History's Toolbox in Health Professions Education: One Skill-Based Session on Social Determinants of Health.

Abstract

Aimed at clinical educators, this article reports on the use of a single skill-based session that introduces learners in Health Professions Education (HPE) to basic techniques from the discipline of history. The premise of the teaching method is a correspondence between medicine's social determinants of health (SDH) and categories of analysis commonly used by historians. At the center are eight categories, or "tools": social, cultural, intellectual, technological, political, economic, racial/ethnic, and gendered. Like the direct and specific implications of many diagnostic signs, each of these adjectives indicate to historians specific types of factors, or determinants. The intervention employs the demonstration-performance teaching method (explanation, demonstration, supervised practice, and evaluation). After the session, learners are able to: use "history's toolbox" as a systematic method for evaluating socio-cultural phenomena inherent in SDH; differentiate eight types of determinants in a historical case study that represents socio-cultural complexity; recognize how categorization simultaneously enhances some determinants while obscuring others, and how the use of constructed social categories in medicine can function to help and harm patients and populations. The intervention described is rooted in scholarship and theoretical questions belonging to the discipline of history, but these are not discussed. Neither the historical content nor the teaching method described here is appropriate for research or teaching in the discipline of history.