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Integrating and Assessing Structural Competency in an Innovative Prehealth Curriculum at Vanderbilt University.

Jonathan M Metzl1, JuLeigh Petty

  • 1J.M. Metzl is Frederick B. Rentschler II Professor of Sociology and Medicine, Health, and Society, director, Center for Medicine, Health, and Society, and professor of psychiatry, Vanderbilt University, Nashville, Tennessee.J. Petty is senior lecturer and assistant director, Center for Medicine, Health, and Society, and senior lecturer, Vanderbilt University, Nashville, Tennessee.

Academic Medicine : Journal of the Association of American Medical Colleges
|February 23, 2017
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Summary

Prehealth students in an innovative major demonstrated understanding of how structural factors influence health disparities. This training is crucial for addressing health-related social justice issues and improving health equity.

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Area of Science:

  • Public Health
  • Medical Education
  • Health Equity

Background:

  • Structural competency is key to understanding health disparities rooted in social, economic, and political factors.
  • Prehealth undergraduate education needs effective strategies to teach structural competency concepts.
  • Evaluating the impact of such training on students is essential.

Purpose of the Study:

  • To assess the impact of a curriculum incorporating structural competency on prehealth students.
  • To evaluate students' ability to identify and analyze structural determinants of health.

Main Methods:

  • Vanderbilt University's Medicine, Health, and Society (MHS) major curriculum was updated to include structural competency.
  • The Structural Foundations of Health (SFH) instrument was developed to assess student skills.
  • The SFH instrument was piloted with MHS seniors.

Main Results:

  • Most students identified structural factors as key to childhood obesity rates and racial heart disease disparities.
  • Students recognized individual, family, social, and political factors influencing health disparities.
  • A majority linked racial disparities in heart disease to socioeconomic factors, discrimination, and policy.

Conclusions:

  • Preliminary data indicate the MHS major effectively trains students in structural competency.
  • Students can identify and analyze the relationship between structural factors and health outcomes.
  • Further research will compare MHS students with traditional premedical students.