Perdomo Joanna, Tolliver Destiny, Hsu Heather, He Yuan, Nash Katherine A, Donatelli Stephanie, Mateo Camila, Akagbosu Cynthia, Alizadeh Faraz, Power-Hays Alexandra, Rainer Tyler, Zheng Daniel J, Kistin Caroline J, Vinci Robert J, Michelson Catherine D
General Academic Pediatrics Fellow, Boston Children's Hospital.
Resident, Department of Pediatrics, Boston Children's Hospital.
MedEdPORTAL. 2019 Nov 22;15:10858. doi: 10.15766/mep_2374-8265.10858.
The medical community recognizes the importance of confronting structural racism and implicit bias to address health inequities. Several curricula aimed at teaching trainees about these issues are described in the literature. However, few curricula exist that engage faculty members as learners rather than teachers of these topics or target interdisciplinary audiences.
We developed a longitudinal case conference curriculum called Health Equity Rounds (HER) to discuss and address the impact of structural racism and implicit bias on patient care. The curriculum engaged participants across training levels and disciplines on these topics utilizing case-based discussion, evidence-based exercises, and two relevant conceptual frameworks. It was delivered quarterly as part of a departmental case conference series. We evaluated HER's feasibility and acceptability by tracking conference attendance and administering postconference surveys. We analyzed quantitative survey data using descriptive statistics and qualitatively reviewed free-text comments.
We delivered seven 1-hour HER conferences at our institution from June 2016 to June 2018. A mean of 66 participants attended each HER. Most survey respondents (88% or more) indicated that HER promoted personal reflection on implicit bias, and 75% or more indicated that HER would impact their clinical practice.
HER provided a unique forum for practitioners across training levels to address structural racism and implicit bias. Our aim in dissemination is to provide meaningful tools for others to adapt at their own institutions, recognizing that HER should serve as a component of larger, multifaceted efforts to decrease structural racism and implicit bias in health care.
医学界认识到应对结构性种族主义和隐性偏见以解决健康不平等问题的重要性。文献中描述了一些旨在向学员传授这些问题的课程。然而，很少有课程能让教员成为这些主题的学习者而非教师，也很少有课程针对跨学科受众。
我们开发了一个名为“健康公平轮值会议”（HER）的纵向病例讨论会课程，以讨论和解决结构性种族主义和隐性偏见对患者护理的影响。该课程利用基于案例的讨论、循证练习和两个相关概念框架，让不同培训水平和学科的参与者参与这些主题的讨论。它作为部门病例讨论会系列的一部分每季度进行一次。我们通过跟踪会议出席情况和进行会后调查来评估HER的可行性和可接受性。我们使用描述性统计分析定量调查数据，并对自由文本评论进行定性审查。
2016年6月至2018年6月，我们在本校举办了七次时长为1小时的HER会议。每次HER会议平均有66名参与者。大多数调查受访者（88%或更多）表示HER促进了对隐性偏见的个人反思，75%或更多的受访者表示HER会影响他们的临床实践。
HER为不同培训水平的从业者提供了一个独特的论坛，以应对结构性种族主义和隐性偏见。我们传播这一课程的目的是为其他人提供有意义的工具，以便在他们自己的机构中进行调整，同时认识到HER应作为减少医疗保健领域结构性种族主义和隐性偏见的更大规模、多方面努力的一个组成部分。
