a Pediatrics, Centre for Medical Education, and Office of Social Accountability and Community Engagement , Faculty of Medicine, McGill University , Montreal , Canada.
b Department of Field Activities , Accreditation Council for Graduate Medical Education , Chicago , IL.
Med Teach. 2019 Apr;41(4):380-384. doi: 10.1080/0142159X.2019.1566600. Epub 2019 Feb 22.
While diversity, equity, and inclusion are much proclaimed aspirational goals in education programs, the clinical learning environment (CLE) frequently falls short of meaningful incorporation of these concepts in processes, policies, and local culture. In this paper, we explore how inclusion, diversity, and equity can and should be defined and operationalized within medical education. Three cases, organized around Hafferty's curricular framework (formal, informal, and hidden), we illustrate lapses and potential best practices in inclusion in the CLE. The essential "best-practice" of programs inclusive of diverse individuals is the design of policies, processes, and behavioral norms co-creatively with all community members. Potential pitfalls to greater inclusion include nostalgic reference to "the past", a neutrality that is operationalized without the rudder of explicit values and not recognizing that ethical obligations between teachers, learners, and programs are at the heart of the discussion of how inclusive learning and work environments are built. Inclusive CLE's provide space for co-creation, understand the need to ensure the voices of the vulnerable (i.e. learners) are heard and valued and through this promote the flourishing of diverse human capital, in keeping with a model that views diversity as a key attribute or organizational excellence.
虽然多样性、公平性和包容性在教育计划中被广泛宣称是理想的目标，但临床学习环境（CLE）在将这些概念融入到过程、政策和当地文化中时往往做得不够。在本文中，我们探讨了在医学教育中如何定义和实施包容性、多样性和公平性。我们围绕 Hafferty 的课程框架（正式、非正式和隐性）组织了三个案例，说明了在 CLE 中包容性方面的失误和潜在最佳实践。包容性计划的基本“最佳实践”是与所有社区成员共同设计政策、流程和行为规范。更广泛包容性的潜在陷阱包括对“过去”的怀旧参考、没有明确价值观为指导的中立性，以及没有认识到教师、学习者和项目之间的道德义务是讨论如何建立包容性学习和工作环境的核心。包容性 CLE 为共同创造提供了空间，理解需要确保弱势群体（即学习者）的声音被听到和重视，并通过这种方式促进多样化人力资本的蓬勃发展，这符合将多样性视为组织卓越的关键属性或组织卓越的模式。
