When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting

Brooks, Katherine C.; Rougas, Steven; George, Paul

doi:10.15766/mep_2374-8265.10523

Cited by 46 publications

(83 citation statements)

References 15 publications

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“…7 In the past decade, several training programs have developed curricula on structural racism and implicit bias for medical students and residents. [8][9][10][11][12][13][14][15] However, few curricula have focused on faculty members as learners rather than teachers of these topics or engaged faculty and trainees together. [16][17][18] This paucity of either team-or faculty-focused curricula is problematic.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 99%

“…HER is unique compared to other curricula in MedEdPORTAL [8][9][10][11][12][13][14] in that we designed it for an interdisciplinary audience spanning training levels. Additionally, we utilized real cases from our own institutions as a foundation for discussion that involved providers, patients, and families sharing their experiences.…”

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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“…Research in the USA has extensively examined the relationship between race and health, demonstrating that people who experience racism have poorer mental and physical health outcomes [ 3 , 11 ], therefore concluding that discrimination is a social determinant of health that has a significant impact on minority populations [ 12 , 13 ]. More specifically, studies on racism in health care have noted that implicit bias of health care providers result in differential clinical treatments and decisions, leading to lower quality care for racialized groups [ 14 , 15 ]. Physicians in the USA have reinforced that differential treatment based on race does exist in the health care system, as they acknowledged that they had more positive associations with their non-racialized patients when compared to their racialized patients [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Insiders’ Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals

Wylie

McConkey

2018

J. Racial and Ethnic Health Disparities

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Discrimination in the health care system has a direct negative impact on health and wellbeing. Experiences of discrimination are considered a root cause for the health inequalities that exist among Indigenous peoples. Experiences of discrimination are commonplace, with patients noting abusive treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This research project examined the perspectives of health care providers and decision-makers to identify what challenges they see facing Indigenous patients and families when accessing health services in a large city in southern Ontario. Discrimination against Indigenous people was identified as major challenges by respondents, noting that it is widespread. This paper discusses the three key discrimination subthemes that were identified, including an unwelcoming environment, stereotyping and stigma, and practice informed by racism. These findings point to the conclusion that in order to improve health care access for Indigenous peoples, we need to go beyond simply making health services more welcoming and inclusive. Practice norms shaped by biases informed by discrimination against Indigenous people are widespread and compromise standards of care. Therefore, the problem needs to be addressed throughout the health care system as part of a quality improvement strategy. This will require not only a significant shift in the attitudes, knowledge, and skills of health care providers, but also the establishment of accountabilities for health care organizations to ensure equitable health services for Indigenous peoples.

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“…Prior work with educational modules on racism for medical students, 24,25 psychiatry residents, 26 third-year clerkship students, 27 and physicians 28,29 has shown an increase in awareness of the importance of racism and bias, as well as an enhancement of a commitment to health equity. These interventions used one of multiple different modalities, including didactic lectures, small-group case-based discussions, online tutorials, and IATs.…”

Section: Introductionmentioning

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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When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting

Abstract: Introduction: There is a growing body of literature illustrating the negative impact of racial bias on clinical

Cited by 46 publications

References 15 publications

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

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

Insiders’ Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals

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

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