Pediatric Hospital Medicine Fellow LSUHSC New Orleans, Louisiana, United States
Background: Medical education literature demonstrates that case based curricula improve learner knowledge and skills regarding social determinants of health (SDH). While education on SDH aligns with the standards set by the Liaison Committee on Medical Education and Council on Medical Student Education in Pediatrics, current resources have limited generalizability to the pediatric clerkship. To address this need, we designed a case based curriculum on SDH for third year medical students on their pediatric clerkship.
Objective: By the end of the curriculum, students will be able to: 1. Identify common SDH affecting pediatric patients. 2. Analyze a pediatric case for SDH that may be affecting patient health. 3. Construct questions to elicit SDH for a pediatric clinical encounter. 4. Recognize resources to help mitigate effects of SDH for pediatric patients.
Design/Methods: The curriculum consists of four flipped classroom modules, delivered via interactive electronic presentations, on SDH for common pediatric diagnoses in addition to small group sessions. Students complete modules prior to each of four small groups. During small groups, a facilitator leads students in analyzing a pediatric case for potential SDH and constructing questions that could be asked to elicit these SDH from patients and families. Students also research a local resource that could help mitigate SDH for a pediatric patient and present their findings. Data collection occurs via students’ analysis of a pediatric case and self-assessment of their knowledge and skills regarding SDH in the pediatric context on a 7-point Likert scale (ranging from strongly disagree to strongly agree) before and after completion of the curriculum.
Results: 167 students have completed the curriculum with pre and post survey response rates of 50% and 39% respectively. Data show improvement in means of student self-assessed ability to: define SDH (5.49 to 6.21), identify SDH commonly affecting pediatric patients (4.81 to 6.12), analyze a case for potential SDH (4.98 to 6.18), form questions to elicit SDH (4.61 to 6.02), and identify resources to help mitigate the effects of SDH in the pediatric context (3.87 to 5.89). 85% of students agreed or strongly agreed that the small groups advanced their understanding of SDH.Conclusion(s): A case based curriculum on SDH using a multi-session flipped classroom approach advances student knowledge and skills regarding SDH in the pediatric context. Future areas for improvement include targeting higher levels on Kirkpatrick’s Model of Evaluation by examining student behavioral changes as a result of participation in the curriculum. CV Roth Dec 2021.pdf