Implementation of Formal Curriculum on Health Care Disparities in Military Family Medicine Residency

Overview

Journal Fam Med

Specialty Public Health

Date 2024 Mar 11

PMID 38467036

Authors

Kathryn E Oppenlander

Meghan F Raleigh

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: The Accreditation Council for Graduate Medical Education (ACGME) requires education on health care disparities (HCD), but research assessing formal curricula is limited. To improve knowledge and confidence in HCD, the family medicine residency program at Darnall Army Medical Center implemented a formal HCD curriculum.

Methods: During the 2021-2022 academic year, starting July 2021, a formal HCD curriculum was implemented for family medicine residents and faculty. Ten lectures on HCDs and implicit bias were given over the course of the year. Residents and faculty were asked to incorporate HCD into their regular continuing medical education lectures. ACGME survey data as well as a pre- and postcurriculum survey were used to assess HCD knowledge and confidence. Descriptive statistics and a paired-sample t tests were calculated to compare pre- to postcurriculum changes.

Results: The percentage of residents who reported that they had received HCD education increased from 72% on the 2021 ACGME survey to 100% in 2022 (N=18). We found a significant (P<.05) improvement in knowledge and confidence across 11 of 12 questions on the pre- and postcurriculum survey.

Conclusions: A formal curriculum in a military family medicine residency setting was effective for improving self-reported HCD knowledge and confidence.

References

Edgoose J, Quiogue M, Sidhar K . How to Identify, Understand, and Unlearn Implicit Bias in Patient Care. Fam Pract Manag. 2019; 26(4):29-33. View

Patow C, Bryan D, Johnson G, Canaan E, Oyewo A, Panda M . Who's in Our Neighborhood? Healthcare Disparities Experiential Education for Residents. Ochsner J. 2016; 16(1):41-4. PMC: 4795499. View

Ramadurai D, Sarcone E, Kearns M, Neumeier A . A Case-Based Critical Care Curriculum for Internal Medicine Residents Addressing Social Determinants of Health. MedEdPORTAL. 2021; 17:11128. PMC: 8015637. DOI: 10.15766/mep_2374-8265.11128. View

Neff J, Holmes S, Knight K, Strong S, Thompson-Lastad A, McGuinness C . Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities. MedEdPORTAL. 2020; 16:10888. PMC: 7182045. DOI: 10.15766/mep_2374-8265.10888. View

Thompson J, Bujalka H, McKeever S, Lipscomb A, Moore S, Hill N . Educational strategies in the health professions to mitigate cognitive and implicit bias impact on decision making: a scoping review. BMC Med Educ. 2023; 23(1):455. PMC: 10280953. DOI: 10.1186/s12909-023-04371-5. View

Noriea A, Redmond N, Weil R, Curry W, Peek M, Willett L . Development of a Multifaceted Health Disparities Curriculum for Medical Residents. Fam Med. 2017; 49(10):796-802. View

Chapman E, Kaatz A, Carnes M . Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. 2013; 28(11):1504-10. PMC: 3797360. DOI: 10.1007/s11606-013-2441-1. View

Perdomo J, Tolliver D, Hsu H, He Y, Nash K, Donatelli S . Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees. MedEdPORTAL. 2020; 15:10858. PMC: 7050660. DOI: 10.15766/mep_2374-8265.10858. View

Gleicher S, Chalmiers M, Aiyanyor B, Jain R, Kotha N, Scott K . Confronting implicit bias toward patients: a scoping review of post-graduate physician curricula. BMC Med Educ. 2022; 22(1):696. PMC: 9520104. DOI: 10.1186/s12909-022-03720-0. View

10.

Americo L, Ramjit A, Wu M, Jensen L, Caplin D, Mazzie J . Health Care Disparities in Radiology: A Primer for Resident Education. Curr Probl Diagn Radiol. 2018; 48(2):108-110. DOI: 10.1067/j.cpradiol.2018.05.007. View

11.

Medlock M, Weissman A, Wong S, Carlo A, Zeng M, Borba C . Racism as a Unique Social Determinant of Mental Health: Development of a Didactic Curriculum for Psychiatry Residents. MedEdPORTAL. 2018; 13. PMC: 5788030. DOI: 10.15766/mep_2374-8265.10618. View

12.

Schnierle J, Christian-Brathwaite N, Louisias M . Implicit Bias: What Every Pediatrician Should Know About the Effect of Bias on Health and Future Directions. Curr Probl Pediatr Adolesc Health Care. 2019; 49(2):34-44. PMC: 6652181. DOI: 10.1016/j.cppeds.2019.01.003. View

13.

Blanco I, Barjaktarovic N, Gonzalez C . Addressing Health Disparities in Medical Education and Clinical Practice. Rheum Dis Clin North Am. 2019; 46(1):179-191. DOI: 10.1016/j.rdc.2019.09.012. View