Patient-centered Approach to Learning Social Determinants of Health

By Elisa Sottile, M.D. | October 18, 2023

Article Citation: Berger S, Harada C. A patient-centered approach to learning social determinants of health for first year medical students. Med Teach 2023; 45(11):1263-1267. DOI: 10.1080/0142159X.2023.2225727 

What is this article about?

This article describes the creation and implementation of a curriculum developed to teach first year medical students about the social determinants of health (SDH).  The curriculum revolves around the stories of four real patients, each with different social circumstances, but with a similar clinical diagnosis. This curriculum, entitled “Patient Stories “was administered over four days as part of a larger course at a single public academic institution.  Students engaged with patients for two of the four days of the module.  Learner activities involved listening, reflecting, delivering oral presentations of patient stories and facilitated debriefs.   The authors report three years of course evaluation data; an overwhelming majority of learners indicated that the “patient stories “cases were effective for their learning in this module. Although qualitative analysis was not completed, comments were also highly favorable.

Why should you read the article?

As outlined by the Liaison Committee on Medical Education, medical schools must provide SDH teaching so that learners understand the multitude of influences impacting their patients’ health.  Providing teaching on SDH early in preclinical years is as critical as teaching cardiovascular physiology. Institutions need effective curriculum that is low cost and easy to implement.  This curriculum that applies experiential learning supplemented with patient interaction is just that. 

How can you use this article?

The curriculum described in this article can be easily implemented.  The authors provide access to all the supporting materials used to administer the content from questions to prompt the patients, to facilitator guides to lead the debrief sessions with the students.  Additionally, the authors share lessons learned and suggestions for improving upon their curriculum.  This curriculum can be adapted to resident education as well.

Review Author:  Elisa Sottile, M.D.; Associate Professor of Internal Medicine and Assistant Dean of Medical Education, University of Florida, Jacksonville, FL. Organization: Clerkship Directors in Internal Medicine