Integrating Cultural Humility and Social Determinants of Health within the Human Anatomy Experience

PURPOSE: Racial, cultural, and socioeconomic biases have deep historical roots in medical education. The accrediting bodies of U.S. medical schools have recognized the problem and in recent years have added cultural competence standards to medical school accreditation requirements. The human anatomy experience during the preclinical years of medical education can facilitate an environment in which students are exposed to and free to discuss topics relating to empathy, racial, cultural, and socioeconomic biases in medicine.

METHOD: In the fall of 2021, the 9.5-week first-year human anatomy experience was organized into three blocks. Instructors used a multifactorial approach to integrate concepts relating to cultural humility and social determinants of health. These concepts were discussed during lectures, laboratory discussion activities, and were a vital component of end of week case presentations. Collaborative quizzes and end of the block written examinations were also used as evaluations during this module. Students were asked to consider and discuss the personal, social/cultural, and psychological dynamics that contribute to a clinical case. Students drew upon their own awareness, perspectives, and experiences. Literature research, faculty experience, and comments provided in the end of module evaluations facilitated an examination of student reactions concerning these presentations.

RESULTS: Overall, comments ranged from being a very rewarding learning experience to distracting from studying testable material. Strong influences on student perception included (1) pressure to only focus on testable material, (2) institutional culture, (3) curricular time, (4) premedical education, and (5) personal perspective.

CONCLUSIONS: The concept of cultural competence in medical education is problematic because it minimizes cross-cultural human interactions to mere technical skills. A more organic approach can help minimize this concern and enable continued engagement, beginning during the human anatomy experience, by facilitating equal curricular importance throughout the entirety of medical education.