Purpose
To adopt a holistic approach to patient care, medical students must be equipped with a thorough understanding of social determinants of health (SDoH). As such, incorporation of SDoH into the curriculum has gained traction in recent years. Although the impact of SDoH on health outcomes is substantial, newly admitted students receive little training on how SDoH can impact patients. We designed an integrated, multi-session module to provide first-year medical students with a foundation in SDoH and bias.

Methods
A three-week, five-session module for delivery early in the first year was designed. The sessions were fully integrated in focus, cases, discussion, and tools. Sessions in the Foundational sciences included utilizing a public health-focused approach to promote identification, analysis, and evaluation of SDoH, case-based learning to explore SDoH and creation of an infographic in small groups based on cases, and active small group format to introduce and discuss unconscious bias. Sessions in Clinical Skills included small groups, facilitator-led role-play with clinical cases to apply SDoH to social history taking, standardized patient interactions to help students apply their understanding of SDoH and bias, and submission of a reflective essay on bias. Pre and Post surveys were administered to assess confidence in explaining SDoH, relating concepts of SDoH, SDoH screening tools, and application of SDoH to the social history. Knowledge was assessed with reflection and infographic assignments.

Results
Students reported an increase (50%) in pre- vs post-confidence in all categories of SDoH assessed. Students successfully demonstrated a good knowledge of the role of SDoH and bias in health care.

Conclusions
Our integrated multi-session module provided medical students with a foundation in SDoH and bias early in the first year. It improved student confidence in multiple areas of SDoH and is easily transferable to other institutions. Future studies are needed to understand the longitudinal impact.