4.6 Article

The Structural Analysis: Incorporating Structurally Competent Clinical Reasoning into Case-Based Presentations

期刊

JOURNAL OF GENERAL INTERNAL MEDICINE
卷 37, 期 13, 页码 3465-3470

出版社

SPRINGER
DOI: 10.1007/s11606-022-07751-7

关键词

social determinants of health; structural competency; medical education

资金

  1. American Medical Association (AMA) Reimagining Residency Grant Initiative
  2. American Medical Association's Accelerating Change in Medical Education Innovation Grants Program

向作者/读者索取更多资源

This article introduces a framework for structural analysis, aiming to help doctors better understand and address the impact of structural and social factors on health in clinical practice. The authors provide four key steps to assist doctors in identifying and addressing structural barriers and social needs faced by patients.
Structural and social determinants of health account for the health disparities we see along social hierarchies, and their impact has been made more evident by the recent COVID-19 pandemic. There have been increasing calls to incorporate structural competency into medical education. The structural and social context, however, has yet to be fully integrated into everyday clinical practice and little has been published on how to concretely imbed structural competency into clinical reasoning. The authors provide a framework for structural analysis, which incorporates four key steps: (1) developing a prioritized clinical problem list, (2) identifying social and structural root causes for clinical problems, (3) constructing and documenting a prioritized structural problem list, and (4) brainstorming solutions to address structural barriers and social needs. They show how structural analysis can be used to operationalize structural reasoning into everyday inpatient and outpatient clinical assessments.

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