A Curated Curriculum Collection to Support Social Determinants of Health Education for the Health Professions

INTRODUCTION

Social determinants of health (SDOH) are defined as the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.¹ The World Health Organization states that “addressing [social determinants of health] appropriately is fundamental for improving health and reducing long-standing inequities in health, which requires action by all sectors and civil society.”¹ This recommendation emphasizes the importance of preparing the next generation of health care professionals to address the social determinants of their patients. The Liaison Committee on Medical Education, the American College of Graduate Medical Education, and the Accreditation Review Commission on Education for the Physician Assistant require that curricula include education about SDOH.^2-4 At the time these requirements were introduced, however, health professions educators lacked guidance or best practices on how to develop a SDOH curriculum.

The National Collaborative for Education to Address the Social Determinants of Health (NCEAS) was established at Northwestern University’s Feinberg School of Medicine in 2016. Since its inception, NCEAS has worked to accelerate the spread of innovative approaches to health professions’ education and to advance learners’ ability to identify, understand, and address SDOH, and better prepare the health care workforce to advance health equity. NCEAS is a program funded by the Health Resources and Services Administration whose mission includes studying and disseminating health professions curricula and programs that develop learner competency in addressing SDOH, population health, and promotion of health care equity. Over the past 6 years, the NCEAS team has developed several dissemination venues to help address SDOH in medical education. These include an annual national conference and monthly webinars and blogs, but arguably the most valuable has been the formation of the online Curriculum Collection (https://sdoheducation.org/curriculum-collection/).

DEVELOPMENT AND CURATION

Launched in 2018, the Curriculum Collection is an indexed database of curricula and assessment materials (including courses, simulations, cases, and experimental learning opportunities) ready for health professions educators to implement. This collection addresses major subject areas of SDOH and is relevant to a broad spectrum of audiences. The Curriculum Collection is currently home to more than 200 resources. This wide array of educational resources focusing on SDOH is indexed and searchable by topic, intended learner type, delivery mode, year published, and other characteristics.

New resources are added to the collection on an ongoing basis after a collaborative review process. Over the past 5 years, the review team has included 8 to 10 health care professionals. Each team member reviews 5 to 10 resources a month using a questionnaire through RedCap (Vanderbilt University) that was created by the group in the early stages of the collection. We meet monthly to discuss the reviews and decide as a group if the resource should be included in the collection. Potential resources have been either curated from existing repositories online (eg, MedEdPORTAL, PubMed) or submitted directly by authors through an online portal.

The NCEAS team members review candidate resources to assess the quality, timeliness, and relevance to 1 or more SDOH topics. Each resource is also annotated with an assessment of its strengths and areas for improvement, and indexed with searchable terms including learner discipline, level, and the specific topic within the SDOH field. Content is of particular relevance to medical, nursing, physician assistant, and dental students, residents, fellows, and clinicians in practice seeking continuing education in this area. The Curriculum Collection is available on a website (https://sdoheducation.org/curriculum-collection/) that also provides general resources on education, practice, or policy related to SDOH.

EXPANSION AND DISSEMINATION

The NCEAS continues to curate and evaluate SDOH curricula and resources to add to the existing web-based Curriculum Collection. Along with reviewing new resources, current activities include re-reviewing existing content to ensure that the posted collection continues to be representative of the NCEAS mission statement, the resources are free from bias, and outdated material is retired. NCEAS team members are also actively curating resources on systematic racism to help inform current educational practice.

A recent review of website analytics shows evidence of increasing dissemination with both national and international reach. Over the last 4 years, 25,924 users from 164 countries have visited the collection website. The most viewed resources in the Curriculum Collection are the resources under the SDOH topic of antiracism. We have also seen a slight uptick in submissions to our Curriculum Collection. This year, we have received 4 submissions so far, in comparison to the past 2 years, during which we received only 1 or 2 submissions each year.

CONCLUSION

We undertook development and curation of the Curriculum Collection resource to fill identified gaps in training related to SDOH in the health professions.^5,6 Educators working in health professions education at any level, including undergraduate and graduate medicine, nursing, pharmacy, continuing education, and other fields, may find these resources relevant to their educational work. This platform also serves as a way to disseminate high-quality curricula and assessments to support others working in this field.