Doucet Hannah Barber, Lin Timmy, Wilson Taneisha
Boston University Chobanian & Avedisian School of Medicine, Department of Pediatrics, Boston, Massachusetts.
Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island.
West J Emerg Med. 2025 May 19;26(3):441-451. doi: 10.5811/westjem.20797.
The purpose of this study was to evaluate the impact of the Discussing Anti-Racism and Equity (DARE) curriculum on individual physician knowledge and practice, as well as on perceptions of group culture.
DARE was a longitudinal multimodal curriculum targeted at pediatric and adult emergency medicine (EM) trainees and faculty, made up of 12 lectures/workshops, three simulations, five book clubs, and two movie screenings. We used a multiphase, parallel convergent mixed-methods approach. Focus groups before and after DARE explored prior education, antiracism attitudes and behaviors, perceived impact of intervention curriculum, and perceptions of departmental medical culture. We elucidated themes using thematic analysis. Surveys of trainees and attendings evaluated individual attitudes and practices related to equity and antiracism.
We held nine focus groups with a total of 52 participants. Half of participants were EM residents (26), and half were faculty (12 pediatric EM and 14 general EM). Four major themes emerged around antiracism education and DARE. Both trainees and faculty reported a lack of standardized or effective prior education, although trainees are beginning to report increased exposure in medical school. Participants reported an overall positive impact of DARE on individual knowledge and practice, with continued room for improvement. Focus groups particularly highlighted a perceived shift in departmental antiracist culture post-DARE. Finally, future curricular aims were elucidated. A total of 56 surveys showed significant improvement in all realms of antiracism medical- practice questions when posed as retrospective pre-post questions (P < 0.01).
The DARE curriculum increased individual antiracism awareness and cultivated culture shift among the targeted clinician group. Focus groups provided clear next steps for ongoing and expanded education.
本研究旨在评估“讨论反种族主义与公平性”（DARE）课程对个体医生的知识与实践以及对群体文化认知的影响。
DARE是一项针对儿科和成人急诊医学（EM）实习生及教员的纵向多模式课程，由12次讲座/工作坊、3次模拟、5次读书俱乐部和2次电影放映组成。我们采用了多阶段、平行收敛混合方法。在DARE课程前后进行焦点小组讨论，探讨先前教育、反种族主义态度与行为、干预课程的感知影响以及对部门医学文化的认知。我们使用主题分析阐明主题。对实习生和主治医生的调查评估了与公平性和反种族主义相关的个体态度与实践。
我们进行了9次焦点小组讨论，共有52名参与者。一半参与者是EM住院医师（26名），另一半是教员（12名儿科EM和14名普通EM）。围绕反种族主义教育和DARE出现了四个主要主题。实习生和教员都报告称缺乏标准化或有效的先前教育，尽管实习生开始报告在医学院的接触有所增加。参与者报告称DARE对个体知识和实践总体有积极影响，但仍有改进空间。焦点小组特别强调了DARE课程后部门反种族主义文化的感知转变。最后，阐明了未来课程目标。当以回顾性前后问题的形式提出时，共56份调查显示在反种族主义医疗实践问题的所有领域都有显著改善（P < 0.01）。
DARE课程提高了个体的反种族主义意识，并在目标临床医生群体中培养了文化转变。焦点小组为持续和扩展教育提供了明确的后续步骤。
