Articulating the canon: The sociology of medical education from 1980 to 2000.

An exciting development in the sociology of medical education has been its recent return as a distinct scholarly conversation in medical sociology. During the 1980s and 1990s, the sociology of medical education, an historically prominent subfield in sociology, seemed to disappear from the scholarly conversation despite ongoing development in this area. In this narrative review I describe this "missing period" of sociology of medical education, discussing complementary explanations for why it receded and describing what research activity did take place during those decades. In reviewing this work, I argue that articulating theoretical advances made within sociology of medical education research during these decades allows us to link foundational research from the 1950s and 1960s with the renaissance of this subfield in the early 2000s. Fundamentally, understanding the intellectual history and development of this subfield supports a broader movement to understand the import of studies of medical training for exploring questions of interest in general sociology.

Practical training in medical sociology "Analysis of social environments of living quarters". A field experiment during the COVID-19 pandemic.

Background: In the summer semester 2020, a new format was introduced at the Otto-von-Guericke-University Magdeburg for first-year medical students in the subject of medical sociology with a neighborhood-related social environment analysis. Didactic approach: Due to the COVID-19 pandemic, the didactic concept had to be changed at short notice from seminar group-related fieldwork in different districts of Magdeburg to individual work at the place of study or home, supplemented by accompanying online offers. The students were asked to characterize their neighborhood in terms of quality of life, health and illness as well as medical care by means of interviews with inhabitants of their immediate living environment, a neighborhood inspection with the taking of photographs and an analysis of official secondary data. The aim was to gain initial experience in scientific work (data collection, presentation and interpretation of results, as well as reporting). An evaluation of this new course and conclusions derived from it for its further development will be reported. Evaluation: 51 percent of the students participated in an evaluation of the course. The clear majority rated the internship as "good" or "very good". As a suggestion for improvement, the desire for optional supplementary individual counseling and better formal preparation for the performance assessments were expressed several times. Two thirds of those surveyed consider the online teaching format to be useful even in post-pandemic times.

Teaching sociology to undergraduate medical students.

Understanding the social basis of health and medicine and the contexts of clinical care are essential components of good medical practice. This includes the ways in which social factors such as class, ethnicity, and gender influence health outcomes and how people experience health, illness, and health care. In our Guide we describe what sociology is and what it brings to medicine, beginning with the nature of the "sociological imagination." Sociological theory and methods are reviewed to explain and illustrate the role of sociology in the context of undergraduate medical education. Reference is made to the 2016 report, A Core Curriculum for Sociology in UK Undergraduate Medical Education by Collett et al. Teaching and student learning are discussed in terms of organization and delivery, with an emphasis on practice. Sections are also included on assessment, evaluation, opportunities, and challenges and the value of a "community of practice" for sociology teachers in medical education.

Sociología médica: origen y campo de acción / Medical sociology: origin and field of action

RESUMEN Se hizo una revisión de la literatura publicada sobre el origen de la sociología médica y su campo de acción. Para ello, se analizaron diversas publicaciones y se resumieron los aspectos más relevantes. A pesar de que la enfermedad siempre ha estado ligada a aspectos socioculturales, recién a mediados del siglo XX, la medicina reconoce la importancia de la sociología en la explicación de temas relacionados a la salud, especialmente para explicar los determinantes sociales de la salud. En la actualidad, los sociólogos trabajan de manera multidisciplinaria con médicos para investigar y analizar cuestiones concernientes a la salud de las personas, para mejorar el bienestar y la calidad de vida de la población. En este sentido, el aporte de la sociología no solo ha enriquecido la comprensión de algunas enfermedades, sino también diferentes aspectos en el quehacer de la medicina.(AU)

ABSTRACT A review of the published literature on the origin of medical sociology and its field of action was made. For this, several publications were analyzed and the most relevant aspects were summarized. Although the concept of disease has always been linked to sociocultural aspects, only until the mid-twentieth century, Medicine recognized the importance of sociology to explain health-related issues, especially the social determinants of health. Currently, sociologists work in a multidisciplinary way with doctors to investigate and analyze issues concerning the health of people, to improve the welfare and quality of life of the population. In this sense, the contribution of Sociology has not only enriched the understanding of some diseases, but also different aspects of the work of Medicine.(AU)

The Gender Lens: Development of a learning aid to introduce gender medicine.

Background and aim: Gender medicine takes into account biological and social differences between men and women in terms of prevalence and course of disease, diagnosis and therapy. Medical students should be made aware of this in the early stages of medical education. However, there is hardly any teaching material currently available. This article presents the adaption and first use of the German "Gender Lens," a tool to introduce gender medicine to medical students. Method: The original Canadian "Gender Lens Tool" was translated into German, tested by (n=5) teachers and adapted based on current scientific concepts. The instrument was applied and evaluated using qualitative methods in a student focus group (n=4). It was then piloted in a cohort of fourth-semester students (n=247) in a seminar addressing gender medicine. These experiences were evaluated using quantitative methods. Results: The German translation of the Gender Lens offers students a framework with which to analyze sex and gender differences in terms of the "prevalence, diagnosis, course, therapy and prevention" of a specific disease. Furthermore, it enables a refined search for causes such as "biological disposition, attitudes and behaviors, family and social networks, occupational and material circumstances and experiences with the health care system." Recommendations were received from the student groups regarding teaching methods. Male and female fourth-semester students agreed that the Gender Lens is useful as an introduction to gender medicine. Discussion: Initial experiences with the Gender Lens adapted for the German curriculum suggest that such a learning aid can contribute to raising awareness of gender medicine in medical students.

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme.

BACKGROUND: The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. OBJECTIVE: As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. METHODS: SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. RESULTS: SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services remains mixed. CONCLUSIONS: SDH training is currently in short supply, and there is a clear role for INTREC to contribute to the training of a critical mass of African researchers on the topic. This work will be accomplished most effectively by building on pre-existing networks, institutions, and methods.

Implementation of Writing Across the Curriculum (WAC) learning approaches in social work and sociology gerontology courses.

This article describes the goals and methods of the international Writing Across the Curriculum (WAC) movement in higher education, and WAC-enriched learning approaches that the author used in teaching a social work gerontology practice course and a sociological theories of aging course. The author's in-class, low-stakes, nongraded writing assignments facilitated students' development of knowledge about gerontological practice and sociological theories, as well as analytical thinking. The assignments are influenced by WAC's perspective that when students write their reactions to information, their understanding and retention of information improves; that writing can facilitate the application of new content to students' own lives and interests; and that increased frequency of writing increases writing comfort and maintenance and can result in the improvement of writing skills. The students' reactions to the assignments have been very positive.

From sick role to practices of health and illness.

CONTEXT: Health care research generally, and medical education research specifically, make increasingly sophisticated use of social science methods, but these methods are often detached from the theories that are the substantive core of the social sciences. Enhanced understanding of theory is especially valuable for gaining a broader perspective on how issues in medical education reflect the social processes that contextualise them. METHODS: This article reviews five social science theories, emphasising their relevance to medical education, beginning with the emergence of the sociology of health and illness in the 1950s, with Talcott Parsons' concept of the 'sick role'. Four turning points since Parsons are then discussed with reference to the theory developed by, respectively, Harold Garfinkel, Michel Foucault and Pierre Bourdieu, and what is called the 'narrative or dialogical turn'. In considering these, the author argues for a theory-grounded research that relates specific problems to what Max Weber called the 'fate of our times'. CONCLUSIONS: The conclusion considers how medical education research can critique the reproduction of a discourse of scarcity in health care, rather than participating in this discourse and legitimating the disciplinary techniques that it renders self-evident.

Limits to social capital: comparing network assistance in two New Orleans neighborhoods devastated by Hurricane Katrina.

Sociological research emphasizes that personal networks offer social resources in times of need and that this capacity varies by the social position of those involved. Yet rarely are sociologists able to make direct comparisons of such inequalities. This study overcomes this methodological challenge by examining network activation among residents of two unequal neighborhoods severely devastated by Hurricane Katrina. Results indicate that local network capacities of Lower Ninth Ward residents relative to those of the more affluent Lakeview neighborhood dissipated before, during, and after the disaster to erode the life chances of individual residents and the neighborhood they once constituted.

Same-sex experience and mental health during the transition between adolescence and young adulthood.

Previous research has demonstrated that people who report same-sex experience tend to have poorer mental health than heterosexual people in adolescence and adulthood. Yet, little is known about how same-sex experience is associated with changes in mental health between the two life stages. Using data from the National Longitudinal Study of Adolescent Health (n = 12,056), this study assesses patterns of same-sex experience between adolescence and young adulthood and their consequences for changes in depressive symptoms, binge drinking, and drug use. Compared to people with no same-sex experience, those who report such experience only in adolescence show greater levels of mental health problems in adolescence, but they do not show any worse mental health changes during the transition into young adulthood. People who develop their first same-sex experience in young adulthood, however, tend to show worse changes, consistent with the argument that entry into a stigmatized role is psychologically harmful. Among females, those who report same-sex experience in both life stages also show worse mental health changes, indicating that the continuity in minority status contributes to their cumulative disadvantage. However, these differences are modest, and substantial amounts of variations in mental health changes are observed within each group. Findings are used to address the dynamic aspect of mental health disparity linked to sexuality.

Origins and canons: medicine and the history of sociology.

Differing accounts are conventionally given of the origins of medical sociology and its parent discipline sociology. These distinct "histories" are justified on the basis that the sociological founders were uninterested in medicine, mortality and disease. This article challenges these "constructions" of the past, proposing the theorization of health not as a "late development of sociology" but an integral part of its formation. Drawing on a selection of key sociological texts, it is argued that evidence of the founders' sustained interest in the infirmities of the individual, of mortality, and in medicine, have been expunged from the historical record through processes of "canonization" and "medicalization."

Sociologia, medicina e a construção da sociologia da saúde: [revisão] / Sociología, medicina y la construcción de la sociología de la salud: [revisión] / Sociology, medicine and the construction of health-related sociology: [review]

Partindo de artigo publicado em 1971 sobre a aproximação entre sociologia e medicina, no Brasil e Reino Unido, foi realizada atualização histórica, com o fim de refletir sobre novas conformações do ensino e pesquisa das ciências sociais e humanas no campo da saúde em ambos os países. A metodologia foi qualitativa, sendo a pesquisa desenvolvida com dados secundários e as reflexões elaboradas a partir da imersão dos autores na realidade brasileira e britânica. Concluiu-se que houve ampliação da interface entre a sociologia e a saúde, embora existam dificuldades antigas e persistentes em relação à estrutura e foco do sistema de saúde, poder na escola médica e cultura estudantil.

Starting from a paper about closing the gap between sociology and medicine in Brazil and the United Kingdom that was published in 1971, a historical update was made with the aim of reflecting on the new shapes of health-related teaching and research within the social and human sciences, in these two countries. The methodology was qualitative and the study was developed using secondary data. The reflections were developed through the authors' immersion in Brazilian and British realities. It was concluded that the interface between sociology and health has expanded, although persistent old difficulties exist in relation to the structure and focus of the healthcare system, medical school power and medical student culture.

Partiendo del artículo publicado en 1971 sobre la aproximación entre sociología y medicina, en Brasil y Reino Unido, fue realizada actualización histórica, con el fin de reflexionar sobre nuevas conformaciones de enseñanza y pesquisa de las ciencias sociales y humanas en el campo de la salud en ambos países. La metodología fue cualitativa, siendo la pesquisa desarrollada con datos secundarios y las reflexiones elaboradas a partir de la inmersión de los autores en la realidad brasilera y británica. Se concluyó que hubo ampliación de la interfase entre la sociología y la salud, a pesar d que existan dificultades antiguas y persistentes con relación a la estructura y foco del sistema de salud, poder en la escuela médica y cultura estudiantil.

Sociology, medicine and the construction of health-related sociology.

Starting from a paper about closing the gap between sociology and medicine in Brazil and the United Kingdom that was published in 1971, a historical update was made with the aim of reflecting on the new shapes of health-related teaching and research within the social and human sciences, in these two countries. The methodology was qualitative and the study was developed using secondary data. The reflections were developed through the authors' immersion in Brazilian and British realities. It was concluded that the interface between sociology and health has expanded, although persistent old difficulties exist in relation to the structure and focus of the healthcare system, medical school power and medical student culture.

Goffman: contribuições para a Sociologia da Saúde / Goffman: contributions to health sociology

Com uma obra que trouxe inegáveis contribuições, Goffman inovou a pesquisa etnográfica nos estudos socioantropológicos. Esta marca pode ser observada desde os seus primeiros trabalhos nos quais aborda a apresentação do self na vida diária, os manicômios, o estigma e são, por sinal, aqueles que mais referências receberam nos estudos sociais sobre a doença, instituições e práticas de saúde. Neste artigo são analisadas essas contribuições e a importância que tiveram para a construção da sociologia da saúde. O texto destaca alguns conceitos que se tornaram fundamentais para os estudos sociológicos da doença e do paciente, como carreira do paciente, instituição total, interação estratégica e organizações formais instrumentais.

Author of a work with undeniable contributions, Goffman brought innovation to ethnographic research in socio-anthropological studies. This characteristic may be already observed in his first works - where he approaches the presentation of 'self' in daily life, asylums, and stigma -, which are those more cited in social studies about the disease, institutions and health practices. This study analyzes these contributions and their importance for the development of the field of health sociology. The text highlights some concepts considered fundamental for sociological studies on the disease and the patient, such as the patient's career, the whole institution, the strategic interaction, and instrumental formal organizations.

Health and disease in context: a community-based social medicine curriculum.

Despite the increasing attention paid to the role of social forces in determining health, most physicians finish their training ill-prepared to address these issues. The authors describe their efforts to fill that training gap for internal medicine residents at Oregon Health and Science University through a community-based social medicine curriculum, designed in 2006 in conjunction with community partners at Central City Concern (CCC), an organization addressing homelessness, poverty, and addiction in downtown Portland, Oregon. The challenge was to develop a curriculum that would (1) fit within the scheduling constraints of an established categorical internal medicine residency program, (2) give all internal medicine residents a chance to better understand how social forces affect health, and (3) help show how they, as health professionals, might intervene to improve health and health care. The authors maintain that by developing this curriculum with community partners--who took the lead in deciding what residents should learn about their community and how they should learn it--the residency program is providing a relatively brief but extremely rich opportunity for residents to engage the personal, social, and health-related issues experienced by clients served by CCC. The authors first provide a brief overview of the curriculum and describe how the principles and practices of community-based participatory research were used in its development. They then discuss the challenges involved in teaching medical residents about social determinants of health, how their academic-community partnership approaches those challenges, and the recently established methods of evaluating the curriculum.