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Using simulation to increase resident comfort discussing social determinants of health.

Authors :
Morrison JM
Marsicek SM
Hopkins AM
Dudas RA
Collins KR
Source :
BMC medical education [BMC Med Educ] 2021 Dec 06; Vol. 21 (1), pp. 601. Date of Electronic Publication: 2021 Dec 06.
Publication Year :
2021

Abstract

Background: Social determinants of health (SDoH) play an important role in pediatric health outcomes. Trainees receive little to no training on how to identify, discuss and counsel families in a clinical setting. The aim of this study was to determine if a simulation-based SDoH training activity would improve pediatric resident comfort with these skills.<br />Methods: We performed a prospective study of a curricular intervention involving simulation cases utilizing standardized patients focused on four social determinants (food insecurity, housing insecurity, barriers to accessing care, and adverse childhood experiences [ACEs]). Residents reported confidence levels with discussing each SDoH and satisfaction with the activity in a retrospective pre-post survey with five-point Likert style questions. Select residents were surveyed again 9-12 months after participation.<br />Results: 85% (33/39) of residents expressed satisfaction with the simulation activity. More residents expressed comfort discussing each SDoH after the activity (Δ% 38-47%; all p < .05), with the greatest effect noted in post-graduate-year-1 (PGY-1) participants. Improvements in comfort were sustained longitudinally during the academic year. More PGY-1 participants reported engaging in ≥ 2 conversations in a clinical setting related to food insecurity (43% vs. 5%; p = .04) and ACEs (71% vs. 20%; p = .02).<br />Discussion: Simulation led to an increased resident comfort with discussing SDoH in a clinical setting. The greatest benefit from such a curriculum is likely realized early in training. Future efforts should investigate if exposure to the simulations and increased comfort level with each topic correlate with increased likelihood to engage in these conversations in the clinical setting.<br /> (© 2021. The Author(s).)

Details

Language :
English
ISSN :
1472-6920
Volume :
21
Issue :
1
Database :
MEDLINE
Journal :
BMC medical education
Publication Type :
Academic Journal
Accession number :
34872529
Full Text :
https://doi.org/10.1186/s12909-021-03044-5