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Purpose <p>Identifying and addressing social determinants of health in patients can improve surgical outcomes. However, methods to screen patients for social determinants of health are not routinely taught to surgical trainees. In this study, we designed a simulation-based intervention to improve screening habits in general surgery residents. We hypothesize that our intervention will improve resident perceptions of common barriers to screening.</p> Methods <p>We conducted a prospective cohort study at a tertiary care academic hospital during the 2023-24 academic year. Residents voluntarily enrolled to participate and were randomized to the non-intervention or intervention group. The intervention group participated in an educational session, consisting of a brief didactic grounded in learning theory followed by a simulated case with a standardized patient, while the non-intervention group did not. After three months, all residents were surveyed about their perceptions of five common barriers to screening on a 5-point Likert scale. Responses were compared between the non-intervention and intervention groups. Semi-structured interviews were conducted with the intervention group at the conclusion of the study. Quantitative data was analyzed using the Mann-Whitney U test. A <i>p</i>-value of less than 0.05 was considered statistically significant. Qualitative data was analyzed using data analysis software (NVivo 14).</p> Results <p>A total of 40 out of the 53 eligible general surgery residents participated in the study (75.5%). Sixteen residents were assigned to the intervention group and 24 to the non-intervention group. Three months after the intervention, residents in the intervention group more strongly agreed with having adequate training, having enough time to screen patients, and felt more confident referring patients to resources when compared to the non-intervention group. During the interviews, residents reported positive changes to their screening habits but also expressed concerns about the sustainability of their screening behavior.</p> Conclusion <p>A simulation-based intervention reduced some perceived barriers to social determinants of health screening among general surgery residents. Incorporating learning theories to complement traditional didactics may have contributed to this effect. However, residents remained concerned about the sustainability of screening behavior over time.</p>

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Simulation-based training reduces barriers to social determinants of health screening in general surgery residents

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Jacky Z. Kwong,
  • Gwyneth A. Sullivan,
  • Ivy M. Sullivan,
  • Erin E. Sullivan,
  • Jose M. Velasco,
  • Brian C. Gulack,
  • Ami N. Shah

摘要

Purpose

Identifying and addressing social determinants of health in patients can improve surgical outcomes. However, methods to screen patients for social determinants of health are not routinely taught to surgical trainees. In this study, we designed a simulation-based intervention to improve screening habits in general surgery residents. We hypothesize that our intervention will improve resident perceptions of common barriers to screening.

Methods

We conducted a prospective cohort study at a tertiary care academic hospital during the 2023-24 academic year. Residents voluntarily enrolled to participate and were randomized to the non-intervention or intervention group. The intervention group participated in an educational session, consisting of a brief didactic grounded in learning theory followed by a simulated case with a standardized patient, while the non-intervention group did not. After three months, all residents were surveyed about their perceptions of five common barriers to screening on a 5-point Likert scale. Responses were compared between the non-intervention and intervention groups. Semi-structured interviews were conducted with the intervention group at the conclusion of the study. Quantitative data was analyzed using the Mann-Whitney U test. A p-value of less than 0.05 was considered statistically significant. Qualitative data was analyzed using data analysis software (NVivo 14).

Results

A total of 40 out of the 53 eligible general surgery residents participated in the study (75.5%). Sixteen residents were assigned to the intervention group and 24 to the non-intervention group. Three months after the intervention, residents in the intervention group more strongly agreed with having adequate training, having enough time to screen patients, and felt more confident referring patients to resources when compared to the non-intervention group. During the interviews, residents reported positive changes to their screening habits but also expressed concerns about the sustainability of their screening behavior.

Conclusion

A simulation-based intervention reduced some perceived barriers to social determinants of health screening among general surgery residents. Incorporating learning theories to complement traditional didactics may have contributed to this effect. However, residents remained concerned about the sustainability of screening behavior over time.