Anderson Hannah L Kakara, Xu Xandro, Edwell April, Lockwood Laura, Cabral Pricilla, Weiss Anna, Poeppelman Rachel Stork, Kalata Kathryn, Shanker A I, Rosenfeld Joshua, Borman-Shoap Emily, Pearce Matt, Karol Courtney, Scheurer Johannah, Hobday Patricia M, O'Connor Meghan, West Daniel C, Balmer Dorene F
Instructor of Pediatrics, University of Pennsylvania Perelman School of Medicine, and PhD candidate, Maastricht University School of Health Professions Education, Philadelphia, Pennsylvania, USA.
Candidate for B.A. in Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Teach Learn Med. 2024 Sep 16:1-9. doi: 10.1080/10401334.2024.2404008.
Marginalized individuals in medicine face many structural inequities which can have enduring consequences on their progress. Therefore, inequity must be addressed by dismantling underlying unjust policies, environments, and curricula. However, once these injustices have been taken apart, how do we build more just systems from the rubble? Many current strategies to address this question have foundational values of urgency, solutionism, and top-down leadership.
This paper explores a counternarrative: Design Justice. As a set of guiding principles, Design Justice centers the experiences and perspectives of marginalized individuals and communities. These principles include mutual accountability and transparency, co-ownership, and community-led outcomes, and honoring local, traditional, Indigenous knowledge.
Rooted in critical scholarship and critical design, Design Justice recognizes the interconnectedness of various forms of marginalization and works to critically examine power dynamics that exist in every design process. These co-created principles act as practical guardrails, directing progress toward justice.
This paper begins with an overview of Design Justice's history in critical scholarship and critical design, providing foundational background knowledge for medical educators, scholars, and leaders in key concepts of justice and design. We explore how the Design Justice principles were developed and have been applied across sectors, highlighting its applications, including education applications. Finally, we raise critical questions about medical education prompted by Design Justice.
医学领域的边缘化个体面临诸多结构性不平等，这可能对他们的职业发展产生持久影响。因此，必须通过拆除潜在的不公正政策、环境和课程来解决不平等问题。然而，一旦消除了这些不公正现象，我们如何从废墟中构建更公正的体系呢？当前许多解决这一问题的策略都有紧迫性、解决主义和自上而下领导的基本价值观。
本文探讨一种反叙事：设计正义。作为一套指导原则，设计正义以边缘化个体和社区的经历及观点为核心。这些原则包括相互问责与透明、共同所有权、社区主导的成果，以及尊重地方、传统、本土知识。
设计正义植根于批判性学术研究和批判性设计，认识到各种形式边缘化的相互关联性，并致力于批判性审视每个设计过程中存在的权力动态。这些共同创造的原则起到了实际的保障作用，引导着通向正义的进程。
本文首先概述设计正义在批判性学术研究和批判性设计中的历史，为医学教育工作者、学者以及关键正义和设计概念的领导者提供基础背景知识。我们探讨设计正义原则是如何形成的，以及如何在各个领域得到应用，重点介绍其应用情况，包括教育应用。最后，我们提出由设计正义引发的关于医学教育的关键问题。
