Curriculum Development by Design Thinking: Analyzing a Program for Social Determinants of Health Screening by Pre-Clerkship Medical Students.

PROBLEM: Health systems science (HSS) curricula in medical schools facilitate an understanding of social determinants of health (SDOH) and their impact on health outcomes. After implementation of an experiential, patient-centered program based around SDOH screening, however, our medical college noted poor student receptivity and engagement. In order to improve the program, we chose a design thinking approach based on the perceived value of actively engaging learners in the design of education. The role of design thinking in curricular quality improvement, however, remains unclear. INTERVENTION: We sought to determine if a current educational model for SDOH screening could be improved by reforming the curriculum using a design thinking workshop involving student and faculty stakeholders. CONTEXT: The current study is a retrospective analysis of first-year medical student, end-of-year evaluations of the Clinical Experience (CE) program at the Sidney Kimmel Medical College before (2018-19) and after (2019-20) implementation of the design thinking workshop and subsequent curriculum changes. IMPACT: Overall positive results significantly increased across all survey questions after the curricular intervention (p < 0.01), indicating increased student satisfaction with the revised curriculum. LESSONS LEARNED: Few studies assess outcomes of design thinking-driven curricular changes. The current study of an SDOH screening program details the implementation of initiatives that originated from a design thinking sprint and assesses program evaluations following these curricular changes. Most of the well-received curricular changes concerned improvements in student training, patient screening and follow-up, and the leveraging of existing technology. The study reinforces the importance of co-creation among stakeholders when redesigning medical curricula.

Virtual Community Health Workers: Approaches to Patient Outreach During the COVID-19 Pandemic.

BACKGROUND: Prior to the COVID-19 pandemic, community health workers (CHWs) in our health system screened patients in-person for social determinants of health and connected them to community resources. However, when our CHWs were required to work remotely from home due to the pandemic, the best platform to optimize contacting these patients was unknown. This study sought to evaluate the effectiveness of three outgoing phone call approaches (*67, Google Voice®, and Doximity Dialer®) in successfully contacting patients. METHODS: We performed a retrospective analysis comparing reach rates across the three outgoing call approaches. RESULTS: Reach rates were highest when Doximity Dialer was used (64.0%, 95% CI: 58.8-69.0) compared with *67 (40.8%, 95% CI: 30.8-51.6) or Google Voice (53.2%, 95% CI: 48.4-57.8) in this analysis of 1,144 outreach calls. CONCLUSION: Due to higher reach rates, we recommend Doximity Dialer for phone-based outreach to patients. Additional research to improve the efficacy of remote outreach is warranted.