The Impact of "See the City You Serve" Field Trip: An Educational Tool for Teaching Social Determinants of Health

• Published in: Journal of graduate medical education 2017-02, Vol.9 (1), p.118-122
• Main Authors: Chang, Aileen Y, Bass, Tracie L, Duwell, Monique, Berger, Jeffrey S, Bangalore, Raksha, Lee, Nancy S, Amdur, Richard L, Andrews, Marcus, Fahnestock, Esme, Kahsay, Lamek, El-Bayoumi, Jehan
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Cities; District of Columbia; Education, Medical, Graduate; Educational Innovation; Healthcare Disparities; Humans; Internship and Residency - methods; Poverty; Social Determinants of Health; Social Welfare; Surveys and Questionnaires
• ISSN: 1949-8349; 1949-8357
• DOI: 10.4300/JGME-D-16-00212.1

There has been limited evaluation of tools for teaching social determinants of health (SDOH). We evaluated a field trip as a tool for teaching SDOH to incoming medical interns. Incoming interns from The George Washington University participated in a bus field trip of Washington, DC, guided by community partners. The field trip introduced trainees to local neighborhoods. Pre- and postactivity surveys developed by the authors were analyzed using a Wilcoxon signed rank test. Reflection responses were recorded and counted for recurrent themes. Incoming interns participated in 2015 (85 of 90, 94%) and in 2016 (96 of 116, 83%). Postactivity, basic knowledge of DC geographic health disparities increased, and a greater percentage of interns reported being at least somewhat comfortable understanding the neighborhoods from which their patients come (2015: 58% versus 89%, < .0001; 2016: 65% versus 88%, < .0001); identifying challenges to health care that affect low-income patients (2015: 74% versus 90%, < .0023); describing community resources (2015: 29% versus 67%, < .0001; 2016: 29% versus 50%, < .0001); and referring patients to local community resources (2015: 25% versus 64%, < .0001; 2016: 36% versus 52%, < .0001). Interns reported that this experience improved their understanding of patients' background and local resources, and that they would change the way they practice. A bus field trip guided by community partners is a feasible way to increase residents' perception of their understanding of local disparities and comfort in addressing SDOH.