Social Contexts in Medicine: A Patient-Centered Curriculum Empowering Medical Students to Provide Contextualized Care
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Introduction: Social Contexts in Medicine (SCIM) is an 18-month program that connects medical students, patients, and physicians for a longitudinal learning experience. SCIM was developed for first- and second-year medical students and seeks to supplement students’ biomedical education with practical experiences built around community and continuity. The program increases students’ awareness of, and skills to address, social determinants of health via a seminar series, a home visit program, and a mentoring component. Methods: The program begins with a seminar series covering communication skills and the basics of social determinants of health, providing the foundation for successful home visits. Students are then paired with a patient for home visits to learn firsthand about the complex social factors that affect health and illness, patient participation in health care systems, and the doctor-patient relationship. In conjunction with the home visits, students obtain guidance from a physician mentor. Results: The SCIM program has been successful during its first 3 years at our institution. Analysis of changes in student attitudes using Crandall’s Medical Student Attitudes Toward the Underserved survey has shown that SCIM students develop more positive attitudes toward the underserved than do their peers completing traditional clinic-based preceptorships. Additionally, in student surveys, the average response to the statement “I learned something valuable I would not have otherwise learned in my classes” has been 4.5 out of 5. Discussion: These findings suggest that the SCIM model contributes to medical education by broadening students’ understanding about the influence of social factors on health and disease.
Drake C, Keeport M, Chapman A, Chakraborti C. Social Contexts in Medicine: a patient-centered curriculum empowering medical students to provide contextualized care. MedEdPORTAL Publications. 2017;13:10541. https://doi.org/10.15766/mep_2374-8265.10541
By the end of the Social Contexts in Medicine program, student participants will be able to:
- Understand and discuss social determinants of health and structural violence—the ways in which societal structures of power, cultural privilege, and unequal distribution of resources all impact patients’ lives and health outcomes.
- Identify major reasons for why patients may or may not be able to access health care systems or comply with medical advice.
- Demonstrate an improved ability to interact with patients in a culturally sensitive and thoughtful manner, develop a relationship of mutual trust, and reflect on how their personal beliefs and socialization may affect the ways in which they interact with patients.
- Describe the basic structures of Medicare and Medicaid (including the populations who are generally eligible and ineligible) and identify local community health initiatives that serve uninsured patients.
- Identify the different types of allied health professionals available (patient advocates, social workers, etc.), the services they provide, and how they can influence care.
Perform basic health screenings such as taking vitals, blood pressure, and blood glucose.
- Physician-Patient Relations, Contextualized Care, Continuity of Care, Social Determinants of Health, Vulnerable Populations
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Authors & Co-Authors
Carolyn Drake, MD, MPH
New York University School of Medicine
Melissa Keeport, MD
Maine Medical Center
Chayan Chakraborti, MD
Tulane University School of Medicine
Tulane University School of Medicine