Original Publication
Open Access

The Social History...It's About the Patient - Culture and All

Published: July 14, 2009 | 10.15766/mep_2374-8265.3149

Included in this publication:

  • Syllabus Preassignment.doc
  • Faculty Instructions.doc
  • Student Evaluation.doc
  • Lecture.ppt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: It is important to encourage students to confront the importance of culture in the patient-physician interaction. We created this four-part, case-based educational module to demonstrate the importance of social history-taking skills within the clinical context. When developing the case for this module, the authors solicited the expertise of the physician diagnosis faculty director to ensure the fundamental principles put forth were consistent throughout the curriculum. In this module students explore the case of Ms. Graupera whose medical history, social history, and culture have shaped the differential diagnosis, and the patient's perception of their illness. Methods: This case is designed to be delivered in small-group interactions with faculty facilitators (groups of 10-15 are ideal) followed by a large-group lecture discussion. During this case, students work to define the concept of culture and how it can be ascertained during the social history. The small-group setting allows faculty to better assess student's diagnostic ability as well as their ability to understand the critical nature of a patient's history in obtaining the correct diagnosis. Results: This resource has been used successfully for the past 3 years as part of a second-year clinical foundations course in undergraduate medical education. Discussion: This case successfully exposes students to culturally specific terms, traditions, and manifestations of illness while emphasizing the important aspects of culture for both patients and physicians. This educational module can be offered either within a cultural competency curriculum, gastroenterology sequence, or a physical diagnosis curriculum. At our institution it was specifically placed within the physical diagnosis course that occurs before the GI sequence.

Educational Objectives

After using this resource, learners will be able to:

  1. Understand, respect, and validate differing values, cultures, and beliefs, and demographics such as sexual orientation, gender, age, race, ethnicity, and class.
  2. Develop communication, interaction, and interviewing skills.
  3. Identify questions about health practices and beliefs that might be important in a specific local community.
  4. Elicit a cultural, social, and medical history, including a patient's health beliefs and model of their illness.
  5. Recognize and manage the impact of bias, class, and power on the clinical encounter.
  6. Demonstrate respect for a patient's cultural and health beliefs.

Author Information

  • Monica Lypson, MD: University of Michigan Medical School
  • Rachel Perlman, MD: University of Michigan Medical School
  • Robert Lash, MD: University of Michigan Medical School
  • Maria Silveria, MD, MPH, MA: University of Michigan Medical School
  • Crista Johnson, MD: University of Michigan Medical School

None to report.

None to report.


Lypson M, Perlman R, Lash R, Silveria M, Johnson C. The social history...It's about the patient - culture and all. MedEdPORTAL. 2009;5:3149. https://doi.org/10.15766/mep_2374-8265.3149