Online Supplement: Enhancing Student Understanding of Cardiovascular Disease Burden in Marginalized Communities in the Physiology Classroom

Physiology education is at the core of biomedical science and medicine. At all learning levels, physiology unites multiple disciplines to explain the mechanisms whereby a risk factor associates with a disease. Sexual and gender minority (SGM; including Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and Two-Spirit [LGBTQIA2S+]) persons and Black, Indigenous, and People of Color (BIPOC) have a higher prevalence of cardiovascular disease (CVD). Moreover, Minority Stress Theory attempts to explain the association of SGM and BIPOC identities with CVD. However, instruction on how to effectively incorporate the ways that social determinants of health are mechanistically linked to disease outcomes in marginalized populations, such as the SGM and BIPOC communities, is needed. We investigated the efficacy of teaching Minority Stress Theory concepts in a single lecture in an upper-level cardiovascular pathophysiology course (N=44 students). To test students understanding of minority-related disease, we used both subjective and objective measures to evaluate student understanding before and after the lecture. Student self-assessment of understanding of health disparity physiological mechanisms (pre-intervention median 3.0 vs post-intervention median 4.0; p<0.0001) and lifestyle/pharmacologic interventions to reduce health disparities in SGM communities (pre-intervention median 3.0 vs post-intervention median 4.0; p=.002) increased post-intervention. We observed similar results of self-assessment of understanding of health disparity physiological mechanisms (pre-intervention median 3.0 vs post-intervention median 4.0; p<0.0001) and appropriate lifestyle/pharmacologic interventions to reduce health disparities (pre-intervention median 4.0 vs post-intervention median 5.0; p=.003) regarding the BIPOC community. Our findings suggest that integrating social determinants of health into pathophysiology courses may result in a more inclusive-minded scientific and medical workforce.