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Accounting for agency in structural competency.

Peter S Cahn1

  • 1Department of Health Professions Education, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, United States of America. pcahn@mghihp.edu.

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Summary
This summary is machine-generated.

Structural competency training can overwhelm health professionals. This paper argues that by understanding how societal structures are human-made, professionals can challenge harmful norms within their local environments to promote health.

Keywords:
AgencyHealth equityHealth professions educationPowerStructural competency

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Area of Science:

  • Health Professions Education
  • Sociology
  • Public Health

Background:

  • Structural competency highlights how societal factors impact health outcomes.
  • Current curricula can overwhelm health professionals with the scale of health problems.
  • Existing frameworks may not adequately address the role of individual agency.

Purpose of the Study:

  • To re-center individual agency within structural competency frameworks.
  • To explore how health professionals can intervene in local power structures.
  • To provide accessible targets for action in health professions education and practice.

Main Methods:

  • Draws on sociological theories (Giddens, Bourdieu, Foucault) on structure and agency.
  • Analyzes the internalization of societal rules and self-discipline.
  • Examines intervention points within learning and clinical environments.

Main Results:

  • Structures are human-made and can be challenged at local levels.
  • Health professionals can intervene in local sites of power to interrupt harmful structures.
  • Contesting norms within education and clinical settings offers accessible action targets.

Conclusions:

  • Reintegrating agency into structural competency empowers health professionals.
  • Interventions at the micro-level of practice and education are feasible and impactful.
  • Challenging local norms can disrupt health-harming structures and promote health equity.