The Impact of Racism on Health: A Health Equity Training on Structural Racism for Military Residents and Fellows.

INTRODUCTION

Recognizing the need for more opportunities to learn about health equity within military graduate medical education (GME), we developed a resident-led curriculum to introduce these concepts from a military cultural competency lens. The Impact of Racism on Health module focuses on structural racism and health disparities.

METHODS

This 60-minute module was presented to ear, nose, and throat (ENT) and pediatrics residents and fellows. It includes a case presentation of an adolescent with an asthma exacerbation, a large-group discussion about social determinants of health and structural racism, and a small-group discussion/debrief conceptualizing the case.

RESULTS

Thirty pediatrics residents and 15 ENT residents participated in this activity with a 46% and 60% pretest response rate, respectively. A two-sample Mann-Whitney test showed statistically significant improvement ( = .005) in knowledge related to structural racism between the pretest ( = 0.5, = 0.3) and posttest ( = 0.7, = 0.1) knowledge assessments with a small effect size ( = 0.4; Z = 2.8).

DISCUSSION

We demonstrated that interactive teaching methods can be used to educate military GME trainees on the impact of structural racism on health outcomes for military health care beneficiaries. Understanding the role of structural racism in the context of military health care using curricula that highlight military-specific health disparities is essential to understanding the role of the military physician in systemically addressing health disparities.