Critical Consciousness as a Framework for Health Equity–Focused Peer Learning

Abstract

Introduction Recognizing the need to teach concepts of health equity, diversity, and inclusion as a part of medical students' preclinical training, we developed a series of workshops in the first year of medical school that introduced students to issues of discrimination and inequity and their effects on health outcomes. This student-led, faculty-supported project, known as Critical Consciousness in Medicine (CCM), adopted critical consciousness as a guiding principle for student learning. Methods Over the course of the 2018–2019 academic year, student leaders developed and delivered five 2-hour workshops to 197 first-year students, with the assistance of student facilitators and input and guidance from faculty advisors. Workshops involved a mix of whole-class presentations and small-group discussions. Session topics included identity and interpersonal relationships, privilege, health disparities, and implicit bias. Results Paired t -test analysis showed statistically significant growth in student self-ratings related to CCM learning objectives as measured in the end-of-year pre-/postsurvey. Student comments in year-end reflections further suggested learning, self-assessment, growth, and appreciation for the workshops' place in the preclinical curriculum. Discussion This project modeled a student-faculty partnership for approaching diversity, inclusion, and health equity in medical education and highlighted the role of students as leaders in educating their peers. The CCM workshop series demonstrated high acceptability as a component of preclinical medical education and may increase student engagement around social issues in health care. CCM also illustrated the promise of using critical consciousness as an approach to educating medical students about equity, diversity, and inclusion.

A narrative analysis of clerkship reflections: Medical student identity development in a changing world

“…Studies have shown how important role‐modelling on clinical rotations is for students; this study adds to a body of literature showing how critical self‐awareness among clinical teachers is for positive professional identity development 11,16 . Efforts to build consciousness around health equity, diversity and inclusion are increasingly recognised as essential to pre‐clinical education and have been embraced as a partnership between students and teachers 17 . Similar efforts need to be made to build students' understanding of these issues and process conflicts during clinical training.…”

“…as a partnership between students and teachers. 17 Similar efforts need to be made to build students' understanding of these issues and process conflicts during clinical training.…”

Critical consciousness of public health nurses: A descriptive, comparative survey

“…The literature and results suggest awareness of critical consciousness may aid PHNs in shaping policy, education, and practice. Awareness of systemic inequities is critical as PHNs advocate for governmental and health system policies that address the root causes of health disparities and promote health equity (Bower et al., 2021; Centers for Disease Control, 2019; Ellison et al., 2021; National Academies of Sciences, Engineering, and Medicine, 2021). In educational settings PHN faculty and other nursing faculty should incorporate the notion of critical consciousness within nursing curricula, ensuring future nurses will be equipped with the understanding and skills to address the complex social, economic, and environmental factors that influence population health (Airhihenbuwa, 1995; Bleakley, 2017; Bower et al., 2021).…”

Education Scholarship Assessment Reconsidered: Expansion of Glassick’s Criteria to Incorporate Health Equity

“…15 Health equity training tools and curricula are increasingly prevalent in health professions education literature and provide best practices for teaching nonbiologic drivers of health, cultural competence, health systems sciences, and inclusive communication and leadership. [16][17][18][19][20][21][22][23][24][25] Training largely focuses on education regarding existing health inequities and to a lesser extent on developing strategies to address them. 26 The bias checklist is a strategy to address health inequity in medical education training that is gaining popularity.…”