Improving Medical Students' Skills to Address Social Determinants of Health during the Internal Medicine Clerkship

Abstract

We developed a quality improvement educational experience to equip third-year medical students (MS3) with tools to address social determinants of health (SDOH) during their internal medicine clerkship. Students used THRIVE, Boston Medical Center's SDOH screening tool and resource referral platform, to screen patients for social needs and provide them with information on resources. We evaluated changes in students' knowledge, attitudes, confidence, and practices in regard to addressing SDOH. Feasibility and acceptability of the experience were also evaluated. Analysis of pre-and post-experience surveys revealed improvement in MS3 confidence providing resources to help patients address SDOH (p<.001, n=41). Of all MS3 (n=158), 63% accessed the THRIVE Directory, and 45% successfully utilized it to print or e-mail resources. One MS3 focus group revealed challenges and time constraints faced by students. While benefits were identified, simplification of the workflow is needed to improve the feasibility and acceptability of the experience.