Fourth-Year Resident, Department of Medicine & Department of Psychiatry, Walter Reed National Military Medical Center.
Second-Year Resident, Department of Medicine & Department of Psychiatry, Walter Reed National Military Medical Center.
MedEdPORTAL. 2024 Sep 12;20:11443. doi: 10.15766/mep_2374-8265.11443. eCollection 2024.
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.
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.
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).
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.
为了在军事研究生医学教育（GME）中获得更多学习健康公平的机会，我们开发了一个由住院医师主导的课程，从军事文化能力的角度介绍这些概念。“种族主义对健康的影响”模块侧重于结构性种族主义和健康差距。
该 60 分钟的模块向耳鼻喉科和儿科住院医师和研究员介绍。它包括一个青少年哮喘发作的病例介绍，一个关于健康决定因素和结构性种族主义的大组讨论，以及一个小组讨论/阐述概念化案例。
30 名儿科住院医师和 15 名耳鼻喉科住院医师参加了这项活动，预测试的回复率分别为 46%和 60%。两个样本曼-惠特尼 U 检验显示，结构种族主义相关知识在预测试（ = 0.5， = 0.3）和后测试（ = 0.7， = 0.1）知识评估之间存在统计学显著改善（ =.005），具有较小的效应量（ = 0.4；Z = 2.8）。
我们证明，互动教学方法可用于教育军事 GME 学员了解结构性种族主义对军事医疗保健受益人的健康结果的影响。使用强调军事特定健康差距的课程了解军事医疗保健中结构性种族主义的作用，对于了解军事医生在系统解决健康差距方面的作用至关重要。
