Creating a Space to Engage Learners in Social Determinants of Health

Several years ago, Shailey Prasad, Family Medicine faculty at the University of Minnesota Medical School noticed a frustration and disconnection in some of the students and residents rotating through the Broadway Family Medicine Clinic.

“I sensed that students and residents were feeling a little disconnected with what brought them to medicine,” Dr. Prasad said. “They were soul-searching around the question: Is this what I came here for? It was clear we needed a way to re-engage them.”

Dr. Prasad observed that the disillusionment seemed to come as students and residents at the Broadway clinic confronted the complexities of the social determinants of health. Many had chosen a career in medicine to help address the economic and social issues that influence health. But, doing so is not easy.

“Economic and social issues facing health care are more abstract; the solutions take time and partnerships to address,” Dr. Prasad said.

In 2012, Dr. Prasad and his colleagues began the Community Health & Advocacy Talks—or CHAT—to create a space for ongoing conversation about the social determinants of health and connect students and residents with partners and allies in the work of health advocacy.

CHAT meetingThe CHAT group began meeting every second Tuesday of the month in the U of M Robert J. Jones Urban Research and Outreach-Engagement Center (UROC). Over the years, CHAT has drawn students, residents, providers and community members to these discussions that cover everything related to health except clinical care.

The group has engaged a broad range of speakers covering a diverse list of subjects. From then mayor R.T. Rybak addressing the achievement gap in Minneapolis to a former gang member, John Turnipseed, discussing the connection of generational violence and attention deficit disorder, participation in the program has included community, business, and academic leaders. Mahmoud El-Kati, Professor Emeritus of history at Macalester College, participated as a speaker in a simulcast of CHAT that drew more than 150 attendees.

The CHAT program has been very successful in creating an environment for these discussions and building awareness about work at the University and surrounding communities. Students and residents from both St. Catherine University and Hennepin Healthcare have participated.

Providing value to learners throughout their careers

Hanna Nedrud, MD, is currently a resident in the North Memorial Family Medicine Residency Program; she completed her undergraduate and medical degrees at the University as well. CHAT has shaped her thinking about her career in medicine throughout her studies.

“The first CHAT I attended featured Dr. Steven Miles discussing gun violence as a public health issue. Before that, I had never connected gun violence and public policy to health issues,” Dr. Nedrud said.  

Dr. Nedrud also had an active role helping to manage the program and recruit speakers for two years. Overall, the experience has made a difference in her practice.

“Medical training focuses largely on disease processes within the body and how we can address them within clinics and hospitals. Yet our health is most impacted by things outside the clinic and hospital walls,”Dr. Nedrud said. “In my practice, I need to pay attention to the environment outside the clinic, be informed about resources for my patients and use my power and privilege as a physician to advocate for positive change.”

The program has made an impact on students and residents who have moved on as well.

“CHAT is a unique program, and has really shaped my thinking and current work on where to seek out expertise as part of an academic health center,” said Brian J. Park, MD, assistant professor of Family Medicine, School of Medicine at Oregon Health & Science University. Dr. Park graduated from the University Medical School in 2014 and was a participant in the first year of CHAT.

Making a space for dialogue in the community

CHAT has been successful in creating space for discussion about topics in the social determinants of health. As the program enters its eighth year, Dr. Prasad envisions deeper engagement across the community to strengthen the relationship with the University. “There is the opportunity to really engage our community members in helping to co-create the program and bring even deeper connections and more meaningful conversation,” Dr. Prasad said.

The next CHAT is scheduled for Tuesday, Feb. 11, at 6 - 7:30 p.m at UROC.

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