Journal of graduate medical education · 2017
The Impact of "See the City You Serve" Field Trip: An Educational Tool for Teaching Social Determinants of Health.
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Chang Aileen Y, Bass Tracie L, Duwell Monique, Berger Jeffrey S, Bangalore Raksha, Lee Nancy S, Amdur Richard L, Andrews Marcus, Fahnestock Esme, Kahsay Lamek, El-Bayoumi Jehan
Аннотация
BACKGROUND: There has been limited evaluation of tools for teaching social determinants of health (SDOH).
OBJECTIVE: We evaluated a field trip as a tool for teaching SDOH to incoming medical interns.
METHODS: Incoming interns from The George Washington University participated in a bus field trip of Washington, DC, guided by community partners. The field trip introduced trainees to local neighborhoods. Pre- and postactivity surveys developed by the authors were analyzed using a Wilcoxon signed rank test. Reflection responses were recorded and counted for recurrent themes.
RESULTS: Incoming interns participated in 2015 (85 of 90, 94%) and in 2016 (96 of 116, 83%). Postactivity, basic knowledge of DC geographic health disparities increased, and a greater percentage of interns reported being at least somewhat comfortable understanding the neighborhoods from which their patients come (2015: 58% versus 89%, P < .0001; 2016: 65% versus 88%, P < .0001); identifying challenges to health care that affect low-income patients (2015: 74% versus 90%, P < .0023); describing community resources (2015: 29% versus 67%, P < .0001; 2016: 29% versus 50%, P < .0001); and referring patients to local community resources (2015: 25% versus 64%, P < .0001; 2016: 36% versus 52%, P < .0001). Interns reported that this experience improved their understanding of patients' background and local resources, and that they would change the way they practice.
CONCLUSIONS: A bus field trip guided by community partners is a feasible way to increase residents' perception of their understanding of local disparities and comfort in addressing SDOH.
OBJECTIVE: We evaluated a field trip as a tool for teaching SDOH to incoming medical interns.
METHODS: Incoming interns from The George Washington University participated in a bus field trip of Washington, DC, guided by community partners. The field trip introduced trainees to local neighborhoods. Pre- and postactivity surveys developed by the authors were analyzed using a Wilcoxon signed rank test. Reflection responses were recorded and counted for recurrent themes.
RESULTS: Incoming interns participated in 2015 (85 of 90, 94%) and in 2016 (96 of 116, 83%). Postactivity, basic knowledge of DC geographic health disparities increased, and a greater percentage of interns reported being at least somewhat comfortable understanding the neighborhoods from which their patients come (2015: 58% versus 89%, P < .0001; 2016: 65% versus 88%, P < .0001); identifying challenges to health care that affect low-income patients (2015: 74% versus 90%, P < .0023); describing community resources (2015: 29% versus 67%, P < .0001; 2016: 29% versus 50%, P < .0001); and referring patients to local community resources (2015: 25% versus 64%, P < .0001; 2016: 36% versus 52%, P < .0001). Interns reported that this experience improved their understanding of patients' background and local resources, and that they would change the way they practice.
CONCLUSIONS: A bus field trip guided by community partners is a feasible way to increase residents' perception of their understanding of local disparities and comfort in addressing SDOH.