A patient-centered approach to learning social determinants of health for first year medical students

INTRODUCTION: To address health disparities, future physicians must understand the role of social determinants of health (SDH). Teaching SDH can be challenging. We created an authentic SDH curriculum using four real myocardial infarction (MI) patients.

METHODS: During the three academic years from 2019-2020 to 2021-2022, 579 first year medical students participated in the four day curriculum. Day 1: students interviewed and learned about their patient's MI. Day 2: students met in small groups and shared their patient's history. At session end, students were familiar with four patient stories. Day 3: students explored their patient's neighborhood and then interviewed their patient again, focusing on SDH. Day 4: students gave formal patient presentations that highlighted SDH. Group discussion followed and reinforced the role of SDH. Students wrote reflections on SDH that were read and graded. End of course evaluations were reviewed.

RESULTS: Five hundred and seventy-nine students completed the curriculum. Course directors graded SDH reflections on a six-point rubric for the years of 2020-2021 and 2021-2022. Ninety percent and 96% of the SDH reflections during the respective years contained 5-6/6 of the rubric components. Ninety-six percent to 98% of students 'agreed' or 'strongly agreed' that the curriculum was effective for their learning.

DISCUSSION: For educators in need of an SDH curriculum that is both engaging and effective, we have found this activity to be feasible, low cost, and highly impactful for first year medical students.[Box: see text].