Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Family Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
J Osteopath Med. 2022 Apr 26;122(6):277-287. doi: 10.1515/jom-2021-0228.
Race is a social construct, not a biological or genetic construct, utilized to categorize people based on observable traits, behaviors, and geographic location. Findings from the Human Genome Project demonstrated that humans share 99.9% of their DNA; despite this evidence, race is frequently utilized as a risk factor for diagnosis and prescribing practices. Diagnosing and treating people based on race is known as race-based medicine. Race-based medicine perpetuates biases and diverts attention and resources from the social determinants of health that cause racial health inequities. Minimal research has examined medical students' understanding of race-based medicine.
The purpose of this study was to assess osteopathic medical students' knowledge, beliefs, and experiences with race-based medicine.
We conducted a descriptive, cross-sectional survey study to assess osteopathic medical students' knowledge, beliefs, and experiences with race-based medicine. An electronic, anonymous survey was distributed to all osteopathic medical students enrolled at a medical school in the Midwest with three campuses during the 2019-2020 academic year. Participants completed a brief demographic questionnaire and the Race-Based Medicine Questionnaire. Descriptive and inferential statistics were conducted utilizing SPSS statistical software version 28.0, and statistical significance was defined as a p<0.05. Open-ended questions were analyzed utilizing content and thematic analyses.
A total of 438 of the 995 osteopathic medical students consented to participate in the study, for a response rate of 44.0%. Among those participants, 221 (52.0%) reported that they had heard of the term "race-based medicine." Familiarity with the term differed by racial background (χ [2] = 24.598, p<0.001), with Black or African American participants indicating greater familiarity with the term compared to all other races. Of the participants familiar with race-based medicine, 79 (44.4%) provided the correct definition for the term; this finding did not differ by any sociodemographic variable. Part of the way through the questionnaire, all participants were provided the correct definition of "race-based medicine" and asked if they thought medical schools should teach race-based medicine. The majority of participants (n=231, 61.4%) supported the teaching of race-based medicine. Qualitative findings elaborated on participants' support or opposition for teaching race-based medicine in medical school. Those in support explained the importance of teaching historical perspectives of race-based medicine as well as race as a data point in epidemiology and its presence on board examinations, whereas those in opposition believed it contradicted osteopathic principles and practice.
Findings showed half of the participants were familiar with race-based medicine, and among those, less than half knew the definition of the term. Highlighting osteopathic philosophy and its focus on the whole person may be one approach to educating osteopathic medical students about race-based medicine.
种族是一种社会建构，而不是生物或遗传建构，用于根据可观察的特征、行为和地理位置对人群进行分类。人类基因组计划的研究结果表明，人类 99.9%的 DNA 是相同的；尽管有这些证据，但种族经常被用作诊断和处方实践的风险因素。根据种族诊断和治疗患者被称为基于种族的医学。基于种族的医学加剧了偏见，并转移了人们对造成种族健康不平等的健康决定因素的注意力和资源。很少有研究检查医学生对基于种族的医学的理解。
本研究旨在评估整骨医学专业学生对基于种族的医学的了解、信念和经验。
我们进行了一项描述性、横断面调查研究，以评估整骨医学专业学生对基于种族的医学的了解、信念和经验。在 2019-2020 学年期间，我们向中西部一所医学院的所有整骨医学专业学生发放了一份电子匿名调查，该医学院有三个校区。参与者完成了一份简短的人口统计学问卷和基于种族的医学问卷。利用 SPSS 统计软件版本 28.0 进行描述性和推理统计，统计学意义定义为 p<0.05。利用内容和主题分析对开放式问题进行了分析。
共有 995 名整骨医学专业学生中的 438 名同意参与研究，回应率为 44.0%。在这些参与者中，221 名（52.0%）报告说他们听说过“基于种族的医学”一词。对该术语的熟悉程度因种族背景而异（χ[2]=24.598，p<0.001），与所有其他种族相比，黑人和非洲裔美国人参与者表示对该术语更为熟悉。在熟悉基于种族的医学的参与者中，有 79 名（44.4%）提供了该术语的正确定义；这一发现与任何社会人口统计学变量均无关。在问卷调查进行到一半时，所有参与者都收到了“基于种族的医学”的正确定义，并被问到他们是否认为医学院应该教授基于种族的医学。大多数参与者（n=231，61.4%）支持教授基于种族的医学。定性研究结果详细阐述了参与者对在医学院教授基于种族的医学的支持或反对。那些支持的人解释了教授基于种族的医学的历史观点以及种族作为流行病学数据点及其在董事会考试中的存在的重要性，而那些反对的人则认为这与整骨医学的原则和实践相矛盾。
研究结果表明，一半的参与者熟悉基于种族的医学，其中不到一半的人知道该术语的定义。强调整骨医学哲学及其对整个人的关注可能是教育整骨医学专业学生了解基于种族的医学的一种方法。
