Metrics details. The school has an active learning curriculum partially conducted through a small group modified problem-based-learning entitled Patient Presentation Problem-based-learning Curriculum PPPC. This course includes a Monday discussion of a patient case and a Friday small group session includes concept mapping of the week's basic, clinical, and health systems science HSS content.
We reviewed group concept maps from 7 pre-clerkship courses. There were an average of We reviewed concept maps for inclusion of DoH icons and HSS content and followed the trend throughout each course of the pre-clerkship curriculum. DoH content was inconsistently present in group concept maps throughout the first three courses, increased towards the end of the first academic year, and then showed a steady decline towards the end of the pre-clerkship curriculum.
Students sometimes include DoH on their concept maps and this improves from the first three courses towards the end of the first academic year. However, students do not prioritize inclusion of DoH in their concept maps at the end of the pre-clerkship curriculum. HSS content is included in less than half of the concept maps in the first course, and then is not included in any group concept maps for the remainder of the curriculum.
Providing feedback to students on inclusion of DoH and HSS in concept mapping may help improve this skill prior to the start of clerkships. Peer Review reports. The Determinants of Health DoH have a greater impact on health and well-being than the biological basis of disease and clinical care [ 1 , 2 ]. Training future physicians with the knowledge, skills, and attitudes to address all DoH is necessary in order to improve health outcomes, reduce disparities, and promote equity [ 2 , 3 ].
Few medical schools give the same longitudinal attention to DoH and health systems science thinking as they do the basic and clinical sciences [ 2 ]. Students give short shrift to learning about DoH and HSS for several reasons including lack of time, prioritization, faculty knowledge, as well as the fact that the impacts of DoH are not routinely taught [ 2 , 3 ]. Many of these concepts are not assessed on institutional and national board exams, and while recommended, are not required teaching subjects by accrediting bodies [ 2 ].
