Program Overview

Introduction to the Study

The proposed study aims to evaluate the state of Social Determinants of Health (SDH) teaching in Obstetrics and Gynecology (O&G) education across Canadian medical schools. Understanding SDH is vital for addressing health inequities, and its teaching is a critical component of medical schools' social accountability mandates.

Background

The World Health Organization defines SDH as "the non-medical factors that influence health outcomes." Pregnancy is a vulnerable period in the life of both the mother and her baby, and literature indicates that mothers living in poverty are more likely to encounter stressful challenges and engage in unhealthy behaviors. Indigenous women are at higher risk of adverse outcomes, such as gestational diabetes and postpartum depression.

Knowledge Gap

Having an overview of current SDH teaching is a necessary first step to augment and improve the teaching of SDH in undergraduate medical education (UGME) curricular content and educational experiences. Existing reviews have synthesized evidence on SDH teaching in undergraduate and postgraduate medical education, but no study has conducted a comprehensive nationwide analysis of the teaching of SDH within curricula related to O&G, women's health, and sexual and reproductive health in UGME in Canada.

Proposed Study

The proposed study will use a qualitative content analysis to systematically assess how SDH are integrated into medical school curricula across Canada. The research will analyze curricula documents from all 17 Canadian medical schools to provide a comprehensive overview of the current state of SDH education.

Data Collection

• Curricular documents will be requested from administrative staff at all 17 Canadian medical schools.
• A standardized protocol will ensure uniformity in the scope of collected materials.
• The sample will include curricula documents such as:
  • Learning objectives and syllabi for Pre-Clerkship course content relating to Obstetrics and Gynecology, Womens Health, and Reproductive and Sexual Medicine
  • Core objectives for Clerkship OB/GYN rotations
  • Organized Pre-Clerkship and Clerkship elective experiences in Obstetrics and Gynecology, Womens Health, and Reproductive and Sexual Medicine

Data Analysis

• A qualitative content analysis will be conducted to assess:
  • The presence or absence and extent (measured in learning hours) of SDH-related content
  • Themes such as health inequities, cultural competence, and systemic barriers
  • Educational methods, including didactic teaching, case-based learning, and experiential activities
• Documents will be coded for recurring themes and categorized to highlight patterns and gaps by both the Principal Investigator and student Co-Investigator.

Timeline and Plan for Dissemination of Results

The study will take place over three months in the summer of 2025. Document collection will occur in June, followed by qualitative analysis in July. Results will be synthesized and presented to the UGME Curriculum Committee, Faculty of Medicine, University of Ottawa, and shared with the networks of the Association of Faculties of Medicine of Canada. A manuscript is planned for submission to a peer-reviewed medical education journal by the end of 2025.