Teaching students to identify and document social determinants of health

Abstract

Purpose

Social determinants of health (SDH) are responsible for significant health disparities, morbidity and mortality. It is important to acculturate trainees to identify and document SDH. This can elevate their perceptions related to the importance and relevance of SDH. Documentation can encourage trainees to see SDH as factors which medical providers should address.

Patients and methods

Researchers devised a novel approach to demonstrate the value of SDH to undergraduate medical students. Proprietary diagnostic codes for SDH and procedure codes for action taken to address them, were developed. Students were encouraged to log these into electronic records for clinical encounters. Students’ voluntary use of these codes was evaluated. Additionally, students were surveyed on their familiarity with the concept of SDH, their perceptions of the importance of SDH, as well as documenting SDH, twice in the study period, and results were compared. In their second year of use, proprietary codes were compared to newly available SDH related ICD-10 codes.

Results

Students utilized proprietary codes more often than SDH related ICD-10 codes. Over 20,000 codes were logged. Comparison of survey items showed modest increases in students’ positive perception about the role of SDH in patient health.

Conclusion

Students’ voluntary logging of SDH codes demonstrates they perceived these factors to be important and relevant to patient encounters. Future analyses will examine students’ knowledge, attitudes, beliefs and practice patterns related to SDH.

Keywords:

• social determinants of health
• medical education
• constructivist learning
• electronic health record

Acknowledgments

Authors would like to acknowledge Helen Hill, DO, MPH for her inspiration for this work.

Disclosure

The authors reports no conflicts of interest in this work.