Antiracist Curriculum Implementation for Pediatric Residents

Nicholas Szoko; Braveen Ragunanthan; Ana Radovic; Jessica L Garrison; Orquidia Torres

doi:10.1177/23821205231162986

Antiracist Curriculum Implementation for Pediatric Residents

J Med Educ Curric Dev. 2023 Apr 26:10:23821205231162986. doi: 10.1177/23821205231162986. eCollection 2023 Jan-Dec.

Authors

Nicholas Szoko¹, Braveen Ragunanthan², Ana Radovic¹, Jessica L Garrison³, Orquidia Torres¹

Affiliations

¹ Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
² Delta Health Center, Inc., Mound Bayou, MS, USA.
³ Division of Pediatric Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Abstract

Objectives: Racism has been recognized as a public health crisis, with calls for greater focus on antiracism in medical training. We sought to evaluate a longitudinal antiracist curriculum among pediatric residents.

Methods: In 2020-2021, we delivered seven educational sessions to pediatric trainees in a single residency program. We administered pre-/post-surveys to assess changes in awareness of structural racism, knowledge of health inequities, antiracist clinical skills, and individual/institutional advocacy behaviors. Awareness was measured with 27 Likert-type items spanning five conceptual domains (schools, healthcare, justice system, employment, and housing/transportation). We evaluated knowledge with 18 true/false or multiple-choice questions. Participants indicated comfort with clinical skills using 13 Likert-type items drawn from national toolkits and policy statements. Individual/institutional advocacy behaviors were measured with 14 items from the Antiracism Behavioral Inventory. McNemar or paired Wilcoxon signed-rank tests compared measures before and after implementation.

Results: Out of 121 residents, 79 (65%) completed pre-surveys, 47 (39%) completed post-surveys, and 37 (31%) were eligible for matching across responses. 78% of respondents were female and 68% identified as White. We found significant increases in awareness across several conceptual domains (schools: p = 0.03; healthcare: p = 0.004; employment: p = 0.003; housing/transportation: p = 0.02). Mean knowledge score increased after implementation (p = 0.03). Self-reported clinical skills improved significantly (p < 0.001). Individual advocacy behaviors increased (p < 0.001); there were no changes in institutional advocacy.

Conclusion: We demonstrate improvements in several educational constructs with a novel antiracist curriculum. Efforts to scale and sustain this work are ongoing, and additional teaching and evaluation methodologies may be incorporated in the future.

Keywords: Antiracism; advocacy; curriculum development; pediatrics.