SDH课程在日本的应用现状及在中国临床教学中的应用展望

Current status of the SDH curriculum in Japan and prospects for its application in Chinese clinical teaching

摘要

除直接导致疾病的因素外，日常生活环境和社会结构性因素也会对健康产生影响，世界卫生组织将其定义为健康社会决定因素（social determinants of health，SDH）。随着社会经济的飞速发展，健康的不平等现象逐渐严重，医疗工作者需要对SDH的含义有深刻理解并能熟练运用到工作之中，以掌握解决这些问题的循证干预措施。日本于2016年将SDH相关内容纳入到医学生毕业前所需达成的课程目标中并获得一定成效。本文介绍日本高校医学部SDH课程目标、课程内容、课程评价及学生反馈的应用现状，阐述SDH纳入临床教学的意义，以期通过借鉴国外经验，对SDH在我国医学临床教学中的本土化运用提供参考依据。

Abstract

In addition to the factors that directly lead to diseases, the daily living environment and social structural factors all have an impact on health. The World Health Organization defines it as social determinants of health (SDH). With the rapid development of the social economy and the increasing severity of health inequality, healthcare workers need to have a deep understanding of the meaning of SDH and be proficient in applying it to their work, in order to master evidence-based interventions to address these issues. In 2016, Japan incorporated SDH related content into the curriculum objectives that medical students need to achieve before graduation and achieved certain results. This article introduces the current status of the application of SDH course objectives, course content, course evaluation and student feedback in the medical departments of Japanese universities, and elaborates on the significance of incorporating SDH into clinical teaching. It aims to provide reference for the localization of SDH in medical clinical teaching in China by drawing on foreign experience.

关键词

健康社会决定因素 / 健康不公平性 / 临床医学教育 / 课程设置 / 日本 / 教学改革

Key words

social determinants of health / health inequities / clinical medical education / curriculum / Japan / reform of teaching