Medical Education and the Minority Tax

Cyrus, Kali D.

doi:10.1001/jama.2017.0196

Cited by 74 publications

(58 citation statements)

References 7 publications

(10 reference statements)

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“…The course director further refined the prompting questions and facilitator notes informed by narrative medicine and perspectives from the medical literature. 14,44–51…”

Section: Methodsmentioning

confidence: 99%

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

et al. 2018

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IntroductionGrowing recognition of the deleterious effects of racism on health has led to calls for increased education on racism for health care professionals. As part of a larger curriculum on health equity and social justice, we developed a new educational session on racism for first-year medical students consisting of a lecture followed by a case-based small-group discussion.MethodsOver the academic years of 2016–2017, 2017–2018, and 2018–2019, a total of 536 first-year medical students participated in this mandatory session. The course materials were developed as a collaboration between faculty and students. The lecture was delivered in a large-group format; the small-group case-based discussion consisted of 10–12 students with one upper-level student facilitator.ResultsThe majority of respondents for the course evaluation felt that the course had met its stated objectives, and many commented that they had an increased awareness of the role of racism in shaping health. Students felt that the small-group activity was especially powerful for learning about racism.DiscussionActive student involvement in curriculum development and small-group facilitation was critical for successful buy-in from students. Additional content on bias, stereotyping, and health care disparities will be the focus of faculty development programs and will also be integrated into the clerkships to build on these important topics as students are immersed in clinical care.

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“…The course director further refined the prompting questions and facilitator notes informed by narrative medicine and perspectives from the medical literature. 14,44–51…”

Section: Methodsmentioning

confidence: 99%

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

et al. 2018

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“…7,17,19,20 Finally, institutions often unfairly rely on a limited number of volunteer faculty-frequently, people of color who are designated or feel personally responsible-to teach on these topics. 21 Engaging a broader faculty audience in learning about structural racism and implicit bias can help institutions develop more faculty leaders in these areas.…”

Section: Introductionmentioning

confidence: 99%

Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees

et al. 2019

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Introduction: The medical community recognizes the importance of confronting structural racism and implicit bias to address health inequities. Several curricula aimed at teaching trainees about these issues are described in the literature. However, few curricula exist that engage faculty members as learners rather than teachers of these topics or target interdisciplinary audiences. Methods: We developed a longitudinal case conference curriculum called Health Equity Rounds (HER) to discuss and address the impact of structural racism and implicit bias on patient care. The curriculum engaged participants across training levels and disciplines on these topics utilizing case-based discussion, evidence-based exercises, and two relevant conceptual frameworks. It was delivered quarterly as part of a departmental case conference series. We evaluated HER's feasibility and acceptability by tracking conference attendance and administering postconference surveys. We analyzed quantitative survey data using descriptive statistics and qualitatively reviewed free-text comments. Results: We delivered seven 1-hour HER conferences at our institution from June 2016 to June 2018. A mean of 66 participants attended each HER. Most survey respondents (88% or more) indicated that HER promoted personal reflection on implicit bias, and 75% or more indicated that HER would impact their clinical practice. Discussion: HER provided a unique forum for practitioners across training levels to address structural racism and implicit bias. Our aim in dissemination is to provide meaningful tools for others to adapt at their own institutions, recognizing that HER should serve as a component of larger, multifaceted efforts to decrease structural racism and implicit bias in health care.

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“…The development and empowerment of these allies should be prioritized 8 to avoid overtaxing SGM faculty. 32 Student feedback on variable faculty teaching and professionalism further reinforces the importance of faculty development initiatives. Explicit teaching instructions for faculty and students can also improve interventions.…”

Section: Sgm Educationmentioning

confidence: 98%

First year medical student experiences with a clinical skills seminar emphasizing sexual and gender minority population complexity

2020

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Purpose: Patients identifying as sexual and gender minorities (SGMs) face healthcare barriers. This problem is partly due to medical training.1 We evaluated first year medical student experiences during a novel four-hour seminar, in which students answered discussion questions, participated in peer role-plays, and interviewed two standardized patients Method: A constructivist qualitative design employed audio-recorded and transcribed student focus groups. Using generic content analysis, transcripts were iteratively coded, emergent categories identified, sensitizing concepts applied, and a thematic framework created. Results: Thirty-five students (71% female) participated in five focus groups. Two themes were developed: SGM bias (faculty, standardized patients [SPs], students, curriculum), and Adaptive Expertise in Clinical Skills (case complexity, learner support, skill development). SPs identifying as SGM brought authenticity and lived experience to their roles. Preceptor variability impacted student learning. Students were concerned when a lack of faculty SGM knowledge accompanied negative biases. Complex SP cases promoted cognitive integration and preparation for clinical work. Conclusions: These students placed importance on the lived experiences of SGM community members. Persistent prejudices amongst faculty negatively influenced student learning. Complex SP cases can promote student adaptive expertise, but risk unproductive learning failures. The lessons learned have implications for clinical skills teaching, learning about minority populations, and medical and health professions education in general.

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Medical Education and the Minority Tax

Cited by 74 publications

References 7 publications

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees

First year medical student experiences with a clinical skills seminar emphasizing sexual and gender minority population complexity

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