Objective: Creating competency-based curricula that calls for measurable competencies in areas of maternal health, social determinants of health, clinical care, quality improvement, and implicit bias is one of the actionable items that must be made to address inequities in care. As a response to many calls to action like this one, a curriculum was developed for all incoming medical students. Adapted from the University of Washington, this program was originally piloted in the Fall of 2020. It is now a mandatory discussion on race in medicine, centered around Dorothy Roberts’ book Fatal Invention. Prior to the discussion, all participants were asked to read three chapters from Fatal Invention and watch Dr. Roberts’ Ted Talk, “The Problem with Race Based Medicine”. At the start of the session, facilitators presented ground rules in their respective small groups to ensure a respectful and productive working environment. Surveys were conducted at the end of the session to track effectiveness and adjust for future sessions. The data illustrated that incoming students strongly endorsed facilitators’ effectiveness in discussing racism in both the voluntary and mandatory cohorts, and over 94% of students in both cohorts believed that anti-racism education is necessary in medical school.
Methods: 1. Prior to the workshop incoming first semester students read chapters 1, 4, and 6 of Dorothy Roberts\' Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century. A worksheet is provided to help guide them through the reading.
2. An hour and half long small group discussion with about 6 – 8 incoming students is facilitated by an upper semester student and a faculty or staff member. The co-facilitators have received training prior to the workshop.
3. In the last ten minutes of the workshop, students answer a brief survey about their experience and knowledge before and after participating in the discussion.
Results: During the inaugural Fall 2020 Antiracism Reading Group workshop, approximately 132 students participated in the voluntary discussion sessions, representing about 30% of incoming students and about 65% of students who participated responded to the survey. In Spring 2021, the program was made mandatory, and 95% of the incoming cohort participated in the discussion sessions and 90% responded to the survey. The results of the survey revealed a positive response to the program. In Fall 2020, 94% of students agreed to the question “Do you think anti-racism education is necessary in medical school?”, and in Spring 2021, 97% agreed. In Fall 2020 and Spring 2021 students answered the question “Did this program help increase your understanding of how racism can affect health?” with very good or good at 83% and 87% respectively. When responding to the question, “Did this program help increase your overall understanding of the role of race in medicine?” 80% and 89% of students agreed, respectively. When answering the question “did this program add to/change your ideas of race as a social construct?” 71% answered yes in the Fall 2020 cohort, whereas 91% answered yes in the Spring 2021 cohort.
Conclusion/ Discussion: Modern academic literature has found that training in implicit bias at all levels of education is fundamental in addressing racial inequities in medicine. The Antiracism Reading Group introduces incoming medical students to the role that race plays in medicine and requires them to confront their biases before they begin their medical education. The workshops were designed as small group discussions to allow students to have a conversation with socially dissimilar colleagues in a safe space. These types of conversations have been shown to give individuals confidence in communicating with others outside of their in-group, reduce avoidance of future conversations with dissimilar patients and colleagues, and foster further conversation and perspective-taking. The feedback from the surveys illustrated that students endorsed the use of time for anti-racism educational goals. The discussions achieved increased understanding of racism in both voluntary and mandatory cohorts, but the mandatory cohort reported a much higher addition of knowledge to ideas about race as a social construct. Participating students find the discussions meaningful and feel encouraged to continue to question biases in medicine.
Topics: Faculty Development Seminar, 2022, Student, Faculty, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Advocacy,
