An experiential learning exercise in understanding social determinants of health in an urban pediatric residency program.

Purpose: As part of the Community Pediatrics Rotation, the Shopping Assignment was developed to allow pediatric residents to understand social determinants of health (SDOH). The purpose of this study was to evaluate the 20-year experience with the Shopping Assignment as a tool in teaching SDOH to pediatric residents.

Methods: In the assignment, residents were designated as the head of a fictional family with limited resources and receiving support through the Michigan Department of Health and Human Services. Residents had to complete a series of exercises based on the family's budget and submit a final cash balance. Creativity was imperative for success. The assignment was graded on a 100-point scale with a 60 % passing score.

Results: 168 Residents completed the assignment over a 20-year period (2000-2019). Most of the residents (79.2 %) worked in groups and 20.8 % worked individually. Residents were 72 % female with 60 % having attended U.S. medical schools. Eighty-six percent of residents obtained a passing score with performance not impacted by gender or medical school location (U.S. versus International). Residents obtaining a passing score performed better (p = 0.001) on most activities evaluated, including final cash balance and overall creativity.

Conclusion: The Shopping Assignment was a successful educational tool in improving residents' knowledge of SDOH. Residents' participation in the activity enhanced empathy for the patients served in their continuity clinics. Although training programs teach some of these concepts to trainees, this is first study to provide a scoring mechanism that quantifies the experiential learning process based on the assigned tasks.