A Novel Social Emergency Medicine Curriculum: An Alternative to Lecture-Based Didactics
Abstract
Learning Objectives: We sought to create a Social EM rotation to improve residents’ understanding of structural vulnerability, health inequity, and social determinants of health and improve their ability to address barriers to care and social needs in the emergency department.
Introduction: Social determinants play an important role in patient health. While many Emergency Medicine (EM) residency programs agree that Social EM is an important component of education, few programs have formal curricula addressing Social EM. Social EM education varies widely from program to program.
Objective: We sought to create a Social EM rotation to meet the needs of EM residents. This rotation would allow dedicated time to learn Social Medicine skills and familiarize residents with hospital and community resources. The main objective is to improve residents’ understanding of structural vulnerability, health inequity, and social determinants of health and improve their ability to address barriers to care and social needs in the emergency department.
Curricular Design: We created a novel, two week Social Emergency Medicine rotation, exposing residents to a variety of Social Emergency Medicine concepts. Residents rotate with community organizations including a street medicine team, medication-assisted treatment clinics, a harm-reduction needle exchange, a medical asylum clinic, a food pharmacy, and a trauma recovery center. These activities are paired with didactics covering topics such as substance use disorder, immigration health, food insecurity, violence intervention, homelessness, incarceration, LGBTQA+ and gender identity, language equity, race and culture, financial insecurity, and healthcare access and coverage.
Impact/Effectiveness: Our novel Social EM rotation was successfully implemented. Five residents have completed the rotation. Residents reported increased knowledge about resources for housing, substance use, immigration rights, and food insecurity and also were more comfortable addressing gender diversity. Residents particularly valued performing asylum work in Tijuana and their street medicine experience. In the future, similar rotations can be implemented at other residency programs through partnerships with local organizations.