Christ Hospital / University of Cincinnati College of Medicine
Study objective: The purpose of the study is to explore the ways in which residents learn and reflect about the social determinants of health (SDH) after participating in single event community field experience.
Background: Residents are required to have training in SDH but there no known best practices to guide educators. Additionally, residents often have a different lived experience than the vulnerable patient population they serve. This gap in experience can inhibit residents from co-creating the best treatment plan tailored to the context of their patients’ lives.
Study design: Residents participated in a daylong field experience in the community, including taking photographs. Afterwards, they had a group discussion in which they shared their photographs, a process known as photovoice, and they wrote a reflection essay. Transcripts of the group discussion and essays were analyzed thematically to determine what and how residents learned. Nearly three years after the event, graduating residents were interviewed. These interviews were also qualitatively analyzed for maintenance of learning.
Conclusions: In addition to learning factual knowledge about SDH, community resources and barriers for patients, the vast majority of residents (95%) demonstrated deeper learning including self-awareness and experiential learning. While consistent global themes were noted in both types of reflection activities, the quantitative distribution of themes varied suggesting each reflection activity is important to learning in different ways. Maintenance of learning was inconclusive due a small number of participants. However, interviews suggest ongoing self-critique and continued plans to improve practice related to addressing SDH.
