Six ways to get a grip by calling-out racism and enacting allyship in medical education (original) (raw)
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Addressing Racism in Medical Education
Family Medicine
Background and Objectives: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities. Methods: A multiracial, interdisciplinary team identified essential elements of teaching about racism. A 1.5-hour faculty development workshop consisted of a didactic presentation, a 3-minute video vignette depicting racial and gender microaggression within a hospital setting, small group discussion, large group debrief, and presentation of a toolkit. Results: One hundred twenty diverse participants attended the workshop at the 2016 Society of Teachers o...
Since 2020, brought to the forefront by movements such as Black Lives Matter and Idle No More, it has been widely acknowledged that systemic racism contributes to racially differentiated health outcomes. Health professional educators have been called to address such disparities within healthcare, policy, and practice. To tackle structural racism within healthcare, one avenue that has emerged is the creation of medical education interventions within postgraduate residency medical programming. The objective of this scoping review is to examine the current literature on anti-racist educational interventions, that integrate a systemic or structural view of racism, within postgraduate medical education. Through the identification and analysis of 23 papers, this review identified three major components of interest across medical interventions, including (a) conceptualization, (b) pedagogical issues, and (c) outcomes & evaluation. There were overlapping points of discussion and analysis within each of these components. Conceptualization addressed how researchers conceptualized racism in different ways, the range of curricular content educators chose to challenge racism, and the absence of community's role in curricular development. Pedagogical issues addressed knowledge vs. skills-based teaching, and tensions between one-time workshops and integrative curriculum. Outcomes and evaluation highlighted self-reported Likert scales as dominant types of evaluation, self-evaluation in educational interventions, and misalignments between intervention outcomes and learning objectives. The findings are unique in their in-depth exploration of anti-racist medical interventions within postgraduate medical education programming, specifically in relation to efforts to address systemic and structural racism. The findings contribute a meaningful review of the current state of the field of medical education and generate new conversations about future possibilities for a broader anti-racist health professions curriculum.
Diversity, equity, and inclusion: one model to move from commitment to action in medical education
SN Social Sciences
The summer of 2020 riveted the attention of our nation with a sense of urgency to address structural racism. Cities declared racism a public health crisis, and organizations called for increased awareness of persistent historic racial inequities and advocacy for change. In medical education, students and institutional leaders felt compelled to transition from passive advocacy to energetic action in order to build a culture of anti-racism. In our institution, we applied J Mierke and V. Williamson's 6-step framework to achieve organizational culture change which is as follows: 1. Identify the catalyst for change; 2. Strategically plan for successful change; 3. Engage and empower organizational members; 4. Cultivate leaders at all levels; 5. Foster innovation, creativity, and risk-taking; 6. Monitor progress, measure success, and celebrate (even the small changes) along the way. In addition, we noted two key considerations for the success of the process: A. Transparency in communication, and B. Flexibility and adjustment to emerging situations. We share our approach using this framework which we believe is generalizable to other organizations. We draw from literature on organizational psychology and lastly call for the continuation and sustainability of the work that will continue to build a diverse, equitable, inclusive, antiracist and vibrant education community.
Preventing Chronic Disease, 2023
What is already known on this topic? People of racial and ethnic minorities have historically received less access to quality health services, which leads to health inequities; racism is a major contributor to these inequities. What is added by this report? Although many institutions offer service-learning courses designed to train community-oriented future physicians, few provide a required, year-long competency-based course aimed at addressing the social determinants of health, particularly racism, through collaborations with communities of color. What are the implications for public health practice? Medical education plays an important role in teaching how racism affects access to and delivery of quality health care to medically underserved communities and recognizing the structures that facilitate ongoing racism in our health care system.
Journal of Social, Behavioral, and Health Sciences, 2023
The COVID pandemic cast a harsh light on the structural and systemic health inequalities that exist in American society and in U.S. medical education. Black and Brown communities were disproportionately affected, and the pandemic highlighted the need for a diverse physician and healthcare workforce. Both the lack of equitable, high-quality healthcare in underrepresented communities and the obstacles that students who are underrepresented in medicine (URiM) experience in medical school are direct consequences of the structural racism that flourishes in U.S. medical schools and healthcare institutions. In this article, we explain structural racism and how it has manifested itself in medical education, including the lack of diversity among faculty and leadership, implicit biases and stereotypes about people of color, and discriminatory language used in evaluations of URiM students. We conclude with potential solutions for addressing structural racism in medical education. These include increasing diversity among faculty and leadership, implementing
The Annals of Family Medicine
The year 2022 was full of growth with STFM creating change and opportunity while focusing on diversity, equity, inclusion, and accessibility, antiracism, advocacy, and residency resources. We are finishing the year strong with 5,782 members as STFM continues to advance family medicine. While we look forward to 2023, we also would like to reflect on and share a few highlights from 2022. • The STFM Antiracism Task Force received 57 applications for an Academic Family Medicine Antiracism Learning Collaborative and selected 20 dyads. The Academic Family Medicine Learning Collaborative is an IRB-approved study to measure the effectiveness of training and implementation of various projects and strategies to: ∘ Empower and educate participants so they will identify racist structures and behaviors within their academic institutions and become leaders for change ∘ Promote allyship ∘ Spread effective change strategies
Theorizing Race and Racism: Preliminary Reflections on the Medical Curriculum
American Journal of Law & Medicine
The current political economic crisis in the United States places in sharp relief the tensions and contradictions of racial capitalism as it manifests materially in health care and in knowledge-producing practices. Despite nearly two decades of investment in research on racial inequality in disease, inequality persists. While the reasons for persistence of inequality are manifold, little attention has been directed to the role of medical education. Importantly, medical education has failed to foster critical theorizing on race and racism to illuminate the often-invisible ways in which race and racism shape biomedical knowledge and clinical practice. Medical students across the nation are advocating for more critical anti-racist education that centers the perspectives and knowledge of marginalized communities. This Article examines the contemporary resurgence in explicit forms of white supremacy in light of growing student activism and research that privileges notions of innate diffe...
Family medicine, 2021
BACKGROUND AND OBJECTIVES Curriculum addressing racism as a driver of inequities is lacking at most health professional programs. We describe and evaluate a faculty development workshop on teaching about racism to facilitate curriculum development at home institutions. METHODS Following development of a curricular toolkit, a train-the-trainer workshop was delivered at the 2017 Society of Teachers of Family Medicine Annual Spring Conference. Preconference evaluation and a needs assessment collected demographic data of participants, their learning communities, and experience in teaching about racism. Post-conference evaluations were completed at 2- and 6-month intervals querying participants' experiences with teaching about racism, including barriers; commitment to change expressed at the workshop; and development of the workshop-delivered curriculum. We analyzed quantitative data using Statistical Package for the Social Sciences (SPSS) software and qualitative data, through open ...