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场所的力量:旅行以探索结构性种族主义和健康差异。

The Power of Place: Travel to Explore Structural Racism and Health Disparities.

机构信息

J. Marbin is director, the University of California, Berkeley-University of California, San Francisco Joint Medical Program (JMP), Berkeley, California.

L. Lewis is associate director, the University of California, Berkeley-University of California, San Francisco Joint Medical Program (JMP), Berkeley, California.

出版信息

Acad Med. 2021 Nov 1;96(11):1569-1573. doi: 10.1097/ACM.0000000000004126.

Abstract

PROBLEM

Dismantling structural racism is essential to achieving health equity, but there is little guidance for medical educators who wish to teach learners to recognize and confront structural racism.

APPROACH

Critical consciousness provides a framework to identify and dismantle structural racism. Using a critical consciousness approach, the authors developed a novel 5-day travel experience to the American South for medical residents and faculty to explore the history and legacy of structural racism and the Civil Rights Movement. The purpose of the travel was to examine the connection between structural racism, especially anti-Black racism, and health disparities to better address health inequities within the participants' own home environment. Throughout the trip, faculty leaders applied principles of cultural humility and techniques from critical pedagogy, including recognizing the value of everyone in the room, creating cognitive disequilibrium, and promoting authentic dialogue.

OUTCOMES

End-of-week surveys revealed that the trip was well received. Organizers learned important lessons related to faculty and resident dynamics, race-based affinity group meetings, and the respectful use of stories as a tool for learning. Post-trip surveys at 1, 6, and 12 months revealed 3 major themes: participants experienced (1) transformed understanding of systemic racism, (2) increased motivation and bravery to act when witnessing interpersonal and structural racism, and (3) increased practice of cultural humility.

NEXT STEPS

Cultural humility and critical pedagogy can be used with travel to support learners in recognizing and confronting structural racism. The application of such techniques should be explored in local learning environments to foster commitment and action toward dismantling structural racism. In teaching structural racism, medical educators must be willing to consider new ways of teaching and learning.

摘要

问题

消除结构性种族主义对于实现健康公平至关重要,但对于希望教导学习者识别和应对结构性种族主义的医学教育者来说,几乎没有指导。

方法

批判意识为识别和消除结构性种族主义提供了一个框架。作者采用批判意识方法,为住院医师和教师开发了一种为期 5 天的美国南部旅行体验,以探索结构性种族主义和民权运动的历史和遗产。旅行的目的是检查结构性种族主义(尤其是反黑人种族主义)与健康差距之间的联系,以便更好地解决参与者自己家庭环境中的健康不平等问题。在整个行程中,教师领导者应用了文化谦逊原则和批判教育学技术,包括认识到房间内每个人的价值、创造认知失衡以及促进真实对话。

结果

周末调查显示,这次旅行很受欢迎。组织者了解了与教师和住院医师动态、基于种族的亲和团体会议以及尊重使用故事作为学习工具相关的重要经验教训。旅行结束后 1、6 和 12 个月的调查显示出 3 个主要主题:参与者经历了 (1) 对系统性种族主义的理解发生转变,(2) 当目睹人际和结构性种族主义时,行动的动力和勇气增加,(3) 文化谦逊的实践增加。

下一步

文化谦逊和批判教育学可以与旅行一起使用,以支持学习者识别和应对结构性种族主义。应在当地学习环境中探索这些技术的应用,以培养消除结构性种族主义的承诺和行动。在教授结构性种族主义时,医学教育者必须愿意考虑新的教学和学习方式。

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