Can non-clinical community placements enhance medical students' understanding of the social determinants of ill health?

Abstract

Objectives: Teaching the social determinants of health using classroom methods and medical settings is not effectual, yet few institutions require students to undertake placements in non-clinical settings. We sought to understand through qualitative investigation how non-clinical community placements contributed to students' understanding of health disparities.

Study design: Qualitative methods.

Methods: Semistructured interviews with eight purposively selected students and a focus group were conducted by an independent, non-medical and non-religiously affiliated researcher. A thematic analysis elicited key themes and findings.

Results: On analysis, students valued the placements, reporting a greater understanding of and empathy for the needs of people from marginalised socio-economic, cultural and ethnic groups. Some believed this was better gained in non-clinical settings where doctor-patient barriers were absent.

Conclusions: Non-clinical community placements may provide a special opportunity to teach health determinants and cultural competence to medical students.

Keywords: Cultural competence; Medical education; Medical student placements; Non-clinical placements; Social determinants.