Implementation of Educational Opportunities for Social Determinants of Health in Health Professions Education: A Scoping Review

Health professions programs have recently increased their efforts to educate health care professionals about the social determinants of health (SDH); however, there seems to be a disconnect between graduate medical education and its applicability to other peer health professions. The current scoping review aims to map the literature that explores the implementation of educational opportunities focused on SDH in health professions education programs. PubMed, CINAHL, ERIC, Education Source, and the Health Policy Reference Center were searched to identify relevant articles. To be included in our review, articles had to have been published in the last 5 years and describe how material related to SDH was implemented into a graduate health professions education program. Outcomes were analyzed by thematic categories by type of curricular delivery (didactic, clinical education, service-learning experience, or reflection), timing of the implementation in the program, methods of implementation, and assessment after implementation. Our search identified 2006 articles that were reviewed by study authors; 36 were included in our full-text review. Information extracted included the study design, type of graduate education, aims of the studies, description of technique, timing of implementation, type of curricular delivery, and outcomes. The majority (23, 63.9%) of studies used an observational design and used 2 or more (27, 75.0%) types of curricular delivery presented to medical students. Didactic (19, 52.8%) and small-group discussion (14, 38.9%) methods were used most often. Assessments were mostly student reflections or self-report items. Overall, students reported increased knowledge and satisfaction with activities. Results of our scoping review indicated that various education opportunities related to SDH exist in graduate health professions education but are likely insufficient. More studies are necessary to investigate the purposeful implementation of SDH and the best methods to assess student knowledge of SDH. Future research should also investigate how to objectively assess student learning of SDH.