Lynn Thérése M, D'urzo Katrina A, Vaughan-Ogunlusi Oluwarotimi, Wiesendanger Kathryn, Colbert-Kaip Sarah, Capcara Austin, Chen Sarah, Sreenan Seamus, Brennan Marian P
Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Department of Endocrinology, Connolly Hospital, Dublin, Ireland.
Med Educ Online. 2023 Dec;28(1):2176802. doi: 10.1080/10872981.2023.2176802.
Systemic racism impacts personal and community health; however, education regarding its role in perpetuating healthcare inequity remains limited in medical curricula. This study implemented and evaluated the impact of a student-led anti-racism programme on medical students' perceptions of racial bias in medicine, awareness of, and confidence to advocate against racism in medicine.
A total of 543 early stage medical students were invited to participate in the programme. Participants were assigned readings and videos exploring racial injustice in medicine and attended a virtual small-group discussion facilitated by faculty and students. Online surveys were used to collect pre- and post-programme data using Likert scales for response items. Open-ended questions were independently reviewed by three authors using reflexive thematic analysis.
Sixty-three early-stage medical students enrolled in the programme, of which 42 completed the pre-programme survey. There was a 76% ( = 32) response rate for the post-programme survey. The majority of students (60%, = 25) had no previous education about racism in medicine. From pre- to post-programme, there was a significant change in students' perceived definition of race from genetic, biological, geographical, and cultural factors to socio-political factors ( < 0.0001). Significant increases in almost all factors assessing student awareness of racism and confidence to advocate against racism were observed. Student-identified barriers to discussing racism included lack of education and lived experience, fear of starting conflict and offending others. All survey respondents would recommend this programme to peers and 69% ( = 32) engaged in further topical self-directed education.
This simple and reproducible programme improved awareness and confidence to advocate against racism in medicine and resulted in a change in opinion regarding race-based medical practice. These findings are in line with best practice towards addressing racial bias in medicine, decolonizing medical curricula and strengthening anti-racism teaching of future physicians.
系统性种族主义影响个人和社区健康；然而，关于其在延续医疗保健不平等方面作用的教育在医学课程中仍然有限。本研究实施并评估了一项由学生主导的反种族主义计划对医学生对医学中种族偏见的认知、对医学中种族主义的认识以及反对医学中种族主义的倡导信心的影响。
共邀请了543名早期医学生参加该计划。参与者被分配阅读材料和视频，探讨医学中的种族不公正问题，并参加由教师和学生主持的虚拟小组讨论。使用在线调查，通过李克特量表收集计划前后的数据。三位作者使用反思性主题分析独立审查开放式问题。
63名早期医学生参加了该计划，其中42名完成了计划前的调查。计划后的调查回复率为76%（n = 32）。大多数学生（60%，n = 25）以前没有接受过关于医学中种族主义的教育。从计划前到计划后，学生对种族的认知定义从遗传、生物、地理和文化因素显著转变为社会政治因素（p < 0.0001）。几乎所有评估学生对种族主义的认识和反对种族主义倡导信心的因素都有显著增加。学生指出的讨论种族主义的障碍包括缺乏教育和生活经历、害怕引发冲突和冒犯他人。所有调查受访者都将向同龄人推荐该计划，69%（n = 32）的人参与了进一步的主题自主教育。
这个简单且可重复的计划提高了反对医学中种族主义的意识和倡导信心，并导致了对基于种族的医疗实践看法的改变。这些发现符合解决医学中种族偏见、使医学课程去殖民化以及加强未来医生反种族主义教学的最佳实践。
