Teaching Anti-Racism in the Clinical Environment: The Five-Minute Moment for Racial Justice in Healthcare

Teaching anti-racism
Published:December 21, 2022DOI:

      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.


      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.


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        • Acosta D
        • Ackerman-Barger K.
        Breaking the Silence: Time to Talk About Race and Racism.
        Acad Med. 2017; 92: 285-288
        • Nguemeni Tiako MJ
        • Forman HP
        • Nunez-Smith M
        Racial Health Disparities, COVID-19, and a Way Forward for US Health Systems.
        J Hosp Med. 2020; 16: 50-52
        • Dobbin F
        • Kalev A.
        Why Doesn't Diversity Training Work? The Challenge for Industry and Academia.
        Anthropol Now. 2018; 10: 48-55
        • Association of American Medical Colleges
        Addressing and Eliminating Racism at the AAMC and Beyond.
        2020 (Published)
        • Abrams LS
        • Moio JA.
        J Soc Work Educ. 2009; 45: 245-261
        • Hafler JP
        • Ownby AR
        • Thompson BM
        • et al.
        Decoding the Learning Environment of Medical Education: A Hidden Curriculum Perspective for Faculty Development.
        Acad Med. 2011; 86: 440-444
        • Chapman EN
        • Kaatz A
        • Carnes M.
        Physicians and Implicit Bias: How Doctors May Unwittingly Perpetuate Health Care Disparities.
        J Gen Intern Med. 2013; 28: 1504-1510
        • Amutah C
        • Greenidge K
        • Mante A
        • et al.
        Misrepresenting Race — The Role of Medical Schools in Propagating Physician Bias.
        N Engl J Med. 2021; 384: 872-878
        • Vyas DA
        • Eisenstein LG
        • Jones DS.
        Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms.
        N Engl J Med. 2020; 383: 874-882
        • Kowalsky RH
        • Rondini AC
        • Platt SL.
        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: 229
        • Eneanya ND
        • Yang W
        • Reese PP.
        Reconsidering the Consequences of Using Race to Estimate Kidney Function.
        JAMA. 2019; 322: 113-114
        • Legha RK
        • Miranda J.
        An Anti-Racist Approach to Achieving Mental Health Equity in Clinical Care.
        Psychiatr Clin North Am. 2020; 43: 451-469
      1. 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

        • Gold MA
        • Rosenthal SL
        • Wainberg ML.
        Walking on Eggshells With Trainees in the Clinical Learning Environment—Avoiding the Eggshells Is Not the Answer.
        JAMA Pediatr. 2019; 173: 907
        • Shankar M
        • Henderson K
        • Garcia R
        • et al.
        Presence 5 for Racial Justice Workshop: Fostering Dialogue Across Medical Education to Disrupt Anti-Black Racism in Clinical Encounters.
        MedEdPORTAL. 10. 2022: 11227 (Published online February)
      2. 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

        • Capers Q
        • Bond DA
        • Nori US.
        Bias and Racism Teaching Rounds at an Academic Medical Center.
        Chest. 2020; 158: 2688-2694
        • Chi J
        • Artandi M
        • Kugler J
        • et al.
        The Five-Minute Moment.
        Am J Med. 2016; 129: 792-795
        • Irby DM
        • Wilkerson I.
        teaching when time is limited.
        BMJ. 2008; 336: 384-387
        • Neher JO
        • Gordon KC
        • Meyer B
        • et al.
        A five-step "microskills" model of clinical teaching.
        J Am Board Fam Pract. 1992; 5: 419-424
        • Yemane L
        • Ramirez M
        • Guerin A
        • et al.
        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)S1876285922005277
        • Peek ME
        • Vela MB
        • Chin MH.
        Practical Lessons for Teaching About Race and Racism: Successfully Leading Free, Frank, and Fearless Discussions.
        Acad Med. 2020; 95: S139-S144
        • Lowell BA
        • Froelich CW
        • Federman DG
        • Kirsner RS.
        Dermatology in primary care prevalance and patient disposition.
        J Am Acad Dermatol. 2001; 45: 350-355
        • Louie P
        • Wilkes R.
        Representations of race and skin tone in medical textbook imagery.
        Soc Sci Med. 2018; 202: 38-42
        • Culp MB
        • Lunsford NB.
        Melanoma Among Non-Hispanic Black Americans.
        Prev Chronic Dis. 2019; 16 (Doi)180640
        • Kelly A
        • Taylor S.C.
        • Lim H.W.
        • Serrano A
        Taylor and Kelly's Dermatology for Skin of Color.
        2e. McGraw Hill. 2016;