Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians.

Area of Science:

• Medical Education
• Public Health
• Social Determinants of Health

Background:

• Societal inequities significantly impact health outcomes, yet their integration into medical training remains inconsistent.
• Structural competency emphasizes the crucial role of social, political, and economic factors in shaping health.
• There is a need to enhance medical education to address these structural influences effectively.

Purpose of the Study:

• To develop, implement, and evaluate a structural competency training program for medical residents.
• To equip residents with the ability to recognize and address the downstream effects of societal structures on patient health.
• To assess the impact of this training on residents' clinical practice and patient interactions.

Main Methods:

• The study was conducted in a California family medicine residency program with a patient population largely below 200% of the federal poverty level.
• Twelve residents participated in the training program.
• Training focused on recognizing and responding to how social, political, and economic structures influence health and illness.

Main Results:

• The training was evaluated using post-training surveys and a follow-up focus group.
• All residents completed the post-training surveys.
• Residents reported positive impacts on their clinical practice and patient relationships.

Conclusions:

• Residents perceived the structural competency training as positively influencing their clinical practice and patient relationships.
• Increased awareness of structural factors contributing to patient health led to feelings of being overwhelmed among residents.
• Participants expressed a need for continued training and support to effectively manage the complexities of structural influences on health.