Disparities Education: What Do Students Want?

González, Cristina M.; Bussey‐Jones, Jada

doi:10.1007/s11606-010-1250-z

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Our study had three main findings. First, it expanded upon what is known about student resistance, 12,15,16,18,21 uncovering individual and structural barriers to student engagement in implicit bias instruction related to discounting of instruction, considerations of individual racial identity, and lack of diversity. Second, our analysis identified potential threats to student engagement including shame, along with opportunities to enhance engagement within the learning environment, and the need for formal facilitator training.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we anticipated focus groups, rather than individual interviews, would yield richer insights based on our previous success using this format to explore student perceptions on anticipated instruction on health disparities. 12 Recruitment, data collection, and analysis were conducted iteratively to fully capture and explore variation in students' perspectives. All aspects of the study were approved by the Institutional Review Board of the Albert Einstein College of Medicine.…”

Section: Methodsmentioning

confidence: 99%

“…11 In our previous work, students expressed their desire to move beyond knowledge and recognition of implicit bias to skill development. 12 To date, most curricula on implicit biases involve one session. [13][14][15][16][17][18][19] In addition, extant explorations of learner reactions to implicit bias training suggest that a single session may not be adequate for learners to transition from resistance to acceptance of implicit bias.…”

Section: Introductionmentioning

confidence: 99%

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A Qualitative Study of New York Medical Student Views on Implicit Bias Instruction: Implications for Curriculum Development

et al. 2019

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BACKGROUND: For at least the past two decades, medical educators have worked to improve patient communication and health care delivery to diverse patient populations; despite efforts, patients continue to report prejudice and bias during their clinical encounters. Targeted instruction in implicit bias recognition and management may promote the delivery of equitable care, but students at times resist this instruction. Little guidance exists to overcome this resistance and to engage students in implicit bias instruction; instruction over time could lead to eventual skill development that is necessary to mitigate the influence of implicit bias on clinical practice behaviors. OBJECTIVE: To explore student perceptions of challenges and opportunities when participating in implicit bias instruction. APPROACH: We conducted a qualitative study that involved 11 focus groups with medical students across each of the four class years to explore their perceptions of challenges and opportunities related to participating in such instruction. We analyzed transcripts for themes. KEY RESULTS: Our analysis suggests a range of attitudes toward implicit bias instruction and identifies contextual factors that may influence these attitudes. The themes were (1) resistance; (2) shame; (3) the negative role of the hidden curriculum; and (4) structural barriers to student engagement. Students expressed resistance to implicit bias instruction; some of these attitudes are fueled from concerns of anticipated shame within the learning environment. Participants also indicated that student engagement in implicit bias instruction was influenced by the hidden curriculum and structural barriers. CONCLUSIONS: These insights can inform future curriculum development efforts. Considerations related to instructional design and programmatic decision-making are highlighted. These considerations for implicit bias instruction may provide useful frameworks for educators looking for opportunities to minimize student resistance and maximize engagement in multi-session instruction in implicit bias recognition and management.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Qualitative Study of New York Medical Student Views on Implicit Bias Instruction: Implications for Curriculum Development

et al. 2019

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“…While the majority of medical schools today include health disparities in their curriculum, many report that they do not feel satisfied with the quality of course offerings [5]. Furthermore, health disparities material, if not implemented well into medical school curriculum, can be met with negative attitudes by medical students [6].…”

Section: Introductionmentioning

confidence: 99%

Environmental Health Burdens and Socioeconomic Status in Rhode Island: Using Geographic Information Systems to Examine Health Disparities in Medical School

Pascual

Palosaari

Ochoa

et al. 2020

Cureus

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Race and class are major predictors of health outcomes in the United States. Health disparities among racial and low-income minorities often have environmental etiologies. Using Rhode Island as a case study, we geocoded and visualized several environmental determinants of health via Geographic Information Systems (GIS) in the entire state and conducted a geospatial analysis to determine whether or not patterns existed along racial and class lines. The variables that we geocoded include elementary schools, fast food restaurants, Superfund sites, and community parks. From a census tract level, we then analyzed the racial and income makeup of each geocoded site. We discovered that, on average, the worst-performing elementary schools, fast food restaurants, and Superfund sites in Rhode Island were clustered in neighborhoods with a larger black population and lower household income. Conversely, community parks and the best elementary schools in Rhode Island tended to be located near neighborhoods with a larger White population and higher household income. Our results provide additional evidence for the pervasiveness of the unequal distribution of environmental health burdens between low-income, minority communities and affluent, predominantly White communities. This summer experiential student project demonstrates the feasibility of incorporating GIS as a practical tool for learning health disparities material at a U.S. medical school. Our study also highlights the value of digital technology and citizen science in helping the public recognize and understand the various environmental factors that perpetuate health disparities.

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“…We can also avoid the resentment they may feel if they are not motivated or do not see the relevance of learning what is being taught. Gonzales and Bussey-Jones directly address these potential barriers to health disparities education and offer valuable lessons and potential solutions generated by students themselves 14 . It is important to recognize that the distinction between hearts and minds is not always clear cut, and that, although some think of the heart as akin to emotion or attitudes and the mind as akin to knowledge or maybe even behavior, these analogies are imprecise.…”

mentioning

confidence: 99%

What Matters in Health Disparities Education—Changing Hearts or Minds?

2010

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A ll medical educators face this question when planning curricula and in the daily course of teaching: "Is it enough to give our students the cognitive tools they need to function effectively, in the form of knowledge or skills, or should we also focus on their attitudes and motivation-their affective inclination and desire to use these tools?" In other words, should we focus on students′ hearts or minds? As several of the manuscripts in this Supplement illustrate, this question is particularly contentious in the context of teaching about health disparities and cultural competency, when addressing students′ attitudes and motivation can be seen as an educator passing judgment 1,2 .The hearts and minds question is especially relevant when teaching interpersonal aspects of care, such as respect and empathy. Some educators prefer to teach specific skills-greet the patient when you come into the room, reflect back the emotion expressed by the patient, etc. An appealing aspect of skills-based teaching is the direct correlation between what is taught and what can be observed as outcomes. However, others believe it is important not only to teach students how to demonstrate empathy and respect, but also to foster a predisposition towards emotional engagement, or one of unconditional positive regard for others 3 . Mostow and colleagues endorse this approach in their description of a model for teaching learners how to bridge racial, ethnic, and cultural differences in the clinical encounter 4 . After finding that existing models focused mainly on behaviors rather than attitudes, they developed an approach that explicitly targets both. Interestingly, their approach to fostering empathy and positive regard for patients involves demonstrating empathy and positive regard for trainees, implying that effective approaches will engage the hearts and minds of both learners and educators.There is an almost metaphysical aspect of the hearts and minds debate that asks if it is morally sufficient for doctors to care for patients, or if we must also care about them. Not surprisingly, ethicists have delved into this issue deeply. Common theories of ethics approach the issue very differently, with virtue-based theories emphasizing emotion and relationships 6 , and principalism focusing on the cognitive processes involved in resolving dilemmas 7. Yet most scholars, even those who strongly endorse the preeminent importance of one theory, wouldn't entirely disregard the merits of certain aspects of the others.From a practical perspective, the hearts and minds debate is important in that it influences how we will choose to spend valuable time with students. Intuitively, it is easier to focus on teaching knowledge and skills than it is to change attitudes, and it seems more efficient to do the former than the latter. Lessons from social and cognitive psychology, however, suggest that teaching knowledge and skills alone, without attending to underlying attitudes, may in some circumstances be an ineffective approach. For instance, studies have f...

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Disparities Education: What Do Students Want?

Cited by 14 publications

References 21 publications

A Qualitative Study of New York Medical Student Views on Implicit Bias Instruction: Implications for Curriculum Development

A Qualitative Study of New York Medical Student Views on Implicit Bias Instruction: Implications for Curriculum Development

Environmental Health Burdens and Socioeconomic Status in Rhode Island: Using Geographic Information Systems to Examine Health Disparities in Medical School

What Matters in Health Disparities Education—Changing Hearts or Minds?

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