Dennis Syeachia N, Gold Rachel S, Wen Frances K
University of Oklahoma-University of Tulsa School of Community Medicine, Department of Family and Community Medicine, Tulsa, OK.
University of Tulsa Albert Schweitzer Fellowship, Tulsa, OK.
Fam Med. 2019 Jan;51(1):41-47. doi: 10.22454/FamMed.2019.704337.
Racism's impact on health has been well documented. Health professional programs are beginning to help learners understand this social determinant of health through curricular integration of education related to racism. Yet educators are hesitant to integrate these concepts into curricula because of lack of expertise or fear associated with learner responses to this potentially sensitive topic. The purpose of this study is to describe the responses of learners to learning sessions on racism as a social determinant of health (SDOH) highlighting structural, personally-mediated, and internalized racism.
Two separate groups-a family and community medicine (FCM) residency program (N=23) and a community health leadership program (N=14)-participated in lectures and workshops on internalized, personally-mediated, and structural sources of racism, and tours introducing them to the local community's historical roots of structural racism, including discussions/reflections on racism's impact on health and health care. Mixed-methods evaluation consisted of learner assessments and reflections on the experiences.
FCM sessions received a positive reception with session averages of 4.15 to 4.75, based on a Likert-type scale (1=did not meet expectations to 5=exceeded expectations). Thematic analysis of community health leadership participant reflections showed thought processing connected to a better understanding of racism. Overall, themes from both programs reflected positive experiences of the sessions.
Our preliminary study findings suggest that educators who encounter internal or external barriers to integrating racism-related concepts into curricula might find that these concepts are well received. This study lays the groundwork for further research into best practices for integration of curriculum on racism as an SDOH for medical schools, residency programs, and other related educational settings.
种族主义对健康的影响已有充分记录。健康专业项目开始通过将与种族主义相关的教育融入课程，帮助学习者理解这一健康的社会决定因素。然而，由于缺乏专业知识或担心学习者对这一潜在敏感话题的反应，教育工作者对将这些概念融入课程犹豫不决。本研究的目的是描述学习者对关于种族主义作为健康的社会决定因素（SDOH）的学习课程的反应，重点突出结构性、个人介导性和内化性种族主义。
两个独立的小组——一个家庭与社区医学（FCM）住院医师项目（N = 23）和一个社区健康领导力项目（N = 14）——参加了关于内化性、个人介导性和结构性种族主义来源的讲座和工作坊，以及带领他们了解当地社区结构性种族主义历史根源的参观活动，包括关于种族主义对健康和医疗保健影响的讨论/反思。混合方法评估包括学习者对这些经历的评估和反思。
基于李克特量表（1 = 未达到期望至5 = 超出期望），FCM课程获得了积极反馈，课程平均分为4.15至4.75。对社区健康领导力参与者反思的主题分析表明，其思维过程与对种族主义的更好理解相关。总体而言，两个项目的主题都反映了课程的积极体验。
我们的初步研究结果表明，在将与种族主义相关的概念融入课程时遇到内部或外部障碍的教育工作者可能会发现这些概念很受欢迎。本研究为进一步探究将种族主义课程作为医学院、住院医师项目及其他相关教育环境的健康社会决定因素的最佳实践奠定了基础。
