Holdren Sarah, Iwai Yoshiko, Lenze Nicholas R, Weil Amy B, Randolph Antonia M
The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Teach Learn Med. 2023 Aug-Sep;35(4):457-466. doi: 10.1080/10401334.2022.2067165. Epub 2022 May 24.
:Diversity, Equity, and Inclusion (DEI) trainings for medical school faculty often lack self-reflective and pedagogically focused components that may promote incorporation of anti-racism and social justice into medical school curricula. : A four-session Narrative Medicine (NM) anti-racism program was designed for medical school faculty using critical race theory, phenomenology, and NM methods. Each workshop consisted of a lecture on key NM concepts and a small-group breakout session incorporating group discussion, close reading, and reflective writing. : This NM anti-racism program was developed and implemented in April 2021 by two medical students for faculty at an institution in the southeastern U.S. The program was supported by the Office of Inclusive Excellence at the institution and held in collaboration with the institution's medical education teaching academy. Program evaluation consisted of pre- and post-program surveys, which queried participants' previous experiences with DEI and medical humanities programs, perceptions of self-identity and privilege, and confidence in teaching concepts of anti-racism. Of the total program participants (n = 32), 19 completed both surveys (54.3%). Survey data were analyzed using bivariate testing methods and qualitative thematic analysis. : Post-program surveys showed 13 (68.4%) participants felt "somewhat more" or "more" comfortable engaging in concepts of race, and 12 (63.2%) participants felt "somewhat more" or "more" comfortable including topics of race into their teaching compared to before the program. Five themes were generated following qualitative analysis: (1) the value of longitudinal narrative reflection in a small-group setting for DEI work; (2) desire to commit more time to DEI, anti-racist, and social justice work while balancing busy teaching and clinical schedules; (3) the value of storytelling in DEI and anti-racism programming; (4) an understanding of deconstructive and reconstructive work of anti-racism in medicine; and (5) an increased ability to educate and enact change through teaching, activism, and institutional cultural and policy changes. : This novel NM DEI training for medical school faculty was successful in increasing comfort discussing and teaching concepts of race in the medical school classroom, while providing a uniquely reflective space for personal growth. Participation in this longitudinal reflective experience was limited by physician schedules, therefore efforts to make time to participate in similar longitudinal interventions must be undertaken.
针对医学院教师的多样性、公平性和包容性(DEI)培训往往缺乏自我反思和以教学为重点的内容,而这些内容可能有助于将反种族主义和社会正义纳入医学院课程。
一个为期四节的叙事医学(NM)反种族主义项目是为医学院教师设计的,采用了批判种族理论、现象学和NM方法。每个工作坊包括一场关于关键NM概念的讲座以及一个小组讨论环节,其中包含小组讨论、精读和反思性写作。
这个NM反种族主义项目由两名医学生于2021年4月为美国东南部一所机构的教师开发并实施。该项目得到了该机构包容性卓越办公室的支持,并与该机构的医学教育教学学院合作举办。项目评估包括项目前后的调查,这些调查询问了参与者之前在DEI和医学人文学项目方面的经历、对自我身份和特权的认知,以及在教授反种族主义概念方面的信心。在项目的所有参与者(n = 32)中,19人完成了两项调查(54.3%)。调查数据采用双变量测试方法和定性主题分析进行分析。
项目后的调查显示,13名(68.4%)参与者感到在涉及种族概念时“稍微更”或“更”自在,12名(63.2%)参与者感到与项目前相比,在将种族话题纳入教学时“稍微更”或“更”自在。定性分析产生了五个主题:(1)在小组环境中进行纵向叙事反思对DEI工作的价值;(2)在平衡繁忙的教学和临床日程安排的同时,希望投入更多时间进行DEI、反种族主义和社会正义工作;(3)讲故事在DEI和反种族主义项目中的价值;(4)对医学中反种族主义的解构性和重建性工作的理解;(5)通过教学、行动主义以及机构文化和政策变革来教育和推动变革的能力增强。
这个针对医学院教师的新颖的NM DEI培训成功地提高了在医学院课堂上讨论和教授种族概念时的自在程度,同时为个人成长提供了一个独特的反思空间。由于医生的日程安排,参与这种纵向反思体验受到了限制,因此必须努力腾出时间参与类似的纵向干预措施。