ArticleJournal of medical education and curricular development
Bridging Classroom Learning and Clinical Practice: A Model for Teaching Structural Competency in the Clinical Learning Environment.
Article in Journal of medical education and curricular development. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Introduction: : Structural competency is essential for teaching health professional students about the social and structural drivers of health (SSDoH) before they enter practice. While some curricula exist, most are classroom-based, and studies suggest that students also seek opportunities to practice these skills in clinical settings with real patients. This curriculum was developed to provide these opportunities. Methods: : To address this, we developed the Structural Influence of Health Project, an innovative curriculum within the required third-year Family Medicine Clerkship on the Kansas City campus of the University of Kansas School of Medicine. The program combines didactic seminars, interprofessional home visits, and structured faculty-led debriefs, allowing students to apply structural competency in real-world clinical contexts. Medical students (n=125) completed pre- and post-surveys, and 90 students provided written responses on how to improve the training. This sample size was based on the students enrolled in the Family Medicine clerkship in the 2021-2022 academic year. Results: : After being exposed to the curriculum, the students showed a significantly improved ability to identify social and structural contributors affecting patients' health. Students reported experiential learning opportunities, such as patient home visits, as valuable for applying SSDoH concepts in real-world settings. They appreciated the inclusivity of the curriculum but suggested that it should be more patient- and community-centered. Many have advocated for a shift from problem identification to actionable solutions, with practical approaches integrated into clinical discussions. Expanding the curriculum to include topics such as gender-affirming care, rural health disparities, and insurance challenges was recommended. Future directions may include more deliberate faculty development to allow greater skill with these difficult topics.
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