Health Justice and Systems of Care: A Required Longitudinal Course for MD Students.

IF 4.8 2区 医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Perspectives on Medical Education Pub Date : 2024-06-21 eCollection Date: 2024-01-01 DOI:10.5334/pme.1325
Ronan Hallowell, Jacob Schreiber, Sonali Saluja, Danica Liberman, Donna Elliott
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Abstract

Problem & background: Medical education has acknowledged the impact of structural societal factors on health, prompting the need for curricula seeking to eliminate health inequities upstream while simultaneously caring for downstream effects of existing inequities. The Keck School of Medicine of USC (KSOM) implemented one such comprehensive curriculum, Health Justice and Systems of Care (HJSC), integrating health systems science, structural competency, and service-learning in a required course spanning the pre-clerkship and clerkship phases with an optional post clerkship elective.

Approach: The HJSC course addresses topics including racism in medicine, health inequities, and health systems science. Using transformative learning theory, it fosters critical consciousness and structural competency. Assessments include case analyses, reflections, team-based learning sessions, and group projects related to social justice in healthcare. The program aims to instill cultural humility and practical application, fostering a holistic approach to medical education that implores physicians to become advocates for health justice.

Outcomes of the innovation: Feedback from students indicated generally positive perceptions of the curriculum. Students provided overall positive comments about discussions with guest speakers. However, students expressed a desire for more concrete examples of how health inequities can be remedied. Some found small-group activities less engaging. Other challenges included providing students of different readiness levels with tailored experiences and seamlessly integrating HJSC content within basic and clinical sciences courses.

Critical reflection: Next steps include continuing to integrate content into the science curriculum and clerkships, improving opportunities for meaningful student interactions, and enhancing faculty development to address health justice concerns in clinical settings.

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健康正义与护理系统:医学博士学生的必修纵向课程。
问题与背景:医学教育已认识到结构性社会因素对健康的影响,因此需要开设课程,力求在上游消除健康不公平现象,同时关注现有不公平现象的下游影响。南加州大学凯克医学院(KSOM)实施了这样一门综合课程--"健康正义与护理系统"(HJSC),将健康系统科学、结构能力和服务学习整合到一门必修课程中,该课程跨越实习前和实习阶段,实习后可选修:HJSC 课程涉及的主题包括医学中的种族主义、健康不平等和健康系统科学。该课程采用变革性学习理论,培养批判意识和结构能力。评估包括案例分析、反思、团队学习课程以及与医疗保健中的社会正义相关的小组项目。该计划旨在灌输文化谦逊和实际应用,培养一种全面的医学教育方法,促使医生成为健康正义的倡导者:学生的反馈表明,他们对课程的看法普遍积极。学生对客座演讲者的讨论总体上给予了积极评价。然而,学生们表示希望能有更多具体的例子来说明如何纠正健康不公平现象。一些学生认为小组活动不太吸引人。其他挑战还包括为不同准备程度的学生提供量身定制的体验,以及将健康与司法服务委员会的内容无缝整合到基础和临床科学课程中:接下来的步骤包括继续将内容整合到科学课程和实习中,增加有意义的学生互动机会,加强教师发展以解决临床环境中的健康正义问题。
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来源期刊
CiteScore
5.70
自引率
8.30%
发文量
31
审稿时长
28 weeks
期刊介绍: Perspectives on Medical Education mission is support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Official journal of the The Netherlands Association of Medical Education (NVMO). Perspectives on Medical Education is a non-profit Open Access journal with no charges for authors to submit or publish an article, and the full text of all articles is freely available immediately upon publication, thanks to the sponsorship of The Netherlands Association for Medical Education. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.
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