Developing an assessment and evaluation toolkit for social determinants of training in medical education and physician assistant education

While it is clearly established that the social determinants of health (SDH) have a large influence on health outcomes and are more prevalent among racial/ethnic minorities and those living in socioeconomically deprived communities (1), best practices for preparing healthcare professionals to address social conditions remain inconclusive. In this project, we propose developing a comprehensive SDH curriculum assessment and evaluation toolkit that can be widely disseminated to medical and physician assistant (PA) training programs.

Project Summary

Learner assessment and evaluation of educational outcomes play an important role in medical education, and accreditation bodies expect that medical education prepares students for the labor force through development of relevant skills and competencies (2). Given the heterogeneity of social determinants of health training across medical education, there are few appropriate indicators of educational effectiveness of programs identified. This research project proposes developing a comprehensive and systematic approach to aligning criteria for SDOH education effectiveness with specific indicators of achievement by adapting to Kirkpatrick’s four level model of training criteria, an evaluation framework widely used in medical education (2, 3).

SDH Assessment & Evaluation

In the clinical setting, the care team includes health professionals from different disciplines working collaboratively to provide the highest level of care for the patient. In particular, the medical and PA care team is an important model in primary care. It is important that both medical students and PA students are trained to work together to identify and address SDH that impact their patients.

The NCEAS has conducted two scoping reviews assessing SDH training in both undergraduate medical education and primary care residency programs (internal, family and pediatric medicine) (4, 5). In primary care residencies, the results of the literature review demonstrated that there are considerable differences in the way programs throughout the United States teach residents about SDH. The variability in programs make it difficult to determine what best practices are in preparing the healthcare workforce to address SDOH in clinical care.

The purpose of this research is to develop an assessment and evaluation toolkit to widely disseminate to medical and PA training programs in order to objectively assess medical students’ and physician assistant students’ preparedness to address SDH in clinical care and to evaluate the effectiveness of these programs.

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Supporting Literature:

  1. World Health Organization. A conceptual framework for action on the social determinants of health. 2010.
  2. Praslova, L. (2010). Adaptation of Kirkpatrick’s four level model of training criteria to assessment of learning outcomes and program evaluation in higher education. Educational Assessment, Evaluation and Accountability, 22(3), 215-225.
  3. Kirkpatrick, D.L. (1959). Techniques for evaluating training programs. Journal of the American Society of Training Directors, 13, 3-9.
  4. Gard, L. A., Peterson, J., Miller, C., Ghosh, N., Youmans, Q., Didwania, A., … & Goel, M. S. (2019). Social Determinants of Health Training in US Primary Care Residency Programs: A Scoping Review. Academic Medicine, 94(1), 135-143.
  5. Doobay-Persaud, A., Adler, M. D., Bartell, T. R., Sheneman, N. E., Martinez, M. D., Mangold, K. A., … & Sheehan, K. M. (2018). Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review. Journal of general internal medicine, 1-11.

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