A Framework for Developing Antiracist Medical Educators and Practitioner–Scholars

Sotto-Santiago, Sylk; Poll-Hunter, Norma; Trice, Traci; Buenconsejo-Lum, Lee; Golden, Sherita Hill; Howell, Joy; Jacobs, Nicole; Lee, Winona; Mason, Hyacinth R. C.; Ogunyemi, Dotun; Crespo, Waleska; Lamba, Sangeeta

doi:10.1097/acm.0000000000004385

Cited by 35 publications

(22 citation statements)

References 33 publications

(46 reference statements)

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“…Some existing literature proposes principles and practices for antiracism in medical education. 11,[24][25][26][27] Areas recognized in extant literature included foundational knowledge and awareness, 11 supporting scientific research focused on addressing and ANNALS OF FAMILY MEDICINE ✦ WWW.ANNFAMMED.ORG ✦ VOL. 21, SUPPLEMENT 2 ✦ 2023 eliminating racism, 24 public health race praxis, and approaches to the development of antiracist medical educators.…”

Section: Areas For Focusmentioning

confidence: 99%

“…21, SUPPLEMENT 2 ✦ 2023 eliminating racism, 24 public health race praxis, and approaches to the development of antiracist medical educators. 11,26 None, however, propose a stepwise guided implementation of an antiracism curriculum for medical students and residents. On the basis of the themes that emerged from our study, a potential conceptual model for implementing antiracism medical education could be developed.…”

Section: Areas For Focusmentioning

confidence: 99%

“…10 Additionally, the AAMC Group on Diversity and Inclusion created a framework to promote antiracist pedagogy. 11 Despite these efforts, little is known about how AHCs have translated words of commitment into action by developing, implementing, and evaluating antiracism pedagogy. We undertook this study to evaluate the current state of antiracism pedagogy in undergraduate and graduate medical curricula, including barriers to and facilitators of implementation.…”

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The Current State of Antiracism Curricula in Undergraduate and Graduate Medical Education: A Qualitative Study of US Academic Health Centers

et al. 2023

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PURPOSEWe undertook a study to evaluate the current state of pedagogy on antiracism, including barriers to implementation and strengths of existing curricula, in undergraduate medical education (UME) and graduate medical education (GME) programs in US academic health centers. METHODSWe conducted a cross-sectional study with an exploratory qualitative approach using semistructured interviews. Participants were leaders of UME and GME programs at 5 institutions participating in the Academic Units for Primary Care Training and Enhancement program and 6 affiliated sites from November 2021 to April 2022. RESULTSA total of 29 program leaders from the 11 academic health centers participated in this study. Three participants from 2 institutions reported the implementation of robust, intentional, and longitudinal antiracism curricula. Nine participants from 7 institutions described race and antiracism-related topics integrated into health equity curricula. Only 9 participants reported having "adequately trained" faculty. Participants mentioned individual, systemic, and structural barriers to implementing antiracism-related training in medical education such as institutional inertia and insufficient resources. Fear related to introducing an antiracism curriculum and undervaluing of this curriculum relative to other content were identified. Through learners and faculty feedback, antiracism content was evaluated and included in UME and GME curricula. Most participants identified learners as a stronger voice for transformation than faculty; antiracism content was mainly included in health equity curricula.CONCLUSIONS Inclusion of antiracism in medical education requires intentional training, focused institutional policies, enhanced foundational awareness of the impact of racism on patients and communities, and changes at the level of institutions and accreditation bodies.

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Section: Areas For Focusmentioning

confidence: 99%

Section: Areas For Focusmentioning

confidence: 99%

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confidence: 99%

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The Current State of Antiracism Curricula in Undergraduate and Graduate Medical Education: A Qualitative Study of US Academic Health Centers

et al. 2023

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“…Toolkits for teaching about structural racism in medical school have been published and presented at recent conferences. [48][49][50][51][52][53][54][55] Clerkships also likely have access to teaching resources internally. In this study, nearly 80% of responding clerkship directors said they could identify a qualified faculty member to teach about systemic racism.…”

Section: Discussionmentioning

confidence: 99%

More Than Half of Family Medicine Clerkships Do Not Address Systemic Racism: A CERA Study

Bridges

Rampon

Mabachi

et al. 2023

Fam Med

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Background and Objectives: The influence of racism in medicine is increasingly acknowledged, and the negative effect of systemic racism on individual and population health is well established. Yet, little is known about how or whether medical students are being educated on this topic. This study investigated the presence and features of curricula related to systemic racism in North American family medicine clerkships. Methods: We conducted a survey of North American family medicine clerkship directors as part of the 2021 Council of Academic Family Medicine’s Educational Research Alliance (CERA) survey. Results: The survey response rate was 49% (78/160). Almost all clerkship directors agreed (n=68; 97.1%) that teaching about racism at all levels of medical education was appropriate. Yet, 60% (n=42) of family medicine clerkship directors reported no formalized curriculum for teaching about racism or bias. Teaching about systemic racism was more likely to be present in the family medicine clerkship at institutions where clerkship directors reported that faculty receive 5 or more hours of training in racism and bias, as compared to institutions where faculty receive 4 or fewer hours of training in racism/bias (odds ratio 2.82, 95% CI 1.05-8.04, P=.045). Programs reported using racism in medicine curricula based in cultural competency (20%); structural competency (10%); both cultural and structural competency (31%); and neither or uncertain (40%). Clerkship directors reported high faculty, student, and institutional engagement in addressing systemic racism. We did not find an association between underrepresented in medicine director identity and racism curricula. Conclusions: In more than half of family medicine clerkships, systemic racism is not addressed, despite interest from students and institutional support. A higher number of hours of faculty training time on the topic of racism was associated with having a systemic racism module in the clerkship curriculum, but we lacked data to identify a causal relationship. Investments in faculty development to teach systemic racism, including discussion of structural competency, are needed.

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“…8 Embedding initiatives into clinical practice is a central component of a proposed framework to develop antiracist medical educators and practitioner-scholars. 9 One speci c clinical challenge for supervisors is how to respond-in real-time, at the coalface of charged affect-to racialized and hostile interactions involving trainees under their supervision. 10 Supervisors responsible for the oversight, protection, and support of their racially minoritized charges are often inconsistent in their approach and have limited guidance to inform their actions.…”

Section: Introductionmentioning

confidence: 99%

Responding to anti-Black racism in clinical supervision: using simulated encounters to develop a behavioral typology

Calhoun

Martin

Adigun

et al. 2022

Preprint

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Context Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. Supervisors charged with the oversight, protection, and support of their racially minoritized trainees are often inconsistent in their approach and have limited guidance to inform their actions. Methods We designed an empirical study in which experienced supervisors responded to seven short, videotaped interactions between 1) a simulated participant (SP) and different clinicians-in-training; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist (entrenching) or antiracist (uprooting) behaviors. After viewing each clip, participants shared their reflections before joining together for a structured debriefing. Using a thematic-phenomenological qualitative approach, we analyzed the corpus of free-text entries and debriefing transcripts. Results We recruited 52 participants into five two-hour-long sessions. They developed a behavioral typology for supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible responses: 1) Gradation: from conciliatory to confrontational; 2) Explicitness: from eliding to naming; 3) Ownership: from individual to shared; 4) Involvement: from deferred (excusing) to cotemporaneous (including); and 5) Stance: from protective to paternalistic. Conclusion A behavioral typology can serve as a rubric for supervisors to engage in reflective practice and for medical educators to inform faculty development initiatives to fight anti-Black racism in clinical practice. In addition, the typology can serve as a framework for facilitated discussion among healthcare providers who may have experienced or witnessed anti-Black racist interactions.

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A Framework for Developing Antiracist Medical Educators and Practitioner–Scholars

Abstract: Supplemental Digital Content is available in the text.

Cited by 35 publications

References 33 publications

The Current State of Antiracism Curricula in Undergraduate and Graduate Medical Education: A Qualitative Study of US Academic Health Centers

The Current State of Antiracism Curricula in Undergraduate and Graduate Medical Education: A Qualitative Study of US Academic Health Centers

More Than Half of Family Medicine Clerkships Do Not Address Systemic Racism: A CERA Study

Responding to anti-Black racism in clinical supervision: using simulated encounters to develop a behavioral typology

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