Breaking Barriers: An Innovation Approach to Teaching Social Determinants

Date of Review: October, 2018

This curriculum, from the Society of Teachers of Family Medicine resource library, is a multifaceted approach for first- year medical students to caring for patients for whom social determinants contribute to poorer health status. A well-annotated slide presentation focuses a great deal on insurance, the ACA, and adherence. It is focused on Missouri’s specific policies, but links are provided for other educators to learn about the policies in their own states. Small group activities consisting of multiple case studies and exercises focused on transportation and income inequality are included. A standardized patient case of a patient with difficulty affording medication for ulcerative colitis rounds out the resource. The resource is very clinically relevant for learners, and is up to date as of 2018. The notes on the slide presentation are extensive. For users outside Missouri, some significant adaptations would need to be made in order to present data about state Medicaid expansion and eligibility. Heather Heiman, MD, NCEAS

Corresponding Author’s Email:


University of Missouri

Where Was the Curriculum Implemented?

Columbia, MO

Source of the Curriculum/Resource:

Society of Teachers of Family Medicine website

Clinical Specialty:

Family and Community Medicine

Level of Learner Assessment:

Appreciation of content/attitude assessment (self reflection, blogging with rubric)

Demonstration of skill in a controlled environment (OSCE, Simulation)


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