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Published on: February 16, 2011
Using Authentic Patient Narratives to Introduce Social Determinants of Health in Graduate Medical Education
Suman Pal1, Miranda Aragon2, Nancy Pandhi3
1is Associate Program Director, Internal Medicine Residency Program, University of Minnesota, Minneapolis, Minnesota, USA.
Background:
Residency orientation provides a unique opportunity to introduce an interdisciplinary group of resident physicians to locally relevant social determinants of health (SDOH).
Objective:
To compare residents' ability to address SDOH before and after an orientation workshop and describe the feasibility and acceptance of utilizing authentic patient narratives in teaching SDOH.
Methods:
All incoming residents at the University of New Mexico in 2 consecutive academic years (AY 2023-2024 and 2024-2025) participated in the workshop. Large group lectures complemented small-group case-based exercises on recognizing and addressing SDOH. In the second year, video excerpts of real patients narrating their experiences with health care were incorporated. A post-session survey measured self-reported ability to recognize and address SDOH.
Results:
One hundred seven of 164 (65%) residents in AY 2023-2024 and 91 of 173 (53%) residents in AY 2024-2025 completed the survey. Both sessions demonstrated statistically significant (P<.001) improvement in resident self-reported ability to: (1) recognize SDOH (pre- and post-workshop mean scores 8.32 [SD 1.17] vs 6.83 [SD 1.89] in AY 2023-2024; 8.67 [SD 1.06] vs 6.97 [SD 2.06] in AY 2024-2025), and (2) address SDOH (7.98 [SD 1.37] vs 6.32 [SD 1.96]; 8.48 [SD 1.28] vs 6.99 [SD 2.00]). Patient videos supported learning, demonstrated by an increase in effect size (Cohen's d 0.1 vs 1.04). Twelve to 18 hours were needed to develop workshop materials, with an additional 6.5 hours required for administrative and facilitator time.
Conclusions:
A workshop during graduate medical education orientation introducing SDOH using authentic patient narratives increased residents' self-reported ability to address SDOH specific to their new patient populations.
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