Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers:...

Recognizing social determinants of health and addressing barriers to health care are an essential part of medical practice for which students' formal training is inadequate. The majority of medical students feel a professional responsibility to understand health policy, but their knowledge of health care legislation and health insurance is lacking, and their primary information sources are outside the medical education setting. This resource provides an easily implemented tool kit to begin to fill these educational gaps.

During their first inpatient medicine clerkship, fourth-year students in a 6-year BA/MD program participated in a classroom activity that included instruction on taking a comprehensive social history and a lecture regarding government insurance. Through an interactive case-based discussion, students developed a list of specific resources and then compiled information to share with their classmates.

Thirty-seven students participated in this learning activity during a brief pilot period. Comparison of preclass and postclass survey data showed that students increased their knowledge regarding insurance programs. Students also increased their self-perceived skills in identifying barriers and arranging resources for patients. The majority of students (94%) intended to apply these skills and knowledge during future clinical rotations.

This resource provides a tool for introductory, interactive learning about health insurance, social history taking, and addressing barriers to health care, and requires minimal resources. The amount of time devoted to the activity, references, and discussion topics can be customized to fit within a school's specific learning goals and overall curriculum on health disparities.