750 - A Residency Curriculum to Support Integration of Social Care into Health Care

Publication Number: 3726.750

Rachel Berman, The Children's Hospital at Montefiore, Bronx, NY, United States; Erin J. Goss, Albert Einstein College of Medicine, New York, NY, United States; Sandra F.. Braganza, The Children's Hospital at Montefiore Einstein, Blauvelt, NY, United States; Iman Hassan, Montefiore Medical Center, Bronx, NY, United States; Emily Buttigieg, Albert Einstein College of Medicine, Bronx, NY, United States; zoon Naqvi, Albert Einstein College of Medicine, North Brunswick, NJ, United States; Manaslu Gurung, The Children's Hospital at Montefiore, Astoria, NY, United States; Victoria Gorski, Montefiore Medical Center, Bronx, NY, United States

Background: The National Academy of Sciences, Engineering, and Medicine (NASEM) identifies five activities (Awareness, Adjustment, Assistance, Alignment, and Advocacy) to facilitate the integration of social care into health care and urges training programs to develop standardized, effective teaching and evaluation methods on social and structural drivers of health (SSDOH). As an interdisciplinary team of physicians in Pediatrics, Family Medicine, Internal Medicine, and Obstetrics/Gynecology, we identified four key curricular topics based on a Delphi survey of experts in social care integration and on faculty and resident feedback. We developed the following corresponding teaching sessions: Background of SSDOH (Awareness), Addressing SSDOH in Clinical Settings (Assistance), HRSN Through a Trauma-Informed Lens (Adjustment), and Physician Advocacy (Advocacy).

Objective: To evaluate the impact of a unified residency curriculum on the integration of social care into health care on resident knowledge about SSDOH, using the NASEM 5A framework.

Design/Methods: The curriculum was delivered to residents in Pediatrics, Family Medicine, Internal Medicine, and Obstetrics/Gynecology in a hospital system with routine HRSN screening and access to community health workers. Before and after receiving the curriculum, residents were asked to complete an 11-item knowledge assessment based on at least one of three cases (child, adult female, adult male) (Table 1). Scores were calculated as the percentage of correct responses, and pre- and post-test scores were compared using independent samples t-tests. Effect sizes were calculated to assess the magnitude of differences. Reliability was measured with Cronbach's α.

Results: A total of 75 pre-test cases and 142 post-test cases were completed by residents in all four specialties. Mean scores increased from 59.4% at baseline to 68.5% post-curriculum. This 9.1% gain represented significant improvement (Table 2).

Conclusion(s): Our curriculum successfully increased residents' knowledge about SSDOH and addressing HRSN in a clinical setting. Future opportunities exist to adapt our curriculum for learners at different levels of training, in other specialties, and in other geographic locations.

Table 1: Case-Based Knowledge Assessment
Answers were multiple-choice responses.

Table 2: Knowledge Assessment Results