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4. An Anti-Racism and Equity Initiative Improves Residency Educational Conferences

Author

James, Aisha K., Matthiesen, Madeleine I., Jasrasaria, Rashmi, Jowell, Amanda R., Kelly, Michael S., Vyas, Darshali A., Zeidman, Jessica A., and Burnett-Bowie, Sherri-Ann M.

Subjects
Diversity, Equity, Inclusion, and Justice
Abstract

BACKGROUND: Graduate medical education curricula may reinforce systemic inequities and bias, thus contributing to health disparities. Curricular interventions and evaluation measures are needed to increase trainee awareness of bias and known inequities in health care. OBJECTIVE: This study sought to improve the content of core noontime internal medicine residency educational conferences by implementing the Department of Medicine Anti-Racism and Equity (DARE) educational initiative. METHODS: DARE best practices were developed from available anti-racism and equity educational materials. Volunteer trainees and faculty in the department of medicine of a large urban academic medical center were recruited and underwent an hourlong training to utilize DARE best practices to coach faculty on improving the anti-racist and equity content of educational conferences. DARE coaches then met with faculty to review the planned 2021-2022 academic year (AY) lectures and facilitate alignment with DARE best practices. A rubric was created from DARE practices and utilized to compare pre-intervention (AY21) and post-intervention (AY22) conferences. RESULTS: Using the DARE best practices while coaching increased the anti-racism and equity content from AY21 to AY22 (total rubric score mean [SD] 0.16 [1.19] to 1.38 [1.39]; P=.001; possible scores -4 to +5), with 75% (21 of 28) of AY22 conferences showing improvement. This included increased diversity of photographs, discussion of the racial or ethnic makeup of research study participants, appropriate use of race in case vignettes, and discussion of the impact of racism or bias on health disparities. CONCLUSIONS: Training coaches to implement DARE best practices improved the anti-racism and equity content of existing noontime internal medicine residency educational conferences.

Published
2023

5. Attitudes and Actions Related to Racism: the Anti-RaCism (ARC) Survey Study

Author

Massachusetts Institute of Technology. Department of Physics, Burnett-Bowie, Sherri-Ann M., Zeidman, Jessica A., Soltoff, Alexander E., Carden, Kylee T., James, Aisha K., Armstrong, Katrina A., Massachusetts Institute of Technology. Department of Physics, Burnett-Bowie, Sherri-Ann M., Zeidman, Jessica A., Soltoff, Alexander E., Carden, Kylee T., James, Aisha K., and Armstrong, Katrina A.

Abstract

Background Racism negatively impacts health and well-being. Members of the medical community must intervene to address racism. Objective To assess whether attitudes about the impact of racism on health or society are associated with intervening around racism. Design Cross-sectional survey of a large department of medicine in an urban academic setting. Participants Interns, residents, fellows, and faculty. Main Measures The primary outcome was the likelihood of intervening around an observed racist encounter or a racist policy. Predictor variables included age, gender identity, race/ethnicity, and attitudes about racism. Key Results Although the majority of the 948 respondents endorsed the impact of racism on health and other societal effects, levels of endorsement were lower among older individuals, or those reporting male gender identity or selecting other race. Higher endorsement of the impact of racism on health was associated with increased odds of speaking up about a racist encounter or racist policy, with odds ratios from 1.18 to 1.30 across scenarios. Likelihood of speaking up about racism did not differ by racial or ethnic group, but older individuals were generally more likely to speak up and individuals between 20 and 29 years of age were more likely to speak with someone other than leadership or the source of a racist encounter. Conclusions Awareness of the effects of racism on health is associated with increased likelihood of intervening when a racist encounter is observed or a racist policy is noted. Including information on the impact of racism on health and creating safe spaces to discuss racism may increase the likelihood of bystander intervention in anti-racism strategies.

Published
2022

12. An Anti-Racism and Equity Initiative Improves Residency Educational Conferences.

Author

James AK, Matthiesen MI, Jasrasaria R, Jowell AR, Kelly MS, Vyas DA, Zeidman JA, and Burnett-Bowie SM

Subjects
Humans, Antiracism, Curriculum, Education, Medical, Graduate, Internship and Residency, Racism
Abstract

Background: Graduate medical education curricula may reinforce systemic inequities and bias, thus contributing to health disparities. Curricular interventions and evaluation measures are needed to increase trainee awareness of bias and known inequities in health care., Objective: This study sought to improve the content of core noontime internal medicine residency educational conferences by implementing the Department of Medicine Anti-Racism and Equity (DARE) educational initiative., Methods: DARE best practices were developed from available anti-racism and equity educational materials. Volunteer trainees and faculty in the department of medicine of a large urban academic medical center were recruited and underwent an hourlong training to utilize DARE best practices to coach faculty on improving the anti-racist and equity content of educational conferences. DARE coaches then met with faculty to review the planned 2021-2022 academic year (AY) lectures and facilitate alignment with DARE best practices. A rubric was created from DARE practices and utilized to compare pre-intervention (AY21) and post-intervention (AY22) conferences., Results: Using the DARE best practices while coaching increased the anti-racism and equity content from AY21 to AY22 (total rubric score mean [SD] 0.16 [1.19] to 1.38 [1.39]; P =.001; possible scores -4 to +5), with 75% (21 of 28) of AY22 conferences showing improvement. This included increased diversity of photographs, discussion of the racial or ethnic makeup of research study participants, appropriate use of race in case vignettes, and discussion of the impact of racism or bias on health disparities., Conclusions: Training coaches to implement DARE best practices improved the anti-racism and equity content of existing noontime internal medicine residency educational conferences., Competing Interests: Conflict of interest: The authors declare they have no competing interests.

Published
2023
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