Students or medical professionals: whose knowledge improved after social-medicine training? Results from a quasi-experimental evaluation study

Purpose Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students’ knowledge changes after social medicine training. Methods This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. Results All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. Conclusions Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups’ knowledge levels.

ORIGINS OF FORMATION OF KYIV SOCIAL AND HYGIENIC SCIENTIFIC SCHOOL: FROM THE FUNDAMENTALS OF MEDICAL SCIENCE, MEDICAL POLICE AND SANITARY STATISTICS TO SOCIAL MEDICINE AND PUBLIC HEALTH

The aim of the work is to study the stages of formation of the Kyiv social and hygienic scientific school, the contribution of its founders to the development of medical and social scientific direction. Materials and methods. The source base consisted of published scientific papers and archive materials. The historical-bibliographic method has been used in this work. Results. The formation and development of the Kyiv social and hygienic school has deep historical roots, beginning with the scientific achievements of many generations of researchers, which were generalized and transformed into the discipline of "state medicine" and began to be taught at the department of state medicine at St. Vladimir's University in Kyiv, and later – at the department of hygiene, medical police, medical geography and statistics. Teaching of medical and social issues continued for a long time at multidisciplinary departments. Prominent hygienists contributed to the formation of the socio-hygienic scientific direction, including professors Subbotin V.A. and Orlov V.D., who highly appreciated the importance of statistics, epidemiology and organization of health work, contributed to their teaching within the training programs for future doctors. A decisive role in the formation of the Kyiv social and hygienic scientific School was played by Professor Korchak-Chepurkivsky O.V., who is considered to be its founder. The course on epidemiology and sanitary statistics developed by him in 1903 and the course "Fundamentals of Social Hygiene and Public Medicine" in 1906 laid a solid foundation for the progressive development of social and hygienic science in Ukraine, helped to establish its theoretical principles, substantiate its content, and improve methodology. Consistent advocacy by scientists of scientifically sound results of socio-hygienic research has often led to his persecution and harassment by the authorities. Insistence of Korchak-Chepurkivsky O.V. on the differentiation of the social and hygienic direction and the creation of a separate department, the mandatory teaching of social hygiene in higher medical education has been crucial for further establishment of departments of social medicine, training of scientific personnel and health professionals. Conclusion. The path of formation of the Kyiv social and hygienic scientific school, which was long, difficult and sometimes tragic, constitutes evidence of the progressive development of social hygiene in Ukraine, highlights the trajectory of the medical and social direction, the role of prominent personalities, especially Korchak-Chepurkivsky O.V. in the formation of conceptual principles and content of social hygiene, training of scientific and pedagogical staff, who continued the work that he started.

A school without railings: rural backgrounds, social medicine, and the circulation of public health material in Colombia, 1930-1946

Ambitious state hygiene education projects designed during liberal governments in Colombia (1930-1946) faced not just the poverty of rural populations, but also the reluctance of local political forces. I analyze hygiene education programs during the first two liberal governments of the Liberal Republic. I argue that public health programs did not reach their audience due to local clientelism and political corruption. The sources of this article come mainly from Colombia’s Ministry of Education reports and cultural magazines. The education sector also had health-related responsibilities and developed assessments of local needs, which contributed to public health programs. Latin America’s public health historiography could be enriched by exploring failures in the implementation of projects in the history of social medicine.

Collective Health: Theory and Practice. Innovations From Latin America

Throughout history, knowledge and practices on the health of populations have had different names: medical police, public health, social medicine, community health, and preventive medicine. To what extent is the Brazilian collective health, established in the 1970s, identified with and differentiated from these diverse movements that preceded it? The analysis of the socio-genesis of a social field allows us to identify the historical conditions that made possible both theoretical formulations and the achievement of technical and social practices. Collective health, a product of transformations within the medical field, constituted a rupture in relation to preventive medicine and public health and hygiene, being part of a social medicine movement in Latin America that, in turn, had identification with European social medicine in the 19th century. Focused on the development of a social theory of health that would support the process of sanitary reform, collective health has been built as a space involving several fields: scientific, bureaucratic, and political. Thus, it brought together health professionals and social scientists from universities, health care services, and social movements. Its scientific subfield has developed, and the sanitary reform project has had several successes related to the organization of a unified health system, which has ensured universal coverage for the population in Brazil. It has incorporated into and dialogued with several reformist movements in international public health, such as health promotion and the pursuit of health equity. Its small relative autonomy stems from subordination to other dominant fields and its dependence on the state and governments. However, its consolidation corresponded to the strengthening of a pole focused on the collective and universal interest, where health is not understood as a commodity, but as a right of citizenship.

A new roadmap for social medicine curriculum design based on mixed methods student and faculty evaluations of the preclinical curriculum

Background To support the development of social medicine curricula that empower medical school graduates to redress health inequities, we conducted a mixed methods student and faculty evaluation of an expanded and innovative preclinical social medicine curriculum. Methods We implemented a longitudinal, interactive preclinical social medicine curriculum that was closely integrated with foundational science teaching then conducted a survey-based mixed methods student and faculty curriculum evaluation. Based on these results, we propose a novel conceptual roadmap for social medicine curriculum design. Results Student and faculty evaluations of an expanded and innovative longitudinal preclinical social medicine curriculum were strongly favorable. Both student and faculty respondents indicated a particular desire for deeper coverage of race and poverty among other social medicine domains. Qualitative student evaluations highlighted the importance of faculty champions to social medicine teaching as well as the educational impact of stories that exemplify the practical impact of the social determinants of health on specific patient experiences. Qualitative faculty evaluations pointed to the challenges of curriculum integration and the need for faculty career development in social medicine teaching. Conclusions Based on mixed methods student and faculty curriculum evaluation data, we propose a novel conceptual roadmap for the design of social medicine curricula at other institutions.