Engaging Communities to Enhance and Strengthen Medical Education: Rationale and Summary of Experience

Abstract

Change in medical education through curricular reform has gained momentum in recent years due to multiple external forces. In addition, health access issues have coalesced to require that a broad set of voices be heard and served through the current health-care system. This requires that medical professionals be especially attuned to their communities and the multitude of cultures and voices that reside within them. In an attempt to illustrate how these changes can be practically incorporated into a medical education curriculum, this article highlights one institution's experience with a community-based health solution. The Georgetown University School of Medicine (GUSOM) Service-Learning program provides an example of how a community-based health solution can bridge the gap of social and clinical medicine through the framework of systems thinking principles and focus on teamwork to facilitate collaboration among faculty, community members, and students. This article will briefly explain the history, learning objectives, and context of the program, and in addition, provide a brief case study examining how the program engaged the problem of increasing immunization rates in the Washington, DC area.

Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

“…All articles except for Powell and Bullock explicitly described programs that used traditional didactic forms of instruction [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77]79 (20) and many described participatory components that were also classroom-based: case-based instruction 59,60,63,69,70,73,77 (7); small group work 61,63,69,77,80 (5); and peer teaching 59,66,67,71,78 (5). All learner-led activities were considered participatory within our charting scheme.…”

“…65,67,[75][76][77]80 Bernstein 76 used critical reflection as a learning tool and as part of program assessment. Bullock 80 described a community-led collaboration where critical reflection is facilitated by faculty and through post-intervention dialogue with community members. Erlich 69 described a comprehensive, multimodal SDH curriculum, created by students and developed using Kern's model.…”

“…Seven articles described intermediate initiatives ranging from a single course or clerkship 64,74,79 through programs that spanned months. 63,65,77,80 Nine of the articles described longitudinal community-based SDH curricula over a span of one year or more. 61, 62, 66, 69-71, 73, 75, 78 Timing is described in greater detail under program/ publication type in Tables 1 and 2. Articles were also classified by the described programs' availability to all students.…”

“…59, 60, 68, 69, 72, 75-77, 79, 80 Only three of these articles reported curricula that were close to a year or more. 69, 75, 80 Buckner 75 and Bullock 80 both described community-based coursework throughout the first year of medical school, and the program described by Erlich 69 was integrated throughout all four years. Four other articles outlined SDH curricula for all medical students that were classified as short-term in duration.…”

“…Twenty articles contained affective student assessment, measuring self-reported changes in knowledge, skills, and attitudes; recognition of the impact of social determinants of health; and desire to serve the underserved. [60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][76][77][78][79][80] Student assessments about attitude change using the Medical Student's Attitudes Toward the Underserved 82 instrument were described in three publications. 62,66,68 Performance-based student assessment was discussed in four articles and limited to clinic-based curricula.…”