Structural Competency of Pre-health Students: Can a Single Course Lead to Meaningful Change?
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ORIGINAL RESEARCH
Structural Competency of Pre-health Students: Can a Single Course Lead to Meaningful Change? Alissa Ruth 1
&
Cindi SturtzSreetharan 1 & Alexandra Brewis 1 & Amber Wutich 1
# International Association of Medical Science Educators 2020
Abstract Scholars within the medical sciences recently have called on undergraduate educators to incorporate the social sciences in order to teach pre-health students structural competencies – or the ability to articulate how social structures produce racial, ethnic, gender, class, and other disparities – in order to better serve these populations medically. Authors used a semester-long course to assess how experiential learning focused on the topic of structural inequities improves structural competency. In Fall 2018, 27 students completed a hands-on, experiential, course focused on structural factors and health disparities. The authors conducted a mixed-methods, pre-/post-test design to solicit data on students’ views on the reasons for high rates of obesity, gender pay disparities, and racial/ethnic housing segregation. Using systematic qualitative data analysis and statistical analysis of coded answers, the authors were able to detect pre-/post-test differences in the number of times students identified structural reasons for the disparities. Statistical analysis showed that students were able to identify an average of 4.63 structural reasons at pre-test, and that increased to 5.93 reasons at post-test (statically significant (p = 0.007)), indicating an increase in structural awareness after participation in the course. Qualitative analysis, using systematic methods of coding and a modified constant comparison method, demonstrated that students’ ability to articulate structural reasons for inequality greatly improved. This experiential learning course, while relatively short, was found to increase students’ ability to identify structural factors and articulate them with deeper understandings. Future curriculum development should consider incorporating experiential learning to promote structural competency, rather than a more traditional passive, content-delivery method of training. Keywords Structural competencies . Pre-health . Experiential learning . Curriculum development
There is an increasing call for new, effective, and replicable approaches that emphasize “structural competency” in medical and health training [1–5] (see also https://structuralcompetency.org/). The approach aims to increase awareness of the effects of high and low power and privilege within social structures that produce inequalities – such as those enacted in policies, economic systems, and sociopolitical institutions [6, 7]. People experience these inequities because of their place within complex social hierarchies, usually at the intersection of factors such as class, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40670-019-00909-9) contains supplementary material, which is available to authorized users. * Alissa Ruth [email protected]
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