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Updated: Oct 27, 2025

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

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Building structural competency through community engagement.

Rohan Khazanchi¹, Heidi Keeler^2,3, Sheritta Strong⁴

¹College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

The Clinical Teacher

|July 19, 2021

Summary

This summary is machine-generated.

This study developed a community-engaged curriculum to teach medical students about social determinants of health (SDOH) and structural inequities. Findings show community partnerships are vital for understanding health disparities and training future physicians.

Keywords:

community engagement community-based medical education (CBME)community-based participatory research (CBPR)social determinants of health (SDOH)structural competency undergraduate medical education (UME)

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Area of Science:

Medical Education
Public Health
Sociology

Background:

Current medical education often inadequately addresses the root causes of health inequities.
Community-engaged pedagogy and structural competency offer frameworks to move beyond passive learning about social determinants of health (SDOH).
These approaches emphasize direct discussion of systemic causes of health inequity through partnerships with marginalized communities.

Purpose of the Study:

To describe the development and evaluation of a community-engaged structural competency curriculum at the University of Nebraska Medical Center.
To explore the impact of sociopolitical structures on local health inequities through this curriculum.
To assess the effectiveness of a collaborative, community-involved approach to medical education on SDOH.

Main Methods:

A community-engaged structural competency curriculum was developed and implemented.
Inductive thematic analysis was used to analyze free-text responses from a post-curriculum survey.
The curriculum involved university, health system, and community stakeholders, including first-year medical students and community members.

Main Results:

The pilot involved 132 first-year medical students, 11 facilitators, and 18 community stakeholders.
Survey analysis revealed a strong desire for community-engaged teaching methods.
Participants recognized the value of a hyperlocal focus and incorporating community members' lived experiences.

Conclusions:

Co-created curricula involving university and community coalitions are essential for fostering a critical understanding of historical inequities and current health disparities.
Community partnerships are crucial for effective medical education on social determinants of health.
Reciprocal partnerships between communities and academic institutions can enhance the training of future physicians.