National Institutes of Allergic and Infectious Diseases, National Institutes of Health, Bethesda, Md.
Department of Pediatrics, Division of Allergy and Immunology, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Ark.
J Allergy Clin Immunol Pract. 2022 Apr;10(4):936-949. doi: 10.1016/j.jaip.2022.02.009. Epub 2022 Feb 18.
Resources to prepare Allergy and Immunology trainees and providers to recognize and address health disparities are lacking. We designed a curriculum using interactive sessions incorporating disease-specific, evidence-based content, and a panel-based workshop with facilitated discussion to prepare Allergy and Immunology trainees to identify structural racism and health disparities. Pre-session surveys revealed that a high portion of trainees reported feeling comfortable recognizing bias and discussing health equity (n = 16, mean = 3.6/5 on a Likert scale), but felt less confident in their ability to address disparities in practice or to identify resources to care for historically disadvantaged communities (n = 16, mean = 2.9/5 on a Likert scale). The curriculum improved respondents' confidence in their ability to address these issues, with a panel-based workshop increasing attendees' scores an average of 0.65 points (n = 17, mean: pre-survey 3.31 vs post-survey 3.95). After the sessions, a toolkit was created to optimize delivery of medical education to address health disparities and define core concepts for this subject. Resources to implement these concepts in research design and recruitment efforts were included. With inadequate guidance for the incorporation of disparities-focused medical education curricula, our educational series, resources, and interactive toolkit add to existing literature to improve disparities competencies in teaching, clinical practices, and research design.
缺乏资源来培训过敏和免疫学受训者和提供者,以识别和解决健康差距。我们设计了一个课程,使用互动环节,纳入特定疾病、基于证据的内容,以及一个小组为基础的研讨会,进行有针对性的讨论,以培训过敏和免疫学受训者识别结构性种族主义和健康差距。课前调查显示,很大一部分受训者表示对识别偏见和讨论健康公平问题感到舒适(n=16,Likert 量表平均得分为 3.6/5),但对自己在实践中解决差距的能力或识别资源来照顾历史上处于不利地位的社区的能力信心不足(n=16,Likert 量表平均得分为 2.9/5)。该课程提高了受访者对解决这些问题的能力的信心,一个小组为基础的研讨会将与会者的分数平均提高了 0.65 分(n=17,平均:课前调查 3.31,课后调查 3.95)。课程结束后,创建了一个工具包,以优化医疗教育的提供,以解决健康差距,并定义这一主题的核心概念。包括实施这些概念的研究设计和招聘工作的资源。由于缺乏纳入以差异为重点的医学教育课程的指导,我们的教育系列、资源和互动工具包增加了现有文献,以提高教学、临床实践和研究设计方面的差异能力。