The Structural Competency Working Group: Lessons from Iterative, Interdisciplinary Development of a Structural Competency Training Module



In the United States and around the world, social, political, and economic structures are hugely determinant of the distribution of illness and health. Structural competency is a promising framework to help clinicians recognize, analyze, ameliorate, and hopefully alter these harmful inequities. To bring this framework to health professionals, the Structural Competency Working Group has developed, operationalized, evaluated, and revised a three hour structural competency training. Encouraging “impractical” innovative thinking, striving to make content “sticky,” and responding to findings from evaluation, the SCWG developed a brief training that we have found to be surprisingly impactful. Our efforts to implement and evaluate this training for a variety of healthcare professions suggest that it can be similarly relevant across a range of fields.We hope our case will inspire others to implement similar trainings in other geographical locations and for professionals in other fields, within and beyond healthcare.


Structural competency Structural violence Naturalizing inequality Medical education Critical pedagogy 



The Structural Competency Working Group’s efforts have been supported by the Berkeley Center for Social Medicine and Deborah Lustig as well as the University of California Humanities Research Institute.

Josh Neff’s work on this project has been supported by the UCSF Resource Allocation Program for Trainees (RAPtr), the Greater Good Science Center Hornaday Fellowship, UC Berkeley-UCSF Joint Medical Program Thesis Grant, and the Helen Marguerite Schoeneman Scholarship.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.UC Berkeley-UCSF Joint Medical ProgramBerkeleyUSA
  2. 2.Division of Society and Environment, Joint Program in Medical AnthropologyBerkeley Center for Social Medicine, University of California, BerkeleyBerkeleyUSA
  3. 3.Samuel Merritt UniversityOaklandUSA
  4. 4.Department of Neurological SurgeryUniversity of California, San FranciscoSan FranciscoUSA
  5. 5.University of Chicago Pritzker School of MedicineChicagoUSA
  6. 6.Department of Medical AnthropologyUniversity of California, BerkeleyBerkeleyUSA
  7. 7.University of California, San FranciscoSan FranciscoUSA
  8. 8.Medical Scientist Training Program, Department of Anthropology, History and Social MedicineUniversity of California, San FranciscoSan FranciscoUSA
  9. 9.Department of Anthropology, History and Social MedicineUniversity of California, San FranciscoSan FranciscoUSA
  10. 10.San Jose State UniversitySan JoseUSA
  11. 11.Oregon Health Sciences UniversityPortlandUSA
  12. 12.Department of Adolescent MedicineUniversity of California San Francisco Benioff Children’s Hospital OaklandOaklandUSA
  13. 13.Internal Medicine Residency Program, Highland HospitalOaklandUSA
  14. 14.University of California, San FranciscoSan FranciscoUSA
  15. 15.Osher Center for Integrative Medicine, University of California, San FranciscoSan FranciscoUSA
  16. 16.Global Health, Drexel UniversityPhiladelphiaUSA

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