Social determinants of health in emergency care: An analysis of student reflections on service-learning projects

Abstract

Background. The inadequacy of training with regard to the social determinants of health in medical education has led to calls for a greater public health focus in medical and health education. This call is no less applicable to the education of emergency care students and other emergency care personnel than to any other category of healthcare practitioner. Emergency care personnel work within communities and are therefore uniquely positioned to identify social causes of poor health and to play a pivotal role in addressing such issues through education, community engagement, advocacy and referral. Objectives. To analyse emergency care students' community-based service-learning projects (SLPs); to explore the application as an educational tool; to improve their understanding of the social determinants of health and the need and potential for emergency care personnel to become critical actors in addressing the social causes of ill health. Methods. Emergency care students (N=80) from three academic years were requested to submit portfolios with narrative reflections on their SLPs. The study was approached from an interpretivist paradigm, and it employed a phenomenological methodology to ascertain the meaning ascribed by emergency care students to their lived experiences through participation in SLPs. Thematic concerns were abstracted and discussed in the context of calls for health and medical curricula to place greater focus on the social determinants of health, and the implications for educating emergency care and other medical personnel. Results. Among emergency caregivers, service learning promoted a practical understanding of the social determinants of health and a sense of social responsibility in communities. Emergency care students can make a positive difference in the lives of individuals and communities. Students were exposed to existing resources and developed an understanding of the challenges and opportunities related to working in communities. The students were enriched by involvement in communities and developed self-awareness, teamwork and other important organisational skills. Conclusions. This study corroborates SLPs as a pedagogical tool to understand the social determinants of health, and the need and potential for emergency care personnel to become critical actors in addressing social causes of ill health. SLPs should therefore be an important tool of emergency care educators - responding to calls of the World Health Organization's Commission on Social Determinants of Health for greater prominence to be given to disease prevention and health promotion in medical and health science curricula. ABSTRACT FROM AUTHOR]; Copyright of African Journal of Health Professions Education is the property of South African Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)