Feasibility of an Antiracism Curriculum in an Academic Pulmonary, Critical Care, and Sleep Medicine Division

Debasree Banerjee; Nicholas J Nassikas; Parvati Singh; Sarah B Andrea; Angela Y Zhang; Yvorn Aswad; Navneet Singh; Stephen R Walsh; Katherine Cox-Flaherty; E Jane Carter; Katherine M Sharkey

doi:10.34197/ats-scholar.2022-0015OC

Feasibility of an Antiracism Curriculum in an Academic Pulmonary, Critical Care, and Sleep Medicine Division

ATS Sch. 2022 Sep 30;3(3):433-448. doi: 10.34197/ats-scholar.2022-0015OC. eCollection 2022 Oct.

Authors

Debasree Banerjee¹, Nicholas J Nassikas^{1

2}, Parvati Singh^{1

3}, Sarah B Andrea^{4

5}, Angela Y Zhang^{6

7}, Yvorn Aswad⁸, Navneet Singh¹, Stephen R Walsh¹, Katherine Cox-Flaherty¹, E Jane Carter¹, Katherine M Sharkey^{1

9}

Affiliations

¹ Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine.
² Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess, Harvard University, Boston, Massachusetts.
³ Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
⁴ Lifespan Biostatistics Epidemiology and Research Design Core, Rhode Island Hospital, Providence, Rhode Island.
⁵ Oregon Health and Science University and Portland State University School of Public Health, Portland, Oregon; and.
⁶ Warren Alpert Medical School.
⁷ Department of Pediatrics, University of Washington, Seattle, Washington.
⁸ Pediatrics, Psychiatry, and Child and Adolescent Psychiatry, and.
⁹ Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island.

Abstract

Background: Structural health inequities and racism adversely affect patient health and the culture of academic medicine. Formal training to educate fellows and faculty on antiracism is lacking.

Objective: Our objective was to design, implement, and assess the feasibility and preliminary efficacy of a year-long antiracism curriculum within a pulmonary, critical care, and sleep medicine division.

Methods: This was a pre- and postintervention observational study conducted between July 2020 and June 2021. The curriculum was offered during an allotted educational meeting time slot at a single-center pulmonary, critical care, and sleep medicine division at a large academic institution to fellows and faculty. The curriculum consisted of 13 1-hour virtual interactive workshops delivered by local experts in diversity, equity, and inclusion topics. Surveys assessed knowledge on racism in medicine; opinions, understanding, and comfort surrounding race and racism in medicine; as well as additional questions to solicit feedback on the curriculum itself via visual analog scale and write-in comments.

Results: Before initiating the curriculum, 74% (n = 28) of respondents reported interest in an antiracism curriculum, and the majority (95%, n = 36) believed that discrimination affects medical staff and patients. Respondents reported only moderate comfort in talking about race (median, 58; interquartile range 41-70 on visual analog scale 0-100, where 100 is strongly agree with "I feel comfortable talking about race"). The postintervention survey demonstrated stability of the belief of the presence of racial discrimination and a 15% increase in self-directed learning about related topics. Although knowledge related to the use of race in medical algorithms improved, 14% fewer participants reported interest in continuing to engage in a division-wide structured antiracism curriculum.

Conclusion: Implementation of a curriculum on justice, equity, diversity, and inclusion within a fellowship program is feasible and addresses an unmet need within graduate medical education.

Keywords: diversity; equity; graduate medical education; racism.