Optimizing allocation of curricular content across the Undergraduate & Graduate Medical Education Continuum

Samara B Ginzburg; Margaret M Hayes; Brittany L Ranchoff; Eva Aagaard; Katharyn M Atkins; Michelle Barnes; Jennifer B Soep; Andrew C Yacht; Erik K Alexander; Richard M Schwartzstein

doi:10.1186/s12909-022-03489-2

Optimizing allocation of curricular content across the Undergraduate & Graduate Medical Education Continuum

BMC Med Educ. 2022 Jun 2;22(1):425. doi: 10.1186/s12909-022-03489-2.

Authors

Samara B Ginzburg^#¹, Margaret M Hayes^#^{2

3}, Brittany L Ranchoff^{4

5}, Eva Aagaard⁶, Katharyn M Atkins^{3

4}, Michelle Barnes⁷, Jennifer B Soep⁸, Andrew C Yacht⁹, Erik K Alexander¹⁰, Richard M Schwartzstein^{11

12}

Affiliations

¹ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. samara.ginzburg@hofstra.edu.
² Medical Intensive Care Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA.
³ Harvard Medical School in Boston, Boston, MA, USA.
⁴ Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁵ University of Massachusetts, Amherst, MA, USA.
⁶ Washington University School of Medicine, St. Louis, MO, USA.
⁷ Clinical pediatrics and internal medicine University of Illinois College of Medicine, Chicago, IL, USA.
⁸ University of Colorado School of Medicine, Aurora, CO, USA.
⁹ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
¹⁰ Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
¹¹ Medicine and Medical Education, Harvard Medical School, Boston, MA, USA.
¹² Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

^# Contributed equally.

Abstract

Background: Medical educators struggle to incorporate socio-cultural topics into crowded curricula. The "continuum of learning" includes undergraduate and graduate medical education. Utilizing an exemplar socio-cultural topic, we studied the feasibility of achieving expert consensus among two groups of faculty (experts in medical education and experts in social determinants of health) on which aspects of the topic could be taught during undergraduate versus graduate medical education.

Methods: A modified Delphi method was used to generate expert consensus on which learning objectives of social determinants of health are best taught at each stage of medical education. Delphi respondents included experts in medical education or social determinants of health. A survey was created using nationally published criteria for social determinants of health learning objectives. Respondents were asked 1) which learning objectives were necessary for every physician (irrespective of specialty) to develop competence upon completion of medical training and 2) when the learning objective should be taught. Respondents were also asked an open-ended question on how they made the determination of when in the medical education continuum the learning objective should be taught.

Results: 26 out of 55 experts (13 social determinants of health and 13 education experts) responded to all 3 Delphi rounds. Experts evaluated a total of 49 learning objectives and were able to achieve consensus for at least one of the two research questions for 45 of 49 (92%) learning objectives. 50% more learning objectives reached consensus for inclusion in undergraduate (n = 21) versus graduate medical education (n = 14).

Conclusions: A modified Delphi technique demonstrated that experts could identify key learning objectives of social determinants of health needed by all physicians and allocate content along the undergraduate and graduate medical education continuum. This approach could serve as a model for similar socio-cultural content. Future work should employ a qualitative approach to capture principles utilized by experts when making these decisions.

Keywords: Continuum of education; Curriculum; Social determinants of health.

MeSH terms

Consensus
Curriculum
Delphi Technique
Education, Medical, Graduate
Education, Medical, Undergraduate* / methods
Humans