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Incorporation of social medicine curriculum in academic and community health centres: a scoping review protocol

Por: Cydis · M. · Hudson · E. · Shipper · A. G. · Lane · A. · Salzman · M.
Introduction

In the field of medicine, there has been a growing understanding of the impact of social and economic inequities on patients’ health outcomes. Social medicine was established with the intention of addressing these social and economic drivers of health when caring for patients. Physicians who practise social medicine aim to take an interdisciplinary and interprofessional approach to patient care with an emphasis on the promotion of health equity and patient advocacy. As the effects of social determinants of health (SDOH) on health outcomes have become more widely appreciated, medical professional organisations and accrediting bodies have advocated for formal education on the impact of SDOH in undergraduate and graduate medical curricula. The goal of this scoping review is to examine how undergraduate and graduate medical education programmes in the USA have implemented social medicine concepts into their curricula.

Methods and analysis

The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The review team worked with a medical librarian, who created a unique search for five databases (PubMed, Embase, Cochrane CENTRAL Register of Controlled Trials, ERIC and the Web of Science Core Collection). Additionally, we will conduct a grey literature search that includes medical school and residency programme websites, as well as Association of American Medical Colleges (AAMC), Council of Residency Directors in Emergency Medicine (CORD), Alliance for Academic Internal Medicine (AAIM) and Society for Academic Emergency Medicine (SAEM) conference abstracts. Two independent reviewers will assess all articles for eligibility. Data will be extracted using the Covidence data extraction tool. We will present the results of the extraction in tabular form. Themes identified during the full-text review and data extraction process will be discussed.

Ethics and dissemination

Data will be gathered from publicly accessible sources, so ethics approval is not necessary. The results will be disseminated through a peer-reviewed journal and reported at conferences related to medical education and social medicine.

Trial registration number

This protocol is registered on OSF (https://doi.org/10.17605/OSF.IO/7PZ8U).

iHEART trial: study protocol for a German multicentre randomised controlled trial on the feasibility and acceptance of an internet-based preoperative intervention to optimise patient expectations and improve outcomes after heart surgery

Por: Compere · V. N. · Balci · S. · Heinz · C. · Schade-Brittinger · C. · Rastan · A. J. · Salzmann-Djufri · M. · Niemann · B. · Boening · A. · Choi · Y.-H. · Zarski · A.-C. · Laferton · J. · Euteneuer · F. · Rief · W. · Salzmann · S.
Introduction

Treatment expectations are a key mechanism of placebo effects in clinical trials. In a previous study (PSY-HEART-I), preoperative expectation optimisation improved quality of life 6 months postcardiac surgery. However, barriers such as travel distance, staffing shortages and COVID-19 limited participation. This study evaluates the feasibility and acceptability of iEXPECT, a brief internet-based intervention designed to optimise expectations before heart surgery.

Methods and analysis

In this three-arm, multicentre randomised controlled trial, 160 patients undergoing elective coronary artery bypass graft surgery are randomised to: (a) standard of care (SOC); (b) SOC plus iEXPECT with phone-based guidance (iEXPECT enhanced) or (c) SOC plus iEXPECT with email-based guidance (iEXPECT limited). The intervention includes four 20 min online modules addressing surgical benefits, side effects and coping strategies. Modules are accompanied by personalised guidance provided through feedback on each module via email or telephone (three before surgery, three booster sessions at 6, 12 and 18 weeks postsurgery). Assessments occur at baseline (5–21 days before surgery), preoperatively (day before surgery), 7 days postsurgery and 6 months later. Primary feasibility outcomes include recruitment (≥1 participant/week/centre), retention (≥49% completing 6-month follow-up including biomarkers) and engagement (≥75% completing ≥1 presurgery module). Acceptability is measured by self-reported enjoyment, usefulness and impact, with acceptance defined as mean scores >3.4 (5-point Likert scale) and CSQ-I ratings. Secondary outcomes include psychological measures, inflammatory markers and heart rate variability.

Ethics and dissemination

Ethical approval was granted by the Ethics Committees of Philipps University Marburg (AZ 229/23 BO) and the University of Giessen (AZ 186/23). All participants provide written informed consent. Results will be shared via publications, conferences and public outreach with relevant consumer advocacy groups.

Trial registration number

DRKS00033284.

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