Best Practices for Acknowledging and Addressing Racial and Ethnic Health Disparities in Medical Education (IAMSE Manuals)

This manual is an instructional guide to provide healthcare educators with best practices for acknowledging and addressing racial and ethnic health disparities (REHD) in medical education. As a collaborative effort written by both medical students and educators, this manual examines the impact of race, racism, and ethnic biases on medical care and health outcomes. This book enables readers to understand and apply key terms encompassing health disparities, bias, and cultural humility as an approach to demystify stereotypes, social assumptions and long-held misperceptions that influence the misuse of race in medical teachings. By examining the construct of race, differences between race-based and race-conscious medicine are distinguished. As such, medical educators will be guided to consider the effects of socioeconomic differences, environmental factors, and institutional racism between population categories with regard to healthcare compliance and outcomes. Supported by evidence-based recommendations, this manual provides medical educators, curriculum managers, and institutions with strategies and checklists to improve their medical curricula to ensure a well-defined understanding of race and ethnicity in medicine. This book serves as a resource for medical educators and students as they aspire to become more culturally competent, equity-minded, and inclusive healthcare professionals. Preface Acknowledgments Contents About the Editors Contributors Chapter 1: An Introductory Framework for Acknowledging and Addressing Racial and Ethnic Health Disparities in Medical Education 1.1 Introduction 1.2 Race as a Social Construct 1.3 The Capitalization of Race in This Text 1.4 How to Use This Manual 1.5 Executive Summary 1.6 Addendum: Glossary of Terms 1.7 Who Is This Manual for? 1.8 Defining Key Terms 1.9 What Are Health Disparities? 1.10 Why Address REHD in the Classroom? 1.11 Cultural Humility 1.12 Addressing REHD in the Classroom and Institution for Health Sciences Education References Chapter 2: What Are Health Disparities? 2.1 Introduction 2.2 Defining Health Disparity and Health Inequity 2.2.1 Health Disparities 2.2.2 Health Inequity and Health Inequality 2.2.3 Methodology and Measuring Health Disparity and Health Inequity 2.2.4 Using Historical Lenses to Describe Health Disparities Around the World 2.2.5 Modern-Day Health Disparity in the Global Sphere 2.3 Conclusion References Chapter 3: The State of Current Integration of Race and Ethnicity in Medical Education 3.1 Introduction 3.2 Implicit Race Bias in Medical Education and Healthcare 3.2.1 Explicit and Implicit Bias: An Overview 3.3 Implicit Bias: From Classroom to Clinic 3.3.1 Race-Based Vs. Race-Conscious 3.4 The History of Race and Medicine and the Future 3.5 Factors That Impact Success for Students of Color 3.5.1 Microaggressions – Its Role and Implications in Medicine 3.5.2 Microassaults Vs. Microinsults Vs. Microinvalidations 3.5.3 How Microaggressions Affect Medical Students’ Ability to Learn 3.5.4 Practicing Micro-Affirmations 3.6 Elaborating on the Correlation Between Students’ Thoughts and Their Ability to Excel 3.6.1 Perceived Contributors to Success in Medical School 3.6.2 Achievement Through Equity in Healthcare Training 3.6.3 Causes and Consequences of Lower Assessed Performances 3.7 Conclusion References Chapter 4: Cultural Humility: An Approach to Mitigate the Challenges of Teaching About Race and Racism 4.1 Introduction 4.2 Shift in Pedagogy & Its Dilemmas 4.3 Challenges with Teaching Race, Racism, and Racial Justice 4.4 Cultural Humility: An Evolved Practice from Cultural Competency 4.4.1 Model Case 4.4.2 Contrary Case 4.5 Conclusion References Chapter 5: Best Practices and Strategies for Medical Educators to Acknowledge and Address REHD in Educational Materials 5.1 Introduction 5.2 Understand the Impact of Race and Racism on Health Outcomes 5.2.1 Do Accurately Identify Race as a Social Construct 5.2.2 Do Use the Correct Biological Language 5.3 Contextualize Racial and Ethnic Differences 5.3.1 Do Provide Historical Context to Disease Burden 5.3.2 Do Acknowledge Structural and Social Determinants of Disease Burden 5.4 Race Is Not an Epidemiological Determinant for Disease Risk, Diagnosis, and/or Treatment 5.4.1 Do Not Pathologize Race 5.4.2 Do Not Use Race as a Risk Factor 5.4.3 Do Not Use Race as a Shortcut or Hint for Clinical Thinking in Assessments and Diagnosis 5.4.4 Do Acknowledge the Flaws in Race-Based Clinical Guidelines and Diagnostic Algorithms 5.4.5 Do Address Examples of Race-Based Clinical Guidelines and Diagnostic Algorithms in the Classroom 5.5 Do Include a Wide Range of Representative Examples 5.5.1 Do Ensure that Descriptive Findings and Language are Inclusive to Marginalized Populations 5.5.2 Do Not Introduce Race or Ethnicity in the First Sentence of a Clinical Vignette 5.6 Do Use Checklists to Assist with Addressing and Acknowledging REHD 5.7 Conclusions References Chapter 6: Acknowledging and Addressing REHD in Medical Education: Best Practices and Strategies for Curriculum Managers and Institutions 6.1 Introduction 6.2 Practices and Strategies for Curriculum Managers 6.3 Curriculum Design and Continuous Quality Improvement 6.3.1 Integrate DEI Topics 6.3.2 Ensure Race Is Presented as a Social Construct 6.4 Feedback Gathering 6.4.1 Curriculum Assessment for Continuous Improvement 6.4.2 Climate Survey 6.5 Faculty Development 6.5.1 Training 6.5.2 Recognition 6.6 Practices and Strategies for Institutions 6.7 Building a Cultural of Inclusivity in Medical Education 6.8 Recruiting and Retaining a Diverse Community 6.9 Required DEI Training for Faculty and Staff 6.10 Zero Tolerance Programs for Micro- and Macro- Aggressions 6.11 Annual Assessments Identify Disparities and Guide Improvement 6.12 Summary and Conclusions References Chapter 7: Charting the Path Toward Health Equity by Acknowledging and Addressing REHD in Medical Education 7.1 Take-Home Points References Addendum: Glossary of Terms Index