Document Type : Original Article

Authors

Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinants
of health (SDH), higher education system must be responsive in training knowledgeable students and
faculty members. Therefore, this study was carried out to determine the responsiveness of higher
education system in relation to the SDH.
METHODS: This is a content analysis study carried out using qualitative approach. Semi‑structured
interviews were used to gain access to the knowledge of experts in the fields of health care, education,
and SDH. Sampling was carried out until data saturation was achieved during which 15 experts were
selected using purposeful sampling method with highest possible variety. Data were categorized
using qualitative content analysis approach.
RESULTS: In total, 11 themes and 43 categories of codes were identified in semi‑structured
interviews with experts. A total of two approaches were identified for the training of responsive
students including educational–research approach and cultural–social approach; five approaches
were identified for the development of faculty members including cognitive development, executive
development, evaluation, promotion and incentives, and revisions; two approaches were identified for
provision of theoretical and practical education including education in a real and active environment
and structural education; and finally, two approaches were identified for evaluation of students and
faculty members in regard to their responsiveness to society’s health needs and SDH including
content and operational approaches.
CONCLUSION: In general, the results of the current study indicate the need for the higher education
system to use educational, research, and society‑based approaches in real and social environments
along with an incentive system and use of evaluation for responsiveness to society’s health needs
and SDH. These results can be useful for the health‑care system and the higher education system.

Keywords

1. Mikkonen J, Raphael D. Social Determinants of Health: The
Canadian Facts. Toronto: York University: School of Health Policy
and Management; 2010.
2. Marmot M, Friel S, Bell R, Houweling TA, Taylor S; Commission
on Social Determinants of Health. Closing the gap in a generation:
Health equity through action on the social determinants of health.
Lancet 2008;372:1661‑9.
3. Wilkinson RG, Marmot M. Social Determinants of Health:
The Solid Facts. Reglonal Office for Europe: World Health
Organization; 2003.
4. Bryant T, Raphael D, Schrecker T, Labonte R. Canada: A land
of missed opportunity for addressing the social determinants of
health. Health Policy 2011;101:44‑58.
5. MahboubiM, Tabibi SJ, NasiripourAA, GohariMR. Accountability
in teaching hospitals: A national study. Health Inf Manag
2014;10:955‑63.
6. Mahboubi M, Tabibi J, Ghahramani F, Nasiripour AA,
Gouhari MR. A model for evaluation and validation of different
dimensions of accountability in teaching hospitals in Iran: 2012.
J Health Administr 2013;16:73-85.
7. MohammadiA, KamaliK. Patients’ perspectives on responsiveness
in outpatient clinics of hospitals at Zanjan University of medical
sciences. Preventive Care Nurs Midwifery J 2015;5:80‑92.
8. Gohari M, Tabibi SJ, Nasiripour A, Mahboubi M. Seven
dimensions of accountability in Iran’s teaching hospitals:
A national study. J Payavard Salamat 2012;6:255‑64.
9. Behroozi N, Ghanadan F, Hashemi SH, Shabani E. Educational
Needs Assessment of Dezful Elementary School Teachers. Third
National Congress of Iranian Industrial and Organizational
Biology; 2018.
10. Biglar M, Bastani P. The challenges of stewardship in medical
education system: A qualitative approach. J Payavard Salamat
2013;7:299‑311.
11. Yaghoubi Far MA, Ghodrati A, Mir Mousavi J, Rahmani A,
Sobhani A, Ghoreishi E. et al. Evaluation of environmental health
training course from students’ viewpoints with emphasis on
responsive education program. Shahid Motahari Educational
Festival, Sabzevar Univ Med Sci 2013.
12. Klein MD, Kahn RS, Baker RC, Fink EE, Parrish DS, White DC.
Training in social determinants of health in primary care: Does
it change resident behavior? Acad Pediatr 2011;11:387‑93.
13. Klein MD, Alcamo AM, Beck AF, O’Toole JK, McLinden D,
Henize A, et al. Can a video curriculum on the social determinants
of health affect residents’ practice and families’ perceptions of
care? Acad Pediatr 2014;14:159‑66.
14. Chokshi DA. Teaching about health disparities using a social
determinants framework. JGen Intern Med 2010;25 Suppl 2:S182‑5.
15. UCL Institute of Health Equity. Working for Health Equity: The
Role of Health Professionals. Global Health Workforce Alliance;
2013. Available from: http://www.who.int/workforcealliance/
knowledge/resources/healthequity/en.
16. Martimianakis MA, Michalec B, Lam J, Cartmill C, Taylor JS,
Hafferty FW. Humanism, the Hidden Curriculum, and
Educational Reform: A Scoping Review and Thematic Analysis.
Acad Med 2015;90:S5‑S13.
17. Klein M. Addressing the Health Professional’s Role in Social
Determinants: Neweducational Approaches. Rockville, MD:
Presented at the August 2015 Meeting of the Advisory Committee
on Training in Primary Care Medicine and Dentistry; 2015.
18. Kasper J, Greene JA, Farmer PE, Jones DS. All Health Is Global
Health, All Medicine Is Social Medicine: Integrating the Social
Sciences Into the Preclinical Curriculum. Acad Med 2016;91:628‑32.