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Undergraduate clinical students Krupa Ravi and Yethrib Mohammed have pioneered a project to produce filmed material to improve teaching about social determinants of health. Here, they explain the importance of promoting patient perspectives.

A computer generated image of a director's chair © Image by Tomislav Jakupec from Pixabay

The Covid-19 Marmot Review recognises that pre-existing socioeconomic inequalities have ‘contributed to the high and unequal death toll from Covid-19’ and emphasises the importance of addressing these inequalities when building back after the pandemic. As medical students, we are taught the principles of Social Determinants of Health (SDH), but it can be difficult to conceptualise how these manifest in real life.

Expert patient tutors in various parts of the Oxford medical course have provided valuable insight into effective communication and the impact of various diagnoses on patients’ lives. In addition, empathic interviewing in the context of Social Determinants of Health is already employed as a medical training tool in some institutions in the US. This inspired us to interview a patient who had first-hand experience of navigating barriers to accessing healthcare and other services contributing to their health, including applying for benefits and engaging with social services.

During the interview, Patient X described his struggles with maintaining personal and professional relationships, building a rapport with his doctor, applying for work and getting a diagnosis (and support for) ADHD and Autism Spectrum Disorder. It was helpful to hear his thoughts on the methods of communication which were particularly effective for him (e.g. e-mail rather than a 5-10 minute verbal consultation) and the exhausting process of applying for benefits in a system which is often misunderstanding of patients’ needs. A patient information leaflet was developed collaboratively with Patient X, explaining the purpose of the interview and clarifying boundaries including confidentiality. The interview was filmed and used as a pilot video for a future online SDH module. The Primary Care Undergraduate Teaching Group plans to develop further filmed interview material to support this project. We feel that collaborative learning experiences such as this would be a great addition to the curriculum.

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