Toward diversity-responsive medical education: taking an intersectionality-based approach to a curriculum evaluation

Abstract

Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a ‘narrow’ or a ‘broad’ definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at using an intersectionality-based approach to define diversity-related learning objectives and to evaluate how biomedical and sociocultural aspects of diversity were integrated into a medical curriculum in the Netherlands. We took a three-phase mixed methods approach. In phase one and two, we defined essential learning objectives based on qualitative interviews with school stakeholders and diversity literature. In phase three, we screened the written curriculum for diversity content (culture, sex/gender and class) and related the results to learning objectives defined in phase two. We identified learning objectives in three areas of education (medical knowledge and skills, patient–physician communication, and reflexivity). Most diversity content pertained to biomedical knowledge and skills. Limited attention was paid to sociocultural issues as determinants of health and healthcare use. Intersections of culture, sex/gender and class remained mostly unaddressed. The curriculum’s diversity-responsiveness could be improved by an operationalization of diversity that goes beyond biomedical traits of assumed homogeneous social groups. Future efforts to take an intersectionality-based approach to curriculum evaluations should include categories of difference other than culture, sex/gender and class as separate, equally important patient identities or groups.

Medical students and professional anatomists do not perceive gender bias within imagery featuring anatomy

“…Previously (Morgan et.al., 2014, 2016), we suggested that it might be helpful to include a short course on the history of anatomy that incorporated an understanding of gender issues in medical training so as to raise awareness and improve students' critical skills. Brenner and Pais () suggest that “anatomical education should not only provide knowledge, but also skills and attitudes, which can be fostered by the involvement of anatomy in medical humanities.” Transformation of the culture of medicine to encourage the formation of an inclusive organizational and educational climate, and the embedding of teaching content related to sociocultural and biomedical aspects of diversity into preclinical and clinical teaching programs, is recommended by Muntinga et al (). Even when gender issues are not formally taught, they can be embedded within the anatomy course if the teachers themselves have sufficient training, understanding and motivation.…”

Building a medical workforce in Tasmania: A profile of medical student intake

“…2 These have been shown to influence rural career preference, particularly when combined. 3,7,8 WP refers to proportional inclusion of students representing the broader community, including those from disadvantaged backgrounds, mature age students, ethnic and cultural groups and students with a disability. 6 Widening participation (WP) and widening access (WA) are two different strategies that aim to increase the diversity of medical students entering medical school, premised to increase culturally and socially appropriate health care to help overcome disparity.…”

“…6 Widening participation (WP) and widening access (WA) are two different strategies that aim to increase the diversity of medical students entering medical school, premised to increase culturally and socially appropriate health care to help overcome disparity. 3,7,8 WP refers to proportional inclusion of students representing the broader community, including those from disadvantaged backgrounds, mature age students, ethnic and cultural groups and students with a disability. 9 WA refers more specifically to selection policies and processes that overcome inequity in meeting standard entry requirements.…”

Editorial: Diversity in Medical Education

“…Despite the advocacy for cultural competence already for decades, and despite the influx of female and minority students, the uptake of diversity issues in all facets of medical education has been slow. Issues are for instance addressing the (under)representation of black and minority students (5), transforming learning climate and organizational cultures (6,7), and integrating diversity issues in curricula (2,(6)(7)(8)(9).…”