Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Learning Objectives: To evaluate the effect of an Experiential Social Medicine Curriculum on residents’ attitudes, perceived responsibility and competence towards vulnerable populations.

Introduction: Social Medicine (SM) is an emerging field that includes the study of the social determinants of health. Despite widespread acknowledgement of its influence in patient care, SM is underemphasized in graduate medical education. Attempts to incorporate SM into residency curricula have shown promising results, though the impact of SM curricula on emergency medicine (EM) residents remains unclear.

Objective: We developed a experiential SM elective for residents and evaluated the impact of the curriculum on residents’ attitudes toward and care of vulnerable populations.

Curricular Design: In 2018-2019, all residents at our EM Residency Program were invited to participate in a two-week SM experiential elective focused on patients experiencing substance use disorders, experiencing homelessness, seen at the border health clinic, seeking asylum, facing primary care access barriers, involved in the Violence Intervention Program (VIP) at our hospital, or involved with the carceral system. Experiences and didactic material were coordinated with community-based organizations. Results: Residents were invited to complete a voluntary, anonymous post-rotation electronic survey exploring changes in their attitudes and competence. Of the thirty-eight residents who participated, twenty-two responded to the survey (58%). No responses were submitted for the elective involving patients experiencing substance use disorders. Overall, participants reported increased understanding and empathy, perceived responsibility, and perceived competence towards working with vulnerable populations after their elective (Table 1).

Impact: Our experiential SM Curriculum positively impacted residents’ attitudes and informed their care of vulnerable populations. Given the pervasive impact of the social determinants of health in the practice of emergency medicine, it may be useful for residency program leaders to integrate experiential electives into existing residency curricula.