Medicine and Society: An Innovative Approach to Training 21st Century Doctors( continued)
training opportunities and key people available on campus and in the larger community, offers a prime opportunity to develop coursework and significant research training that emphasizes CDU’ s vital mission.
“ This course is in alignment with CDU’ s focus and mission on serving the underserved by educating and cultivating diverse health professional leaders who are dedicated to social justice and health equity for underserved populations through outstanding education, research, clinical service, and community engagement,” Dr. George added.“ Our course covers all these key concepts highlighted in our mission. We hope that students that come out of our program are equipped with structural and cultural competencies to understand and address the social and cultural determinants of health that shape their patients’ lives. In this course, we have two ways that we are teaching students about how to be effective providers both inside and outside the clinical setting:
1. Case based learning – Through encounters with standardized patients who present with both medically and socially complex challenges, students learn to understand and address both the medical and the social factors that shape such patients’ health outcomes. They are guided on this journey by a pair of medical and community faculty members, who use the provided case materials to not only train students on how to build trust and communicate and care for such patients with cultural humility, but also consider the historical legacy of racism, other social determinants of health and health policies that have shaped patient experiences of health care.
2. Community Education Research Projects( CERP) focus on learning about place-based challenges and opportunities in South Los Angeles in the access and delivery of health care for health conditions that are prevalent in South LA from the perspective of multiple stakeholders. As a team, students learn both from the literature and from direct interaction with South LA stakeholders – patients / families, health care providers( i. e., not just physicians but also health care teams), CBOs, Churches, government officials, policy makers, and researchers. Through this type of community engagement, we hope that they can become more aware of the types of challenges and opportunities there are in communities to support health and healing for the patients they serve. the Social Determinants of Health and combating health disparities.“ The medical model tends to focus on illness at the individual patient level i. e., identifying the causes of presenting illnesses and treating patients to alleviate symptoms,” Dr. George continued.
“ But we have lots of evidence accumulated over decades about the importance of shifting from a biomedical model individual level focus to a public health model that incorporates social determinants of health at the patient levels as well as the communities where they live, work and play. A socioecological model is a great example of a way to think about how the relationship at the center between health care providers and patients are shaped by the concentric circles of family, community / neighborhood, social and political institutions, and policies. What we hope that students will receive from this course are cultural and structural competencies to be effective care providers with multicultural patients who often experience complex health care needs, living and working in under-resourced neighborhoods.
Participation in this course offers students something unique not experienced in other medical school programs.“ Cultural competency training is the norm in medical schools and residency programs and helps to instill cultural humility in a culturally diverse world. But this training, while important, does not equip future doctors to understand and address broader SDOH factors that shape their patients’ lives.
“ To cultural competency, we add structural competency training, which requires them to understand social structure as durable patterned arrangements. Such social structures include social and economic systems, that can produce and sustain health inequities. Using such structural and cultural competencies, our future physicians will understand the health-related behaviors of their patients in contextualized ways.
They will have the tools to understand how social institutions such as clinics, hospitals and health care systems are shaped by health policies, regulatory agencies, insurance plans and political, economic and religious institutions as well as racism, sexism and other such social forces. While the patients they treat will have the agency to choose how they react to these forces, our students will understand that their patients have to overcome many social barriers from health literacy and language barriers to financial, food and housing insecurities in order to successfully access health care and adhere to treatment plans.
The course also offers an innovative way of addressing
CDU College of Medicine | PG. 33