Argueza Bianca R, Young Elisabeth S, Deering Laura, Franco Mauricio, Nightingale Jamila, Irving Paul, Edwell April, McBride Dannielle, Marbin Jyothi
Department of Pediatrics (BR Argueza, L Deering, M Fran co, A Edwell, and D McBride), University of California, San Francisco.
Department of Pediatrics (ES Young), Ann & Robert H. Lurie Children's Hospital of Chicago, Ill.
Acad Pediatr. 2024 Mar;24(2):184-189. doi: 10.1016/j.acap.2023.08.002. Epub 2023 Aug 9.
Intentionally discussing racism and health equity in clinical reasoning conference may provide an opportunity to reinforce antiracist praxis. We aimed to understand 1) whether these discussions provide a meaningful opportunity to practice applying an antiracist lens in patient care, 2) the feasibility of implementing these discussions in a clinical reasoning format, and 3) the acceptability to Black, Indigenous, and People of Color (BIPOC) and white residents.
In 2021, 4 clinical reasoning conference pilot sessions were implemented in a pediatrics residency program. Trained faculty facilitated discussions on mitigating inequity in clinical cases. Residents who attended at least 1 session were invited to participate in focus groups, which were analyzed using grounded theory.
Thirty residents attended each pilot session out of the 30 to 35 who had the opportunity to attend. The focus groups included 6 BIPOC and 6 white residents. The discussions offered a meaningful opportunity to practice recognizing and naming racism. Having faculty facilitators made the discussions more feasible. Both groups experienced benefits and wanted the discussions to continue, but BIPOC residents want more engagement from their white peers.
Discussing racism and health equity in clinical reasoning conference was a meaningful, feasible, and acceptable opportunity for antiracist praxis.
在临床推理会议中有意讨论种族主义和健康公平问题，可能会为强化反种族主义实践提供契机。我们旨在了解：1）这些讨论是否能为在患者护理中运用反种族主义视角提供有意义的实践机会；2）以临床推理形式开展这些讨论的可行性；3）黑人和原住民及有色人种（BIPOC）居民和白人住院医师对此的接受程度。
2021年，在一个儿科住院医师培训项目中开展了4次临床推理会议试点。由经过培训的教员主持关于减轻临床病例中不公平现象的讨论。邀请至少参加过1次会议的住院医师参加焦点小组，采用扎根理论进行分析。
有机会参加的30至35名住院医师中，每次试点会议有30名住院医师参加。焦点小组包括6名BIPOC居民和6名白人住院医师。这些讨论为实践识别和指出种族主义提供了有意义的机会。有教员主持使讨论更具可行性。两组都从中受益并希望讨论继续，但BIPOC居民希望他们的白人同行能更多地参与进来。
在临床推理会议中讨论种族主义和健康公平问题，是反种族主义实践的一个有意义、可行且可接受的机会。
