Measuring the Impact of an Interprofessional and Multidisciplinary Graduate Medical Case Conference on Socioeconomic Healthcare Disparities in Nephrology
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
- Schoer, Morgan, Washington University in St Louis, St Louis, Missouri, United States
- Rajashekar, Gaurav, Washington University in St Louis, St Louis, Missouri, United States
- O Brien, Frank J., Washington University in St Louis, St Louis, Missouri, United States
According to the most recent ACGME survey, 70% of fellows reported either no training in cultural competency, or generic training only. Learning to recognize unconscious biases, understand socioeconomic healthcare barriers, and utilize available resources will improve patient care. Specifically in nephrology, in which Black Americans are 4-5x more likely to develop kidney disease than the general population, it is critical that we train fellows how to partner with other health professionals to best navigate cultural differences and advocate for their patients in order to achieve equity and reduce disparities. We developed a specific curriculum at a single large academic institution to address this issue.
We partnered with the rheumatology and infectious diseases divisions to build a four-part curriculum addressing various aspects of health barriers and equity. Each division was tasked to create a one-hour interactive workshop addressing different high-yield topics. Attendings, fellows, social workers, and nurses were invited to participate. Pre- and post-session surveys querying fellows’ comfort in identifying and addressing structural and social determinants of health were administered.
On a Likert scale from one to five, one being “very uncomfortable” and five being “very comfortable,” fellows’ (N=16) comfort with understanding and applying St. Louis geopolitical history in the context of medical interactions rose from median value 2.0 to 3.0 (p=0.008). Fellows’ comfort in recognizing and strengthening social networks rose from 2.0 to 3.5 (p=0.002). Other metrics showed non-significant improvements.
Interprofessional and interdisciplinary case discussions about socioeconomic barriers to healthcare improved fellows’ comfort in identifying and addressing structural and social determinants of health.