Prescribing Solutions: Development of a Community-Centered Approach to Teaching the Social Determinants of Health in the ED

Learning Objectives: Following this session, learners will be able to recognize specific challenges facing their ED patient population, select community partners for patient referral based on personal experience, and be empowered to use local resources to prescribe social solutions from the ED.Introduction: Patients are increasingly affected by societal and structural factors that impact their health. EM physicians must understand their community’s unique needs and leverage the social determinants of health (SDH) to provide efficient, comprehensive care. SDH are traditionally taught in a classroom-based setting providing little guidance in translating this knowledge into clinical practice. This leads to dissatisfaction and burnout as trainees become aware of health disparities without potential solutions. We developed a community-centered experiential approach that introduces SDH to EM residents, providing tangible ways to intervene and prescribe solutions to ED patients facing SDH barriers.Curricular Design: SDH in CLE Day was implemented during the orientation block for 12 EM PGY-1 residents. Over 5 hours, residents were introduced to the local community through population-based small group discussions. Residents toured two community centers to learn about accessible resources for patients in the ED. While traveling between sites, resident groups led by faculty facilitators discussed personal experiences with SDH as well as ED-based patient scenarios where SDH could be leveraged to optimize patient outcomes.Impact: Twelve first-year residents (100%) completed post-orientation evaluations. The session was highly successful in enhancing interns’ understanding of the local population with 92% agreement. Additionally, 83% agreed they felt empowered to intervene on SDH challenges in the ED as a result of the session. Residents described the day as “eye-opening,” “valuable,” and “humbling.” Overall, a community-centered experiential approach to teaching SDH is effective in empowering EM residents to recognize and intervene on SDH facing their patients. Future directions include increasing the number of participating community sites and incorporating activities to better introduce concepts of power and privilege to trainees