When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting
Overview
Medical Education
Affiliations
Introduction: There is a growing body of literature illustrating the negative impact of racial bias on clinical care. Despite the growing evidence, medical schools have been slow to make necessary curricular changes. Most attempts to educate on racial health disparities focus on transferring knowledge and do not foster the development of skills to understand one's own bias or address bias and racism in the clinical setting. To address this, we developed a small-group, case-based curriculum for rising third-year medical students.
Methods: This session was designed to be delivered in concurrently run, 1-hour small-group sessions, with each small group ideally comprising no more than 10 students and one facilitator. The curriculum was integrated into an existing 3-week clerkship preparation course for 122 students during the 2015-2016 academic year. The session materials include a facilitator's guide and three cases for discussion.
Results: The session was evaluated using a 6-point Likert scale (1 = , 6 = ). Students rated this session overall a 4.28 out of 6 ( = 79). Qualitative feedback varied, with the most common theme focusing on the need for more time to discuss this topic.
Discussion: Though one session before starting clinical clerkships is not enough to maintain the practice of sustained critical thinking regarding bias and racism in clinical medicine, this session is a starting point for curriculum developers looking to use an evidence-based approach to racial bias in clinical care.
Wright V, Stepp E, Flemming B, Kandler C, Wait T, Godshall-Bennett L MedEdPORTAL. 2024; 20:11443.
PMID: 39268085 PMC: 11390879. DOI: 10.15766/mep_2374-8265.11443.
Race Dialogues and Potential Application in Clinical Environments: A Scoping Review.
Borowsky H, Schofield C, Du T, Margo J, Williams K, Sloan D J Gen Intern Med. 2024; 39(15):3064-3072.
PMID: 39042181 PMC: 11576711. DOI: 10.1007/s11606-024-08915-3.
Racial Implicit Bias and Communication Among Physicians in a Simulated Environment.
Gonzalez C, Ark T, Fisher M, Marantz P, Burgess D, Milan F JAMA Netw Open. 2024; 7(3):e242181.
PMID: 38506811 PMC: 10955368. DOI: 10.1001/jamanetworkopen.2024.2181.
Alexander A, Singh M, Scott A, Moreira R, Atkinson T, Fissel R MedEdPublish (2016). 2024; 10:129.
PMID: 38486600 PMC: 10939538. DOI: 10.15694/mep.2021.000129.1.
Implicit Bias and Patient Care: Mitigating Bias, Preventing Harm.
Barber Doucet H, Wilson T, Vrablik L, Wing R MedEdPORTAL. 2023; 19:11343.
PMID: 37731596 PMC: 10507144. DOI: 10.15766/mep_2374-8265.11343.