHODS The authors conducted an online cross-sectional survey in May 2011 among physicians who are graduates of Israeli medical schools. RESULTS The study included 1050 physicians practicing medicine in Israel: 36% who are graduates from the Hebrew University, 26% from Tel Aviv University, 22% from the Technion and 16% from Ben-Gurion University. A greater percentage of physicians who studied either at the Technion or Ben-Gurion are working or have worked in the periphery (∼50% vs. ∼30% at the Hebrew and Tel Aviv Universities). Among Ben-Gurion graduates, 47% are active in social medicine programs vs. 34-38% from other schools. Among physicians active in social medicine programs, 32% of Ben-Gurion alumni estimated that their medical education greatly influenced their social medicine involvement vs. 8-15% from other schools. Hebrew University alumni described their studies as more research-oriented. In contrast, Ben-Gurion graduates described their studies as more social medicine-oriented and they exhibited more positive attitudes about the role of physicians in reducing health disparities. DISCUSSION Social medicine-oriented medical education induces a socialization process reinforcing human values regarding doctor-patient relationships and produces positive attitudes among future doctors about social involvement. Findings emphasize the need to develop educational programs with this orientation and to strengthen medical schools in the periphery.
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Kutzner M. [Continuing education in insurance medicine - a responsibility for reinsurers]. Versicherungsmedizin 2012; 64:113-114. [PMID: 22997670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Ostendorf GM. [Social medicine expert assessment of occupational work capacity]. Versicherungsmedizin 2012; 64:90. [PMID: 22808651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Fornari A, Anderson M, Simon S, Korin E, Swiderski D, Strelnick AH. Learning social medicine in the Bronx: an orientation for primary care residents. Teach Learn Med 2011; 23:85-89. [PMID: 21240789 DOI: 10.1080/10401334.2011.536898] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Primary care educators face the challenge of teaching the social context of health and disease to clinicians. DESCRIPTION Since 1975, the Residency Program in Social Medicine has trained clinicians to practice in urban underserved communities. During Orientation Month, 1st-year residents are relieved of inpatient duties and participate in learning activities addressing social and cultural aspects of health. Learning objectives include understanding patients' social context, their community, and the role of physicians as professionals. Recent innovations include incorporating an overall theme, weekly case studies, "triple jump" exercises, community mapping projects, patient-led community tours, and theme-specific visits to community institutions (e.g., prisons). EVALUATION Residents complete weekly formative evaluations, a summative evaluation, and narrative reflections. Faculty complete an evaluative questionnaire. CONCLUSIONS Orientation is a highly rated and valued part of our curriculum. Its success derives from ongoing curricular innovation and evolution, a departmental commitment to social medicine, and positive community response to our learners' interest and energy.
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Affiliation(s)
- Alice Fornari
- Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York 10467, USA
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Michael YL, Gregg J, Amann T, Solotaroff R, Sve C, Bowen JL. Evaluation of a community-based, service-oriented social medicine residency curriculum. Prog Community Health Partnersh 2011; 5:433-442. [PMID: 22616211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Educators can create opportunities for physicians-in-training to learn about the health care needs of the underserved and expose learners to models of care and opportunities for service. OBJECTIVES We evaluated a community-based, service-oriented Social Medicine curriculum for Internal Medicine interns and residents initiated in 2007. METHODS Qualitative data were collected through focus groups. CONCLUSIONS Potent community-based experiential learning with adequate time and encouragement to hear clients' stories allowed residents to gain an understanding of some of the complex factors that contribute to ill health in this population and seemed to influence residents' confidence in their skills in working with an undeserved population, particularly a population struggling with addiction. However, the curriculum did not provide adequate time for facilitated, personal reflection. These data will assist community health partnerships in developing their own curricula to address health needs of the underserved.
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Affiliation(s)
- Yvonne L Michael
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, USA
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21
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Juresa V, Musil V, Sosić Z, Majer M, Pavleković G. [Community health course--student's evaluation]. Acta Med Croatica 2010; 64:397-404. [PMID: 21692264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. AIM The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. SUBJECTS AND METHODS The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. RESULTS The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar, 63% with field research, and 49% with water sampling. DISCUSSION At some medical schools, there are similar attempts to bring students more closely to life conditions, especially to rural communities. Different schools of medicine in the world have attempted to improve and adapt current curricula towards community-oriented education of medical students during undergraduate study and residency. In some countries, there is also the need of improvement of health care in rural areas. CONCLUSION Results of the course evaluation showed that students had recognized the exceptional value of community health course as a whole. They perceived it as the most valuable and most useful experience in their medical study. By participating in local health care and social care activities in rural area, they got an insight into both the health care system and socio-medical determinants of health.
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Affiliation(s)
- Vesna Juresa
- Department of Social Medicine and Organization of Health Care, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
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Strassburg HM. [Possibilities and limits of social pediatrics in Germany]. Kinderkrankenschwester 2010; 29:94-98. [PMID: 20364653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- H M Strassburg
- Universitäts-Kinderklinik, SPZ Frühdiagnosezentrum, Würzburg.
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Westerling R, Burström B, Kristenson M. [Secure the competence in social medicine!]. Lakartidningen 2009; 106:1948-1949. [PMID: 19764370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Strelnick AH, Swiderski D, Fornari A, Gorski V, Korin E, Ozuah P, Townsend JM, Selwyn PA. The residency program in social medicine of Montefiore Medical Center: 37 years of mission-driven, interdisciplinary training in primary care, population health, and social medicine. Acad Med 2008; 83:378-389. [PMID: 18367900 DOI: 10.1097/acm.0b013e31816684a4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received Title VII grants during most of its history. The RPSM has tailored its mission and structured its curriculum to promote a community and population orientation and to provide the requisite knowledge and skills for integrating social medicine into clinical practice. Six unique hallmarks of RPSM training are (1) mission-oriented resident recruitment/selection and self-management, (2) interdisciplinary collaborative training among primary care professionals, (3) community-health-center-based and community-oriented primary care education, (4) biopsychosocial and ecological family systems curriculum, (5) the social medicine core curriculum and projects, and (6) grant support through Title VII. These hallmark curricular, training, and funding elements, in which population health is deeply embedded, have been carefully evaluated, regularly revised, and empirically validated since the program's inception. Practice outcomes for RPSM graduates as leaders in and advocates for population health and the care of underserved communities are described and discussed in this case study.
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Affiliation(s)
- A H Strelnick
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
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Doran KM, Kirley K, Barnosky AR, Williams JC, Cheng JE. Developing a novel Poverty in Healthcare curriculum for medical students at the University of Michigan Medical School. Acad Med 2008; 83:5-13. [PMID: 18162743 DOI: 10.1097/acm.0b013e31815c6791] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Nearly 90 million Americans live below 200% of the federal poverty threshold. The links between lower socioeconomic status and poor health are clear, and all physicians face the resulting challenges in patient care. Current medical school curricula do not adequately prepare students to address this issue despite recommendations from the Association of American Medical Colleges and the Institute of Medicine. In response, students and faculty at the University of Michigan Medical Center established the Poverty in Healthcare curriculum, which encompasses required learning experiences spanning all four years of undergraduate medical education. This article describes the design and implementation of this curriculum. The authors provide thorough descriptions of the individual learning experiences, including community site visits, longitudinal cases, mini-electives, and family centered experiences. The authors also discuss the history, costs, challenges, and evaluation process related to the Poverty in Healthcare curriculum, including issues specifically related to medical students' involvement in developing and implementing the curriculum. This information may be used as a guide for other medical schools in the development of curricula to address this current gap in medical student education.
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Affiliation(s)
- Kelly M Doran
- New York University/Bellevue Hospital Center, New York, New York, USA
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Nechaeva GI, Temnikova EA, Solodnikova LD. [On medical and social work in the complex treatment of senile age patients with chronic heart insufficiency]. Adv Gerontol 2008; 21:148-152. [PMID: 18546840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The section of medical-social work was entered for the first time into National Recommendations VNOC and OSSN on diagnostics and treatment of chronic heart failure, the second revision. The social help is especially important for persons of senile age and long-livers. It is expedient to study to what extent the employees of social service are ready to participate in the complex observation and treatment of these patients. Interrogation of 274 workers of the complex centers for in-home social service has been worked out. The level of knowledge on matters of conducting persons of senile age with chronic heart failure proved to be low. Majority respondents have not shown any readiness to join medical-social programs carried out by public health institutions.
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Abstract
Despite the increasing attention paid to the role of social forces in determining health, most physicians finish their training ill-prepared to address these issues. The authors describe their efforts to fill that training gap for internal medicine residents at Oregon Health and Science University through a community-based social medicine curriculum, designed in 2006 in conjunction with community partners at Central City Concern (CCC), an organization addressing homelessness, poverty, and addiction in downtown Portland, Oregon. The challenge was to develop a curriculum that would (1) fit within the scheduling constraints of an established categorical internal medicine residency program, (2) give all internal medicine residents a chance to better understand how social forces affect health, and (3) help show how they, as health professionals, might intervene to improve health and health care. The authors maintain that by developing this curriculum with community partners--who took the lead in deciding what residents should learn about their community and how they should learn it--the residency program is providing a relatively brief but extremely rich opportunity for residents to engage the personal, social, and health-related issues experienced by clients served by CCC. The authors first provide a brief overview of the curriculum and describe how the principles and practices of community-based participatory research were used in its development. They then discuss the challenges involved in teaching medical residents about social determinants of health, how their academic-community partnership approaches those challenges, and the recently established methods of evaluating the curriculum.
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Affiliation(s)
- Jessica Gregg
- Division of General Internal Medicine, Department of Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA.
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Löwe B, Wild B, Herzog W, Niehoff D, Hartmann M. [Crash course "clinical research in psychosocial medicine": changes in research knowledge and subjective research competence]. Psychother Psychosom Med Psychol 2007; 57:405-8. [PMID: 17849369 DOI: 10.1055/s-2007-970941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the field of psychosocial medicine, there is a lack of structured training programs in clinical research methodology for young investigators. This study investigates changes in research knowledge and subjective research competence during a one-day crash course in clinical research. In addition, the participants evaluated the quality of the course. The crash course, held at the 2007 meeting of the German Council of Psychosomatic Medicine, consisted of 10 lessons regarding clinical study design, biostatistics, and publication of study results. Changes in research knowledge and subjective research competence were measured with multiple-choice and open-ended questions using a one-group pre-post-test-design. All 11 participants (73 % male, mean age 37.0 +/- 9.5 years) completed the evaluations at the beginning and at the end of the course. The crash course was associated with a significant increase in research knowledge (effect size = 1.3; p < 0.001), but no significant change was found with respect to subjective research competence (effect size = 0.2; p = 0.52). Overall, the quality of the course was rated as excellent; 10 of the 11 participants (91 %) would participate again in a similar crash course. The substantial increase in research knowledge suggests that structured courses in clinical research methodology should regularly be offered to young investigators, e. g. within the scope of research meetings or other national structures.
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Affiliation(s)
- Bernd Löwe
- Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf.
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Affiliation(s)
- François Baudier
- Médecin de santé publique, l'Union régionale des caisses d'assurance maladie de Franche-Comté, URCAM de Franche-Comté, 1 bis rue Delavelle, 25000 Besançon
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Nechaeva GI, Temnikova EA, Borid'ko GI, Solodnikova LD. [Therapeutic education of social workers: first results]. Kardiologiia 2007; 47:67-70. [PMID: 18260931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
For the improvement of compliance of old age patients to therapy of chronic heart failure (CHF) we carried out therapeutic training of social workers serving these patients at their homes. Efficacy of training was assessed by means of analysis of questionnaires given to 87 social workers before and after training sessions. It has been established that therapeutic education of social workers significantly elevates level of their awareness of the problems of CHF, promotes more correct understanding of their role in organization of care of old age patients with CHF and interaction with medical institutions.
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Yano E, Yamanouchi Y, Maeda H, Kusaka Y, Nakahori Y, Motohashi Y, Yasumura S. [An evaluation of teaching objectives for seminars and clerkship of social medicine in medical schools in Japan]. Nihon Koshu Eisei Zasshi 2006; 53:285-92. [PMID: 16761689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the curriculum of seminars and clerkship for social medicine in medical schools in Japan, with special reference to teaching objectives. METHODS A survey was conducted in December, 2002 by sending questionnaires to all the member departments of the Conference for Hygiene and Public Health Teaching in Medical Schools in Japan. Teaching objectives for seminars and clerkship of social medicine stated in their curricula were analyzed by frequencies of key words related to learner's "Knowledge, Attitude, and Behavior". Also, five professors of public health independently rated the stated teaching objectives using nine evaluation criteria divided into three levels and mean ratings were obtained. RESULTS Although 80% of the schools described their General Instructional Objectives (GIOs), only 63% of the universities stated Specific Behavioral Objectives (SBOs). Evaluation of the contents of the descriptions revealed that, although many courses described the GIOs with the student as subjective, only a small number of courses mentioned "Attitude and Behavior" in SBO. Also, many courses did not make any apparent distinction between GIOs and SBOs. CONCLUSIONS Practical training is a crucial component in medical education and seminars and clerkship play an important role in teaching social medicine to medical students. However, the present study revealed that many medical schools in Japan do not have adequately defined teaching objectives. Improvement of the curricula in courses of social medicine is required with particular reference to specific behavioral objectives and goals for seminars and clerkship.
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Affiliation(s)
- Eiji Yano
- Department of Hygiene and Public Health, Teikyo University School of Medicine
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Erler A, Fuchs J. [An example for a practice-oriented curriculum in social medicine under conditions of the new medical licensing regulations. Experiences with practiced-oriented teaching and possibilities for including practical issues in the teaching syllabus of medicine after the introduction of new medical licensing regulations]. Gesundheitswesen 2005; 67:355-60. [PMID: 15918123 DOI: 10.1055/s-2005-858218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Experience with teaching medical students the subject of Social Medicine shows that their interest can be greatly improved by including practical issues such as interviewing chronically ill patients at home, or visiting patient counselling services in the community. With the introduction of the new licensing regulations for physicians, there will be only one final examination and the medical faculties will now have to conduct the examinations themselves. In order to create legal confidence in the results, sufficient homogeneity of the teaching syllabus in Vocational and Social Medicine courses as well as in the new Health Economics courses must be assured for all students. The merger of the two medical faculties of the Free University and the Humboldt University in Berlin have increased student numbers to 400 per semester, so that 20 groups will have to be taught simultaneously. This situation makes excursions to patients or to community facilities nearly impossible. Potential alternatives to allow inclusion of practical issues in the course, even under the new circumstances, are the use of problem-based learning techniques (PBL) such as the creation of theoretical cases dealing with special problems of Social Medicine or the use of standardised patients.
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Affiliation(s)
- A Erler
- Institut für Gesundheitssystemforschung, Zentrum für Human- und Gesundheitswissenschaften der Berliner Hochschulmedizin.
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Abstract
With the new national licensing regulations for physicians subsections of the social medicine became discrete subjects. The question arises, which contents the social medicine can have in the future, with consideration of important basic conditions. Such are the progress of medical knowledge, the representation of social medicine at medical faculties, changes of the medical supply, the transformation of jobs and the globalization. On a long-term basis effects of the demographic development, changes of the family structure and the financing of health and illness are important too. The social medicine should promptly make quality-assured contents available with consideration of the Internet. Such contents could be the comprehensive consultation, investigation and control of patient careers as well as the consultation and investigation from health problems in municipalities and in the society. In addition an inductive and practical oriented curriculum should be compiled, using the subject catalogue of the social medicine as well as a new basic textbook of social medicine.
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Affiliation(s)
- R Brennecke
- Institut für Gesundheitssystemforschung, Charité, Universitätsmedizin Berlin.
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Radysh IF. [Theoretical issues of state management of public health in dissertations of ukranian researches]. Lik Sprava 2005:81-8. [PMID: 16025686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The authors have analyzed theses on state management for the period 1998-2004. Theoretical issues of State Management of Public Health are presented in these research works.
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Nylenna M, Larsen BI. [Social medicine--a discipline for historians or physicians?]. Tidsskr Nor Laegeforen 2004; 124:3217-9. [PMID: 15608769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Affiliation(s)
- Magne Nylenna
- Sosial- og helsedirektoratet, Postboks 7000 St. Olavs plass, 0130 Oslo.
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Øgar P. [Is the life of social medicine of value?]. Tidsskr Nor Laegeforen 2004; 124:3083-5. [PMID: 15586195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Affiliation(s)
- Petter Øgar
- Fylkesmannen i Sogn og Fjordane, 6863 Leikanger.
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Utsunomiya O. [Enforcement of the new primary clinical training system for physicians]. Fukuoka Igaku Zasshi 2004; 95:237-40. [PMID: 15678877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Osamu Utsunomiya
- Office for Clinical Training, Medical Professions Division, Health Policy Bureau, Ministry of Health, Labor and Welfare
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Heller D, McCoy K, Cunningham C. An invisible barrier to integrating HIV primary care with harm reduction services: philosophical clashes between the harm reduction and medical models. Public Health Rep 2004; 119:32-9. [PMID: 15147647 PMCID: PMC1502252 DOI: 10.1177/003335490411900109] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Overall AIDS mortality in the United States has declined in recent years, but declines have not been consistent across all populations. Due to an array of barriers to care, minorities and poor people who are active substance users have not benefited as others have from advances in the treatment of HIV disease. One way to address this problem is to integrate HIV primary care into harm reduction programs that already effectively serve this population. Such collaborations, however, are difficult to initiate and sustain. Philosophical differences between the medical model and the harm reduction model, which often remain invisible to the parties involved, underlie these difficulties. This article addresses the issue by describing a partnership in the Bronx, NY, between CitiWide Harm Reduction Inc. (CitiWideHR) and the Montefiore Medical Center. It focuses specifically on the sources of philosophical differences between models, and briefly assesses the potential for successful collaborations of this sort.
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Abstract
Research on women's issues in medicine was developed in the Nordic countries from the beginning of the 1980s. The theoretical developments led to a change of concepts from women's health to gender research, within which the structurally organised relations between men and women are analysed. Over the last decades, gender research has slowly been established in medical faculties, as a result of a strong political commitment for increased research and integration of gender issues in the university curriculum in Sweden. The government has made substantial investments in order to stimulate gender research and education in different disciplines, with special focus on medicine. Academic medicine has responded to this development with different strategies, including resistance and redefining concepts. Gender research has slowly become integrated into both research and teaching within Nordic academic medicine, although the pathway has not been easy. Gender research has had political support but there is a risk of backlash. Medical students' reactions to gender education can be compared with academic medicine's reactions towards gender research. Obstacles and possibilities are described in relation to teaching gender in schools of medicine. Most important is to recognise the risks for increased gender stereotypes and increased essentialism among the students, unless gender is taught from a theoretical perspective.
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Affiliation(s)
- Anne Hammarström
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, S-901 85 Umeå, Sweden.
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Abstract
The Women's Health Project, School of Public Health, Johannesburg, South Africa, has for more than the past decade been running various gender and health training courses for participants from at least 20 different countries. In this paper I interrogate the motivation behind and methods of the gender training and offer three prompts that assist facilitators in promoting participants' understanding of gender theory. (1) Does this program/action take gender into account? (2) Does this program/action challenge gender norms? (3) Does this program/action promote women's autonomy? Examples of training sessions are described to illustrate how our methods iterate with the content of the courses and, in particular, how the training links to actions practitioners may engage in to redress gender inequalities at work. I go on to argue that both structural and inter-relational aspects of health programs are important in addressing gender and health concerns and discuss the impact of such training on participants and health services.
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Affiliation(s)
- Sharon Fonn
- School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, South Africa.
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Abstract
Latin American social medicine arose during the 1950s and 1960s, drawing its inspiration from the social movements that emerged in France, Germany, and England in the mid-19th century. The Latin American movement of social medicine has clear ideological goals. It is organized around the Latin American Association of Social Medicine, which was founded in 1984 and is regarded as a social, political, and academic movement. This article takes a historical perspective and presents the reasons for the emergence and identity of the association, focusing on the main developments and contributions of this movement from the 1990s until the present time.
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Affiliation(s)
- Débora Tajer
- Department of Psychology, University of Buenos Aires, Argentina.
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Ramić-Catak A. [Education in public health specialties in Bosnia-Herzegovina--learned lessons and recommendations]. Med Arh 2004; 58:23-5. [PMID: 15077449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Inspite the ongoing reform process in health sector of the Federation of B&H, there are still disharmony in the current legislation framework of specialization training of health staff in public health. The paper contained a comparative overview of the training plans and programmes of current specializations social medicine and organization with health economics and public health in B&H as also news from Croatia and Slovenia. Through discussing of current situation in the Federation of B&H, this paper is aimed to initiate more active approach of all the public health professionals in defining priority actions in harmonization of specialization training of health staff in public health sector, in line with international guidelines.
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Abstract
This case study describes strategies developed for medical students to conduct Specific (as opposed to Sensitive) searches in PubMed so they can quickly locate several relevant references to articles on the population and social aspects of medicine. The Specific search strategy protocol for population and social aspects of medicine involves use of the MeSH Database, certain features of the Detailed Display in the MeSH Database, and applying Limits. By teaching the Specific form of search strategy, busy users can learn a handful of basic techniques that should yield a useful proportion of references, thereby ensuring these users' frequent success.
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Bourgois P. University of California, San Francisco, School of Medicine, Department of Anthropology, History and Social Medicine. Acad Med 2003; 78:1060-1061. [PMID: 14534115 DOI: 10.1097/00001888-200310000-00030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Donchin M. Principles for planning the teaching of health promotion in an MPH course. Public Health Rev 2003; 30:231-8. [PMID: 12613709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
The Ottawa Charter on Health Promotion defined the term Health Promotion as "the process of enabling people to increase control over, and to improve, their health". It also specifies that "to reach a state of complete physical mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment". Three main strategies for promoting health were stated: advocacy, enabling, and mediating. A great emphasis was put on policy. The Jakarta Declaration at the 4th International Conference on Health Promotion in 1997 reconfirmed the Ottawa Charter and added to it that "Health Promotion is carried out by and with people, not on or to people". The learning objectives of health promotion should refer to the values and strategies of 'Health 21', to the strategies and areas of action in health promotion as specified in the Ottawa Charter, and it should be relevant to the needs of the society that the participants are going to serve. The main goal of a training program in health promotion should be to develop competence in health promotion. "Competence" refers to the combination of three domains: attitudes, knowledge, and skills. Each school of public health or planners of an MPH course should decide upon the right mix of these three domains, according to their institute's mission and goals.
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Affiliation(s)
- Milka Donchin
- Department of Social Medicine, Hebrew University-Hadassah Braun School of Public Health and Community Medicine, P.O.B. 12272, Jerusalem 91120, Israel.
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Richter ED, Berman T. Environmental and occupational medicine and injury prevention: education and impact, classroom and community. Public Health Rev 2003; 30:277-92. [PMID: 12617060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
The core value guiding the work of physicians and health workers, including those in Environmental and Occupational Epidemiology and Medicine and Injury Prevention, is to protect the health of the public, especially its most vulnerable individuals. In these fields, we emphasize teaching the use of epidemiology, the core discipline of public health, as a tool for early detection and prevention of disease and injury, as well as an instrument for hypothesis testing. The classic core topics are toxic and physical exposures and their effects, and strategies for their prevention; emerging issues are child labor, mass violence, and democide. In environmental health, students need to be prepared for the reality that the most important and severe problems are often the most difficult to investigate, solve, and evaluate. The following are some recommendations for producing graduates who are effective in protecting communities from environmental hazards and risks: (1) Teach the precautionary principle and its application; (2) Evaluate programs for teaching environmental and occupational health, medicine and epidemiology in schools of public health by their impact on the WHO health indicators and their impact on measures of ecosystem sustainability; (3) Develop problem-oriented projects and give academic credit for projects with definable public health impact and redefine the role of the health officer as the chief resident for Schools of Public Health and Community Medicine; (4) Teach the abuses of child labor and working conditions of women in the workplace and how to prevent the hazards and risks from the more common types of child work; (5) Upgrade teaching of injury prevention and prevention of deaths from external causes; (6) Teach students to recognize the insensitivity of epidemiology as a tool for early detection of true risk; (7) Teach the importance of context in the use of tests of statistical significance; (8) Teach the epidemiologic importance of short latency periods from high exposures as sentinel events for later group risk for cancer and stating the case for action; (9) Protect students and colleagues who are whistleblowers in environmental health from harassment and punishment; (10) Develop curricula and workshops that promote the use of epidemiologic tools for preventing genocide, democide, and their precursors. Schools of Public Health and Community Medicine are at the interface between the resources of academic power and the major problems of community health. Implementing the above recommendations will strengthen academic investigation and impact.
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Affiliation(s)
- Elihu D Richter
- Unit of Occupational Medicine, Department of Health Management, Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel.
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Gofin R. The Research Forum for MPH students. Public Health Rev 2003; 30:239-45. [PMID: 12613710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Over the years, the experience with the Research Forum has shown that the framework is effective in providing the time frame and the academic support for the preparation of the proposals. It provides the students with an additional opportunity for the integration of knowledge gained during the MPH core and elective courses and for developing skills in writing and appraising a proposal or an essay on a public health issue. For the faculty it is another instance in which methodological issues are stressed, public health themes are discussed, and a systematic approach is emphasized. This process helps the students to achieve high academic levels for their proposals, and the final theses or papers are enhanced. This is evidenced by the fact that many of these works are also published in peer-reviewed journals, a sample of which is shown in the references. Students from Countries of Eastern Europe and the Commonwealth of Independent States have the opportunity to apply to the Soros Foundation Open Society Institute (OSI) for projects on their return to their home institution, which may include a continuation of their research project or master's paper topic. This project is to be carried out during the first year of their return home with financial support up to $5,000. These projects have been presented to Braun SPH faculty at summer seminars held in Russia in 2001 and 2002.
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Affiliation(s)
- Rosa Gofin
- Department of Social Medicine, Hebrew University-Hadassah Braun School of Public Health and Community Medicine, P.O.B. 12272, Jerusalem 91120, Israel.
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