Aquifer Social Determinants of Health

Aquifer Culture in Health Care
Aquifer Culture in Health Care

Aquifer Social Determinants of Health provides foundational knowledge and a framework for building skills that minimize the effects of social determinants of health (SDOH) on health outcomes.


Aquifer Social Determinants of Health builds a foundational understanding of social determinants of health and teaches evidence-based strategies to help improve health outcomes and equity for patients. By exploring SDOH in the context of a virtual patient case, learners have the opportunity to work through a realistic patient interaction, reflecting on their own implicit biases and cultural awareness and developing communication and clinical skills that identify underlying issues and provide patient-centered care.

What are Social Determinants of Health?

Social determinants of health are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. Social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

Coming July 1: New Module & Access

As of July 1, Social Determinants of Health will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer Social Determinants of Health. Learn more…

  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • Case content focused on learning fundamental communication skills and systems knowledge key to providing care that maximizes health equity
  • A combination of cases, readings, and tools to help students translate skills to clinical practice
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material, embedded reflection questions, and full references in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools to create custom courses to match a specific curriculum

The overview and resources module provides key foundational learning on SDOH, with definitions, developing an understanding of how cultural beliefs and community culture affect health outcomes, and strategies for improving clinician-patient interactions. 

The two virtual patient cases provide an opportunity for students to learn in the context of a realistic patient scenario, working to develop their own cultural awareness, interpersonal skills, and professionalism. Learners are able to practice application of the information in a safe space, working through patient and family interactions and to practice using the tools when caring for a patient.

While the patients are children in these cases, the learning objectives are applicable to patients of all ages.

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including High Value Care, will follow a new course structure.

A new principles module will be added to the course, which covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.

After completing the principles module, students unlock additional application cases (the existing High Value Care cases) that explore realistic case scenarios. Application cases are concise and focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Social Determinants of Health is designed for any level student in a medical school or health professions program.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide with learning objectives and a new active learning module, providing a ready-to-use optional classroom activity to be used in conjunction with the cases. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

While Aquifer Social Determinants of Health is designed for independent study, students may benefit from a combination of approaches to instruction. Educators can link the course to other learning opportunities within the clinical or didactic curriculum, such as using cases as a common clinical encounter for discussion or creating assignments around the case content.

Aquifer’s previous Culture in Healthcare course was retired on October 22, 2020, in order to thoroughly update the content and teaching about bias, health inequities, and healthcare outcomes. The new Social Determinants of Health course includes reframed versions of two former Culture in Health Care cases. The two cases have been revised to remove language and content related to cultural competency, and thoroughly reviewed to eliminate bias and stereotyping. The shorter, reformatted cases do retain the reflective components that were a part of the original cases.

Programs that requested special access to Aquifer Culture in Healthcare to complete their coursework have access to the archived course through June 30, 2021. As of July 1, the new Social Determinants of Health course will be available as a contemporary replacement for all teachers and learners. 

View a full list of side-by-side learning objectives for Aquifer Culture in Healthcare and Social Determinants of health.

Case 1: Overview & Resources

  • Give examples of health care disparities.
  • Define health equity.
  • Define social and structural determinants of health.
  • Discuss community culture and medical culture and their impact on patient health.
  • Outline strategies to manage bias and power differentials in the clinician-patient interaction.
  • Discuss health beliefs and their impact on health care outcomes.

Case 2: 2-year-old with fever and headache

Covering language as a social determinant of health

  • Reflect on cultural norms to work toward cultural self-awareness.
  • Use negotiating and problem-solving skills in shared decision-making with patients using the LEARN model to foster shared decision making.
  • List factors related to language that affect clinician-patient communication and explain their effect on health care outcomes.
  • Identify situations where use of an interpreter is indicated and recognize how both clinician and patient comfort and desire to use an interpreter can impact care.
  • Outline elements of professional behavior in caring for patients with language barriers.

Case 3: 2-year-old with pneumonia

Covering poverty as a social determinant of health

  • Identify and address personal biases.
  • Identify strategies to improve and maximize communication.
  • Define poverty and discuss its impact on health care outcomes.
  • List strategies to assess and mitigate the effect of poverty on health care outcomes.

Learn More

3 Minute Video

Learn how Aquifer Social Determinants of Health—available free of charge—can benefit students and faculty in your program from Aquifer’s Chief Academic Officer Sherilyn Smith, MD.

Listen to the Aquifer Educator Connection Podcast with Regina Welkie, MSPAS, PA-C and Emily McSparin, MPA, PA-C, of DeSales Univeristy Physician Assistant Program, as they discuss how they were able to successfully integrate SDOH into a clinical curriculum by incorporating Aquifer cases into a journal club format. The Aquifer cases give students a shared experience and provide a springboard for a broader small group discussion about SDOH concepts they have experienced during clinical rotations. This approach resulted in deep, authentic conversations between students and faculty around the real impacts of SDOH on patient care.


What Students are Saying: Social Determinants of Health Cases

Aquifer’s Social Determinants of Health (SDOH) cases focus on helping students improve health outcomes and equity for patients through realistic patient interactions, encouraging students to reflect on their own implicit biases and cultural awareness. These cases are intended to provide foundational knowledge for students, and foster discussion on this essential topic in classroom settings. By developing communication and clinical skills, students can identify underlying issues and provide patient-centered care.

Since the cases launched in July, we’ve had many positive reviews from students through our Student Advisory Group and five-star case rating comments, such as:

“The cases shed light on a really important, sometimes overlooked issue and explained it clearly in a situation that could very well be encountered in real life. This case especially explained what our role as med students is when higher-up professionals do not act in a culturally appropriate manner.”