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设计一门社会正义课程以提升住院医师培训学员的批判性意识。

Design of a Social Justice Curriculum to Expand Critical Consciousness Among Resident Trainees.

作者信息

Rock Robert M, Ferrel Vanessa K, Diaz Chanelle, González Corro Luis, Oki Oladimeji, Ansah-Samuels Ekua, Gao Qi, Kim Ryung S, Hassan Iman

机构信息

Research Associate, Department of Medicine, Yale School of Medicine, New Haven, CT, USA.

Internal Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

J Gen Intern Med. 2025 Jan;40(1):185-191. doi: 10.1007/s11606-024-08986-2. Epub 2024 Aug 7.

Abstract

BACKGROUND

Health equity curricula emphasizing critical pedagogy and centering perspectives of those with marginalized identities, both in curriculum design and execution, have yet to be described in interdisciplinary graduate medical education settings.

AIM

The application of public health critical race praxis (PHCRP) in the redesign and evaluation of a social medicine immersion month (SMIM) curriculum.

SETTING

A mandatory, 4-week course within the Residency Program for Social Medicine in the Bronx, NY.

PARTICIPANTS

First-year residents in internal medicine, family medicine, pediatrics, and clinical psychology fellows between 2019 and 2020.

PROGRAM DESCRIPTION

Residents and faculty underrepresented in medicine employed PHCRP to ground SMIM in critical pedagogy and structural competency with the goals of increasing critical consciousness, sensitizing trainees to structural barriers faced by patients, and promoting meaningful engagement in advocacy.

PROGRAM EVALUATION

SMIM was evaluated pre- and post-curriculum using a validated critical consciousness and intersectionality survey, with additional questions to assess competency and behaviors. Participants also provided course feedback. Participants demonstrated significant increases across all domains of the measure (Racism + 1.62 (p < .01), Classism + 1.62 (p < .05), Heterosexism + 1.06 (p < .05)). Participant feedback was positive.

DISCUSSION

PHCRP is a valuable model for designing health equity curriculum. SMIM provides insights for incorporating this framework into GME curricula.

摘要

背景

在跨学科研究生医学教育环境中,尚未有关于在课程设计和实施中强调批判教育学并以边缘化身份者视角为中心的健康公平课程的描述。

目的

将公共卫生批判种族实践(PHCRP)应用于社会医学沉浸式月(SMIM)课程的重新设计和评估。

背景

纽约布朗克斯区社会医学住院医师项目中的一门为期4周的必修课。

参与者

2019年至2020年间的内科、家庭医学、儿科学一年级住院医师以及临床心理学研究员。

项目描述

医学领域代表性不足的住院医师和教员运用PHCRP,将SMIM建立在批判教育学和结构能力基础上,目标是提高批判意识,使学员对患者面临的结构障碍敏感,并促进有意义的倡导参与。

项目评估

在课程前后使用经过验证的批判意识和交叉性调查对SMIM进行评估,并增加了评估能力和行为的问题。参与者还提供了课程反馈。参与者在该测量的所有领域均有显著提高(种族主义+1.62(p<.01),阶级主义+1.62(p<.05),异性恋主义+1.06(p<.05))。参与者反馈积极。

讨论

PHCRP是设计健康公平课程的宝贵模式。SMIM为将该框架纳入研究生医学教育课程提供了见解。

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