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Reflection on March 2018 HMIchat on Health Equity

This blog reflection is co-authored by Mobola Campbell-Yesufu and Christina Cruz

The March #HMIchat focused on health equity and social determinants of health. We kicked off the first synchronous hour with excited and engaged health professions educators sharing what health equity means to them. Over the course of the next 23 hours, including both synchronous sessions, we shared our experiences, challenges and future directions in teaching health equity. With almost 100 participants sending 500 plus tweets on this topic, we amassed a veritable treasure trove of teaching pearls during the chat. Here are the highlights:

Health equity vs. health equality: Equality refers to distribution of same amount of resources to each person, while equity looks at each person’s needs and distributes the right amount of resources needed to achieve the desired result.

 It was clear to us as educators why it is important to teach health equity but we struggled with knowing which was the most effective method to use. There is no right answer – many shared strategies that they are currently using and suggested some innovative ideas to consider implementing. 

Teaching about health equity: Innovative, practical & effective strategies

  • Begin the conversation with your learners. Identify opportunities to highlight social determinants of health and collaborate with other disciplines as you develop curricula (social workers, nurses, pharmacists, public health, medical anthropology).
  • Traditional lectures will not suffice. It is important to ensure the content is real (case-based), relevant and local (city/state data) – as @TinaMCruz1 shared “grounded in the communities we serve”.
  • Don’t relegate social determinants of health to just the social history – treat it as the contextual information that it is and weave it throughout the history of present illness and incorporate it in your assessment and plan (@templeratcliffe, @ShreyaTrivediMD)
  • Experiential opportunities such as immersion experiences and longitudinal integrated clerkships offer learners real-world exposure to these issues that affect our patients. @stephanieyzhou suggested that electives on homeless health, addictions and refugee health are great experiential opportunities.
  • Community-based participatory teaching – Get students out into the community and have community members teach students about their experiences. It’s a reminder that these are the lived experiences of our patients, and not just abstract concepts we learn in a classroom.
  • Incorporate reflective practice in the curriculum
  • Consider how design thinking can fit in. Can we engage not just the learners but also the patients and community in developing health equity curricula?
  • Simulation in identifying and addressing social determinants of health can be used to help learners develop empathy, identify bias and address difficult situations.
  • Consider the intersectionality of health equity and healthcare quality. Engage learners through quality improvement (QI) projects on health equity when possible.
  • Teach students health advocacy and provide outlets to do so: op-eds, social media, student interest groups, getting involved in health policy (@stephaniyzhou)
  • Rigorous assessment of the learner skills in SDOH can be challenging (@HeatherHeiman) – and is still a work in progress for many

By the end of the chat, we felt energized by the passion and engagement of our worldwide community of educators. We realized that there is not one right answer to how best to teach health equity and social determinants of health. Instead, we learned from each other, added new tools to our health equity and advocacy toolbox and made connections with others who might be collaborators on future projects in this area.

 

Resources shared:

  1. Iveris L Martinez, Isis Artze-Vega, Alan L. Wells, Jorge Camilo Mora & Marin Gillis (2014) Twelve tips for teaching social determinants of health in medicine, Medical Teacher, 37:7, 647-652.
  2. National Consortium for Multicultural Education for Health Professionals. http://culturalmeded.stanford.edu/teaching/healthcaredisparities.html (Accessed March 15, 2018).
  3. Camara Phyllis Jones Levels of Racism: A Theoretic Framework and a Gardener’s Tale. Am J Public Health 2000;90:1212-1215
  4. Achieving Health Equity: How Academic Medicine is Addressing the Social Determinants of Health. https://www.aamc.org/download/460392/data/sdoharticles.pdf (Accessed March 15, 2018).
  5. National Academies of Sciences, Engineering and Medicine. 2016. A framework for educating health professionals to address the social determinants of health. Washington, DC: The National Academies Press


Co-Author BIO 's

Mobola Campbell-Yesufu is an Assistant Professor of Medicine at Feinberg School of Medicine, Northwestern University. She developed and implemented a Social Determinants of Health curriculum for Internal Medicine residents, and is currently developing the Health Equity and Advocacy Clinical Scholars Program for GME trainees at Northwestern.

 

Christina Cruz is an Assistant Professor of Medicine at Icahn School of Medicine, Mount Sinai Beth Israel and Associate Program Director for Ambulatory Care. She oversees GME Ambulatory and Wellness Curricula. She is interested in the intersection of medical education and social accountability.

 

 

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Thursday, 13 December 2018