A Framework for Educating Health Professionals to Address the Social Determinants of Health (2016) / Chapter Skim
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Appendix A: Educating Health Professionals to Address the Social Determinants of Health
Appendix A: Educating Health Professionals to Address the Social Determinants of Health
Pages 109-132
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This paper provides a review of the literature that describes the current practice of educating health professionals to address the social determinants of health in and with communities. Based on these findings, we formulate recommendations on how to strengthen health professional education by addressing the social determinants of health.
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A team at the Department of Family Medicine and Primary Health Care of Ghent University then conducted an analysis of the identified papers. The team consisted of Sara Willems, master in health promotion and professor in health equity; Kaatje Van Roy, medical doctor, psychologist, and senior researcher; and Jan De Maeseneer, medical doctor, full professor in family medicine, and head of the department.
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Additional records Records excluded identified through based on title and other sources abstract (n = 4)
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The screening tool can be found in Annex A-1 at the end of this appendix. RESULTS Global Descriptions of the Programs Location of the Schools Where the Programs Run As noted, 33 papers describing training programs for health professional students addressing the social determinants of health in/with the community were found.
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. Although none of the included programs was designed for health professionals, some programs were designed for students who already had some professional experience, such as registered nurse (R.N.)
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Examples of such frameworks include cultural competence, social justice, social responsibility, social accountability, human rights, patient-centered care, and advocacy for patient health. Program Goals In many of the included papers, the program goals are more or less clearly stated.
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A definition that is often referred to is the one formulated by Health Professions Schools in Service to the Nation, outlining service learning as "a structured learning experience that combines community service with explicit learning objectives, preparation, and reflection" (Seifer, 1998, p.
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Care for individual community members includes, for instance, home visits that focus on health education, arrangement of referrals, evaluation and improvement of health literacy, and development of an interprofessional care plan (De Los Santos et al., 2014)
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Examples include taking health histories, assisting local physicians with health assessments (Larson et al., 2010) , providing foot care to persons in a homeless shelter (Schoon et al., 2012)
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33) notes that for true service learning, (medical)
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. Quantitative data basically rely on surveys measuring students' evaluation of and satisfaction with different aspects of the training, their career choices or readiness for interprofessional learning, and their attitudes toward the specific population with which they worked.3 Qualitative data comprise mainly information obtained from students' reflective journals, focus groups, and interviews (most often with students, sometimes with trainers or community members)
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. This was in contrast with the findings of another study that service learning can increase students' empathy toward those who live in poverty while at the same time solidifying perceptions that the poor are different from other members of society (Jarrell et al., 2014)
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Bell and Buelow (2014) state that in their program, "the various experiences were all necessary to ensure achievement of student learning outcomes." (This program comprises an online poverty simulation, reflection and discussion, several online and in-class lessons with corresponding quizzes, interprofessional team assignments, a home visit, weekly clinical work with reflective journals, and a final team presentation.)
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report that funding constraints limited the number of students that could participate. Some papers mention grants that were available for participating students, mostly to take part in international programs (e.g., Larson et al., 2010; Meili et al., 2011)
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After strict inclusion criteria were applied to the papers in the original database, 33 papers were selected for this review. As mentioned earlier, we found that fewer papers mentioned "social determinants of health" as a goal (n = 9)
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Several authors emphasize its different components, which basically encompass both elements of the term "service learning." "Service" refers to the fact that a genuine collaboration with the community should be established. Community members should be involved at all stages of the training and should also benefit from the cooperation.
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needs assessment, developing and implementing a project or intervention, organizing educational sessions for community members, and caring for individual patients. Nonexperiential learning components included lectures, group discussions, workshops to build capacities, simulation experiences, reading assignments, online activities, presentations, and research projects.
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• Both components of "service learning" should be carefully in corporated into the training. • appropriate amount of student guidance should be offered.
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Is there an impact on the social determinants of health and on the community's status? Do programs contribute to increased social accountability of in stitutions for health professional education?
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Duration of training: Total Duration of training: Community learning part Program in curriculum Obligatory / Elective / Extracurricular Participants: Level Undergraduate students / Postgraduate students / Professionals Participants: Type of health profession Participants: Number Start of program Described Goal of Training Educational approach Framework/model SDH explicit aim Yes / No Focus on SDH Central / Marginal References to SDH SDH discussed as outcome 6 Part of this Annex A-1, Table A-1, a literature review summary, is available at http://www. nap.edu/catalog/21923.
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APPENDIX A 129 Content of Training (Components) IF RESEARCH PAPER Type Quantitative / Qualitative / Mixed Data Research topic Number of participants Main findings (if relevant and not in IOM questions)
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2014. Interprofessional education and service learning: A model for the future of health professions education.
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2015. Service learning: A vehicle for building health equity and eliminating health disparities.
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