M.E. Peek is associate professor of medicine, Section of General Internal Medicine, member, Center for the Study of Race, Politics and Culture, and associate director, Chicago Center for Diabetes Translation Research, The University of Chicago, Chicago, Illinois.
M.B. Vela is professor of medicine, Section of General Internal Medicine, member, Center for the Study of Race, Politics and Culture, and associate dean, Multicultural Affairs, The University of Chicago, Chicago, Illinois.
Acad Med. 2020 Dec;95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments):S139-S144. doi: 10.1097/ACM.0000000000003710.
Successfully teaching about race and racism requires a careful balance of emotional safety and honest truth-telling. Creating such environments where all learners can thrive and grow together is a challenge, but a consistently doable one. This article describes 12 lessons learned within 4 main themes: ground rules; language and communication; concepts of social constructs, intersectionality, and bidirectional biases; and structural racism, solutions, and advocacy. The authors' recommendations for how to successfully teach health professions students about race and racism come from their collective experience of over 60 years of instruction, research, and practice. Proficiency in discussing race and addressing racism will become increasingly relevant as health care institutions strive to address the social needs of patients (e.g., food insecurity, housing instability) that contribute to poor health and are largely driven by structural inequities. Having interprofessional team-based care, with teams better able to understand and counteract their own biases, will be critical to addressing the social and structural determinants of health for marginalized patients. Recognizing that implicit biases about race impact both patients and health professions students from underrepresented racial/ethnic backgrounds is a critical step toward building robust curricula about race and health equity that will improve the learning environment for trainees and reduce health disparities.
成功教授有关种族和种族主义的知识需要在情感安全和诚实的真相之间取得谨慎的平衡。创造这样一个环境，让所有学习者都能共同茁壮成长是一项挑战，但也是一项始终可行的挑战。本文描述了在 4 个主要主题内学到的 12 个经验教训：基本规则；语言和沟通；社会结构、交叉性和双向偏见的概念；以及结构性种族主义、解决方案和倡导。作者关于如何成功地向医疗保健专业的学生教授种族和种族主义的建议来自他们 60 多年的教学、研究和实践经验。随着医疗机构努力满足导致健康状况不佳的患者的社会需求（例如，粮食不安全，住房不稳定），熟练地讨论种族问题和解决种族主义问题将变得越来越重要，而这些社会需求主要是由结构性不平等造成的。拥有以团队为基础的专业间护理，团队能够更好地理解和抵消自己的偏见，对于解决边缘化患者的健康的社会和结构性决定因素至关重要。认识到种族方面的隐性偏见会影响来自代表性不足的种族/族裔背景的患者和医疗保健专业学生，是建立关于种族和健康公平的强大课程的关键一步，这将改善学员的学习环境并减少健康差距。
