Video Curriculum on Screening for the Social Determinants of Health

Format Publication ID Version Published
Presentation, Video, Evaluation Tool 9575 1 October 9, 2013

Description

Social Determinants of Health (SDH) are emerging as a major barrier to the promotion of child health in the 21st century. The effects of poverty, including food insecurity, unsafe housing conditions, inadequate educational interventions, domestic violence, and limited access to medical care, have been linked to poor health and developmental outcomes in children. Many pediatric residents lack competence in identifying families that face social, economic or environmental difficulties and feel inadequately prepared to counsel and refer patients and families to appropriate community resources due to their limited training during medical school and early residency years. Additionally, the majority of pediatric residents were not raised in poverty, so they cannot build upon their past experiences. Effective child advocacy training is a critical aspect of pediatric residency education and is required by the Accreditation Council for Graduate Medical Education (ACGME). Thus, it is imperative to develop innovative educational strategies to train residents in screening for and identification of SDH.

This curriculum was developed following a needs assessment and positive feedback obtained after a brief one-time educational experience with videotaped social history vignettes. In response, a multidisciplinary team of primary care clinic faculty, medical educators, and legal partners with content expertise collaborated for the development of this curriculum.

Scripts for a series of video vignettes depicting typical scenarios of resident physicians screening for SDH in continuity clinic were developed with clinic parents and resident physicians acting in their respective roles. Videotaping was done by a professional videographer. For each vignette, two versions, inappropriate and appropriate, were created using the same actors. In the inappropriate versions, resident actors failed to adequately screen for SDH despite verbal and non-verbal cues by the parent actors. In the appropriate versions, resident actors encountered the same cues, and they subsequently engaged the parent in a family-centered conversation that focused on screening for SDH. Vignettes highlighted screening for food insecurity, public benefits, housing conditions, maternal depression, domestic violence and education.

In addition, a “day in the life” series was created to allow actual patients and families from the clinic tell their story of how screening, detection, and intervention impacted their family’s lives. The topics of the “day in the life” series were chosen to complement the benefits, housing, and education vignettes.

Citation

Klein M, Beck A, Kahn R, Henize A, O'Toole J, Alcamo A, McLinden D. Video Curriculum on Screening for the Social Determinants of Health. MedEdPORTAL; 2013. Available from: www.mededportal.org/publication/9575

Educational Objectives

  1. To recognize the barriers to health that patients and families from diverse socio-economic backgrounds face.
  2. To be able to evaluate a collection of simulated social screening videos.
  3. To discuss empathetic engagement of patients and families in an attempt to maximize residents’ effectiveness in screening for SDH.
  4. To formulate a plan to mitigate the effects of SDH through referrals to government agencies and/or community resources.

Keywords

  • Social Determinants of Health, Poverty (MeSH), Primary Health Care (MeSH), Resident Education, Medical Legal Partnership

Specialty

  • Medical
    • Pediatrics

Competencies Addressed

  • Medical
    • Interpersonal & Communication Skills
    • Medical Competencies
    • Patient Care

Academic Focus

  • Basic Sciences
    • Sociology
  • Clinical Sciences
    • Clinical Skills/Doctoring

Professional Interest

  • Ambulatory Education
  • Assessment
  • Curriculum Development/Evaluation
  • Public Health Sciences

Intended Audience

  • Administration
    • Community-based
    • Practice
  • Practicing Health Professional
    • Physician
  • Professional School Post-Graduate Training
    • Resident

Instructional Methods

  • Assessment
    • Communication Skills
  • Lecture

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