Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities.
Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities.
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DOI：
10.15766/mep_2374-8265.10888
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发表时间：
2020-03-13
影响因子：
--
通讯作者：
Nelson, Nicholas
中科院分区：
文献类型：
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作者：
Neff, Joshua;Holmes, Seth M;Nelson, Nicholas
简介：关于健康和保健方面的差距的研究表明，社会、经济和政治因素是健康状况不佳的主要驱动因素。然而，这种结构性力量在卫生和保健方面的作用并没有均衡地纳入医疗培训。结构能力的框架提供了一个范例，为培训卫生专业人员认识和应对上游的影响，结构因素对患者的健康和healthcare.Methods：我们报告了一个简短的，跨专业的结构能力课程，在32个不同的情况下，2015年和2017年之间在整个旧金山弗朗西斯科湾区。在与医学和跨专业教育专家协商后，我们开发了开放式的书面反馈调查，以定性评估该课程对参与者的影响。通过定向主题分析，编码语言，和概念，以确定关键themes.Results：三个核心主题出现从参与者的评论分析的定性数据进行了分析。首先，参与者重视课程的重点是在现实世界的临床，社区和政策背景下的结构能力框架的应用。第二，有临床经验的参与者（居民，研究员和教师）报告说，课程帮助他们重新构建他们如何看待病人。第三，与会者报告的感觉重新连接到他们原来的动机进入health professions.Discussion：这结构能力课程填补了卫生专业教育的空白，通过装备学习者了解和应对的作用，社会，经济和政治结构因素在病人和社区健康。
Introduction: Research on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on patient health and health care.Methods: We report on a brief, interprofessional structural competency curriculum implemented in 32 distinct instances between 2015 and 2017 throughout the San Francisco Bay Area. In consultation with medical and interprofessional education experts, we developed open-ended, written-response surveys to qualitatively evaluate this curriculum's impact on participants. Qualitative data from 15 iterations were analyzed via directed thematic analysis, coding language, and concepts to identify key themes.Results: Three core themes emerged from analysis of participants' comments. First, participants valued the curriculum's focus on the application of the structural competency framework in real-world clinical, community, and policy contexts. Second, participants with clinical experience (residents, fellows, and faculty) reported that the curriculum helped them reframe how they thought about patients. Third, participants reported feeling reconnected to their original motivations for entering the health professions.Discussion: This structural competency curriculum fills a gap in health professional education by equipping learners to understand and respond to the role that social, economic, and political structural factors play in patient and community health.