Avoiding Racial Essentialism in Medical Science Curricula

Braun, Lundy; Saunders, Barry F.

doi:10.1001/journalofethics.2017.19.6.peer1-1706

Cited by 42 publications

(25 citation statements)

References 27 publications

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“…10,11 Throughout medical training, students and trainees are exposed to multiple methods of instruction that enhance bias and misconceptions about race, genetics, culture, and disparities. 12–16 In this context, teaching medical professionals about structural racism and how to recognize and address bias in clinical encounters has become increasingly imperative. 11,17–20…”

Section: Introductionmentioning

confidence: 99%

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

et al. 2018

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IntroductionGrowing recognition of the deleterious effects of racism on health has led to calls for increased education on racism for health care professionals. As part of a larger curriculum on health equity and social justice, we developed a new educational session on racism for first-year medical students consisting of a lecture followed by a case-based small-group discussion.MethodsOver the academic years of 2016–2017, 2017–2018, and 2018–2019, a total of 536 first-year medical students participated in this mandatory session. The course materials were developed as a collaboration between faculty and students. The lecture was delivered in a large-group format; the small-group case-based discussion consisted of 10–12 students with one upper-level student facilitator.ResultsThe majority of respondents for the course evaluation felt that the course had met its stated objectives, and many commented that they had an increased awareness of the role of racism in shaping health. Students felt that the small-group activity was especially powerful for learning about racism.DiscussionActive student involvement in curriculum development and small-group facilitation was critical for successful buy-in from students. Additional content on bias, stereotyping, and health care disparities will be the focus of faculty development programs and will also be integrated into the clerkships to build on these important topics as students are immersed in clinical care.

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Section: Introductionmentioning

confidence: 99%

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

et al. 2018

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“…Students learn to associate race with disease conditions, such as sarcoidosis, cystic fibrosis, hypertension, and focal segmental glomerulonephritis, which upholds their implicit understandings of race as a biological trait. 33 , 34 Professors might misleadingly equate genetic ancestry, which could be meaningful when traced to a narrowly circumscribed population of origin (eg, Biafada people), with race (eg, African ancestry). 35 , 36 On the wards, students learn that race is relevant to treatment decisions and have inadequate power to question the racialised assumptions of their supervisors.…”

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confidence: 99%

From race-based to race-conscious medicine: how anti-racist uprisings call us to act

2020

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and countless others-coupled with horrifying statistics about the dispro portionate burden of COVID-19 on Black and Brown communities-have forced the USA and the world to reckon with how structural racism conditions survival. Although clinicians often imagine themselves as benef cent caregivers, it is increasingly clear that medicine is not a stand-alone institution immune to racial inequities, but rather is an institution of structural racism. A pervasive example of this participation is race-based medicine, the system by which research charac terising race as an essential, biological variable, translates into clinical practice, leading to inequitable care. In this Viewpoint, we discuss examples of race-based medicine, how it is learned, and how it perpetuates health-care disparities. We introduce raceconscious medicine as an alternative approach that emphasises racism, rather than race, as a key determinant of illness and health, encouraging providers to focus only on the most relevant data to mitigate health inequities.Research in clinical medicine and epidemiology requires explicit hypotheses; however, hypotheses involving race are frequently implicit and circular, relying on conventional wisdom that Black and Brown people are genetically distinct from White people. 1 This common knowledge descends from European colonialisation, at which time race was developed as a tool to divide and control populations worldwide. Race is thus a social and power construct, with meanings that have shifted over time to suit political goals, including to assert biological inferiority of dark-skinned populations. 2 In fact, race is a poor proxy for human variation. Physical characteristics used to identify racial groups vary with geography and do not correspond to underlying biological traits. Genetic research shows that humans cannot be divided into biologically distinct subcategories. 3,4 Furthermore, ongoing overlap and mixture between populations erodes any meaningful genetic difference. 5 Despite the absence of meaningful correspondence between race and genetics, race is repeatedly used as a shortcut in clinical medicine. For instance, Black patients are presumed to have greater muscle mass than patients of other races and estimates of their renal function are accordingly adjusted. 6 On the basis of the understanding that Asian patients have higher visceral body fat than do people of other races, they are considered to be at risk for diabetes at lower bodymass indices. 7 Angiotensin-converting enzyme (ACE) inhibitors are considered less effec tive in Black patients than in White patients, and they might not be prescribed to Black patients with hypertension (table ). 1, We argue

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“…More to the point, medical education, in general, continues to avoid confronting the contribution of physician bias to health disparities, preferring curricula of racial disparities without racism in medicine. 60–62 Medical schools have typically reduced health care inequities to the common topics of “disparity statistics, power analysis, and cultural competence training” 63 (p364) and the omission of the contribution of medical professionals to health inequities. 64 (p442) It is therefore hardly surprising that students and faculty are ready with the mantras of “everyone is treated equally” and “we treat all patients the same.” 65 (pp7–8)…”

Section: Collusive Factorsmentioning

confidence: 99%

“…One persistent criticism by social scientists has been the slow adoption of race as a social construct in medical education. Why has sociological theory barely seeped into changing how medical students are taught about racial disparities 60–62 ? Why the absence of social and behavioral scientists and humanists in medical school faculty and curriculum integration?…”

Section: Collusive Factorsmentioning

confidence: 99%

Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations

Parsons

2020

Int J Health Serv

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This article reviews the literature on racism in medicine in the United States and reflects on the persistent barriers to diminishing racial biases in the U.S. health care system. Espoused strategies for decreasing racial disparities and reducing racial biases among physicians are critiqued, and recommendations are offered. Those recommendations include increasing the number of minority students in medical school, using Xavier University in New Orleans, Louisiana, as the model for medical school preparation; revamping the teaching of cultural competence; ensuring the quality of non-clinical staff; and reducing the risk of burnout among medical providers.

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Avoiding Racial Essentialism in Medical Science Curricula

Cited by 42 publications

References 27 publications

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

Exploring Racism and Health: An Intensive Interactive Session for Medical Students

From race-based to race-conscious medicine: how anti-racist uprisings call us to act

Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations

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