Clinical Significance
- •Radical transformation of the medical education landscape is needed to disrupt structural racism in healthcare.
- •Many practicing physicians are unaware of the present-day practices that perpetuate racial bias and contribute to healthcare disparities.
- •A structured framework on how to teach this expansive topic in the clinical learning environment can be an effective way to engage learners in real-time as they encounter teachable moments with patients.
Abstract
Dismantling racism in health care demands that medical education promote racial justice
throughout all stages of medical training. However, racial bias can be fostered unintentionally,
influencing the way we make decisions as clinicians with downstream effects on patient
health and health equity. The development of any anti-racism curriculum in medicine
requires the ability to identify racial bias in practices we have not previously recognized
as explicitly racist or unjust. This has limited the creation and delivery of effective
antiracism education in healthcare.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Breaking the Silence: Time to Talk About Race and Racism.Acad Med. 2017; 92: 285-288https://doi.org/10.1097/ACM.0000000000001416
- Racial Health Disparities, COVID-19, and a Way Forward for US Health Systems.J Hosp Med. 2020; 16: 50-52https://doi.org/10.12788/jhm.3545
- Why Doesn't Diversity Training Work? The Challenge for Industry and Academia.Anthropol Now. 2018; 10: 48-55https://doi.org/10.1080/19428200.2018.1493182
- Addressing and Eliminating Racism at the AAMC and Beyond.2020 (Published)
- CRITICAL RACE THEORY AND THE CULTURAL COMPETENCE DILEMMA IN SOCIAL WORK EDUCATION.J Soc Work Educ. 2009; 45: 245-261https://doi.org/10.5175/JSWE.2009.200700109
- Decoding the Learning Environment of Medical Education: A Hidden Curriculum Perspective for Faculty Development.Acad Med. 2011; 86: 440-444https://doi.org/10.1097/ACM.0b013e31820df8e2
- Physicians and Implicit Bias: How Doctors May Unwittingly Perpetuate Health Care Disparities.J Gen Intern Med. 2013; 28: 1504-1510https://doi.org/10.1007/s11606-013-2441-1
- Misrepresenting Race — The Role of Medical Schools in Propagating Physician Bias.N Engl J Med. 2021; 384: 872-878https://doi.org/10.1056/NEJMms2025768
- Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms.N Engl J Med. 2020; 383: 874-882https://doi.org/10.1056/NEJMms2004740
- The Case for Removing Race From the American Academy of Pediatrics Clinical Practice Guideline for Urinary Tract Infection in Infants and Young Children With Fever.JAMA Pediatr. 2020; 174: 229https://doi.org/10.1001/jamapediatrics.2019.5242
- Reconsidering the Consequences of Using Race to Estimate Kidney Function.JAMA. 2019; 322: 113-114https://doi.org/10.1001/jama.2019.5774
- An Anti-Racist Approach to Achieving Mental Health Equity in Clinical Care.Psychiatr Clin North Am. 2020; 43: 451-469https://doi.org/10.1016/j.psc.2020.05.002
Diffey L, Mignone J. Implementing Anti-Racist Pedagogy in Health Professional Education: A Realist Review. Health Educ Care. 2017;2(1). doi:10.15761/HEC.1000114
- Walking on Eggshells With Trainees in the Clinical Learning Environment—Avoiding the Eggshells Is Not the Answer.JAMA Pediatr. 2019; 173: 907https://doi.org/10.1001/jamapediatrics.2019.2501
- Presence 5 for Racial Justice Workshop: Fostering Dialogue Across Medical Education to Disrupt Anti-Black Racism in Clinical Encounters.MedEdPORTAL. 10. 2022: 11227https://doi.org/10.15766/mep_2374-8265.11227 (Published online February)
Perdomo J, Tolliver D, Hsu H, et al. Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees. MedEdPORTAL. Published online November 25, 2019:10858. doi:10.15766/mep_2374-8265.10858
- Bias and Racism Teaching Rounds at an Academic Medical Center.Chest. 2020; 158: 2688-2694https://doi.org/10.1016/j.chest.2020.08.2073
- The Five-Minute Moment.Am J Med. 2016; 129: 792-795https://doi.org/10.1016/j.amjmed.2016.02.020
- teaching when time is limited.BMJ. 2008; 336: 384-387
- A five-step "microskills" model of clinical teaching.J Am Board Fam Pract. 1992; 5: 419-424
- Sparking a Movement, Not a Moment: Framework and Outcomes From a Pediatrics Department-Wide Coalition to Advance Anti-Racism.Acad Pediatr. 2022; (Published online October)S1876285922005277https://doi.org/10.1016/j.acap.2022.10.003
- Practical Lessons for Teaching About Race and Racism: Successfully Leading Free, Frank, and Fearless Discussions.Acad Med. 2020; 95: S139-S144https://doi.org/10.1097/ACM.0000000000003710
- Dermatology in primary care prevalance and patient disposition.J Am Acad Dermatol. 2001; 45: 350-355
- Representations of race and skin tone in medical textbook imagery.Soc Sci Med. 2018; 202: 38-42
- Melanoma Among Non-Hispanic Black Americans.Prev Chronic Dis. 2019; 16 (Doi)180640https://doi.org/10.5888/pcd16.180640
- Taylor and Kelly's Dermatology for Skin of Color.2e. McGraw Hill. 2016;
Article info
Publication history
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
