Objective. To describe a health equity curriculum created for pharmacy students and evaluate students' perceptions and structural competency after completion of the curriculum. Methods. A health equity curriculum (HEC) based on transformative learning and structural competency frameworks was implemented as a 10-week mandatory component of the pass-no pass neuropsychiatric theme for second-year pharmacy students. Each week, students reviewed materials around a neuropsychiatric-related health equity topic and responded to discussion prompts through asynchronous forums or synchronous Zoom discussions. The HEC was evaluated through assessment of structural competency through a validated instrument (SCI), an objective structured clinical examination (OSCE), and a questionnaire. Results. All enrolled second-year pharmacy students (n=124) participated in the HEC. Of the 75 (68%) students who completed the SCI, 46 (61%) were able to identify structural determinants of health, explain how structures contribute to health disparities, or design structural interventions. Ninety-six (77%) students were able to address their OSCE standardized patient's mistrust in the health care system. Thematic analysis of student comments elucidated three themes-allyship, peer connection, and self-awareness. Students rated asynchronous discussion forums as significantly less effective than Zoom discussions and patient cases for achieving curricular objectives. Conclusion.A remote, mandatory, blended health equity curriculum demonstrated an effective model for social justiceoriented education. From our experience, a curriculum spread throughout the didactic curriculum with a blended approach is an effective way to incorporate health equity conversations into existing programs and could be an important step in training student pharmacists to be advocates for social justice.
Objective To teach learners to identify and recognize structural causes of health disparities, design interventions, and engage in equitable, civil, and compassionate discussions. Background The racial injustices amplified by the COVID‐19 pandemic have stressed the importance of educating healthcare practitioners to be advocates for social justice. Structural competency provides a framework for teaching students to be aware of structural causes of health disparities and design interventions to address them. We designed and implemented a ten‐week Health Equity curriculum to promote structural competency and reduce implicit bias in healthcare providers. Here, we report on the design, implementation, student performance and student attitudes regarding this curriculum. Methods The Health Equity curriculum was a mandatory component of the Neuropsychiatric Theme for second year Pharmacy students. Students were assigned to subgroups of 5‐6 and were distributed across self‐identified gender and ethnicity. The curriculum was conducted remotely and consisted of didactic material, asynchronous online discussions, and synchronous Zoom discussions. Didactic material included videos, podcasts, journal articles, and faculty‐created lectures. Asynchronous discussions were structured around the didactic content and open‐ended prompts were provided to stimulate conversation. Three live discussions provided students with space to discuss the topics in real time. Four main topics were covered: (1) cultural and structural influences on mental health, (2) mental health and LGBTQ populations, (3) homelessness, deinstitutionalization and the mental health system, and (4) a student‐identified topic. A survey was administered before and after the curriculum, and topics were assessed in OSCE (Objective Structured Clinical Examination). Results Student responses from pre‐ and post‐surveys will be compared and quantitatively analyzed. A thematic qualitative analysis of student responses to open‐ended questions will be conducted and compared. OSCE performance will be assessed for application of what was learned. Conclusion Given the challenges of integrating health disparities education into already impacted curricula, we believe our curriculum presents a rich learning experience with minimal in‐class time and has potential for wide dissemination across health professional schools, with the opportunity for interprofessional collaboration. This curriculum has gone through one iteration with one cohort of students. However, given its innovative nature, we will gain insights into student engagement and performance in an online Health Equity curriculum.
Physicians of the future will be expected to synthesize new knowledge and appropriately apply it in patient care. Here, we report on the effects of and student attitudes towards resource‐enhanced exams by comparing student performance on closed‐book exams with or without access to pharmacology flashcards. Setting: the University of California, San Francisco (UCSF) School of Medicine (SOM), class of 2021 (N = 149), followed over 4 years. We provided pharmacology flashcards for studying purposes in all blocks; flashcards were only accessible during closed‐book exams in 2 of 5 blocks. We collected pharmacology open‐ended question (OEQ) scores and analyzed results using repeated measures ANOVA (SPSS). We collected MS4 survey data using Qualtrics and conducted a thematic content analysis. Performance on pharmacology questions on exams was not higher with access to pharmacology flashcards during exams. The number of students who passed pharmacology questions without flashcards on exams was as follows: 137 ± 3.7, 132 ± 5.0, and 134 ± 7.9 (average ± SEM). The number of students who passed pharmacology questions with flashcards on exams was as follows: 132 ± 6.6 and 120 ± 7.5. Survey comments revealed several themes. Access to pharmacology flashcards during exams allowed learners to focus on understanding the bigger picture and reduced stress. A subset of students reported having access to flashcards on pre‐clerkship exams hurt their preparation for clerkships. Flashcards as exam resources were received well by approximately half the class, who reported benefits including more time to focus on understanding bigger picture concepts and reduced stress.
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