The design and implementation of a longitudinal social medicine curriculum at the University of Vermont’s Larner College of Medicine

Abstract

Background Despite an abundant literature advocating that social determinants of health (SDH) be taught during undergraduate medical education, there are few detailed descriptions of how to design and implement longitudinal core curricula that is delivered to all students and accomplishes this goal. Methods In this paper, we describe the design and implementation of a social medicine curriculum at the University of Vermont’s Larner College of Medicine (UVM Larner). Using Kern’s principles, we designed a longitudinal curriculum that extends through both preclinical and clinical training for all students and focused on integrating SDH material directly into basic science and clinical training. Results We successfully developed and implemented two primary tools, a “Social Medicine Theme of the Week” (SMTW) in preclinical training, and SDH rounds in the clinical setting to deliver SDH content to all learners at UVM Larner. Conclusions Extensive student-faculty partnerships, robust needs assessment, and focusing on longitudinal and integrated SDH content delivery to all students were key features that contributed to successful design and implementation.

Building the Generalist Physician to Support Adolescence and Emerging Adulthood: A Narrative Review

“…Such endeavors serve to provide the knowledge and skills necessary for students to obtain transdisciplinary skills across the core clinical clerkships (including internal medicine and pediatrics) [ 15 ], reduce the fragmentation of the clerkship experience [ 16 ], and sequence the development of students to ensure that they obtain fundamental general clinical skills, such as presentation [ 17 ]. This model of longitudinality in the undergraduate curriculum has moved beyond clinical skills to encompass such topics as evidence-based medicine [ 18 , 19 ], clinical informatics [ 20 ], and social medicine [ 21 ]. In line with the aforementioned longitudinality, rather than clerkship reform seeking to add prototype information to the student’s medical knowledge that is insufficient to build an understanding of clinical science [ 22 ], clerkship reform has primarily focused on situating the student within the continuum of care to learn from experience as a means to support the development of skills in clinical science [ 23 ].…”

A new roadmap for social medicine curriculum design based on mixed methods student and faculty evaluations of the preclinical curriculum

“…This approach involves a weekly student announcement describing that week's theme, listing of the theme and relevant objectives in the student online scheduling portal, SMTW topic synthesis with PCR session and faculty integration of theme content or personal reflection in foundational science active learning sessions. The curricular design and implementation are described in more detail separately [21].…”

“…The student survey was emailed in 2019 to all first-year medical students in the weekly UVM Larner newsletter at the completion of the same preclinical curriculum described previously [21]. Additional emails and announcements were sent and made to the first-year class for 3 weeks following initial administration encouraging survey participation.…”

“…One obstacle to progress may be that each institution has a unique baseline approach to social medicine teaching and thus a different pathway toward design of a fully realized social medicine curriculum. To provide a conceptual framework for all institutions conducting social medicine curriculum design, we conducted a mixed methods evaluation of an expanded and innovative preclinical social medicine curriculum at the University of Vermont's Larner College of Medicine (UVM Larner) as recently described in more detail in this journal [21]. Based on this mixed methods curriculum evaluation, we propose a conceptual framework for social medicine curriculum design.…”

Assessment and Evaluation in Social Determinants of Health Education: a National Survey of US Medical Schools and Physician Assistant Programs

“…3,4 The published literature regarding educational practices and curricular design considerations regarding SDOH curricula has been growing over the past two decades, with marked acceleration in the last few years. [5][6][7][8][9] However, a major gap persists in the area of effective SDOH learner assessment and program evaluation. Consequently, there is limited information, lack of standardization, and little dissemination of either curricular materials or assessment tools.…”