Medical students’ knowledge of race-related history reveals areas for improvement in achieving health equity

Abstract

Background Medical schools have increasingly integrated social justice, anti-racism, and health equity training into their curricula. Yet, no research examines whether medical students understand the complex history of racial injustice. We sought to investigate the relationship between medical students’ historical knowledge and their perceptions regarding health equity. Methods Medical students at one large urban medical school self-rated their familiarity and importance of various racially-significant historical events and persons, as well as their agreement with statements regarding health equity, education, and preparedness to act. Descriptive and multivariate analyses were conducted in R. Results Of 166 (RR=31.3%) participants, 96% agreed that understanding historical context is necessary in medicine; yet 65% of students could not describe the historical significance of racial events or persons. Only 57% felt that they understood this context, and the same percentage felt other medical students did not. A minority of students felt empowered (40%) or prepared (31%) to take action when they witness racial injustice in healthcare. Multiracial identity was significantly associated with increased knowledge of African American history (p<0.01), and a humanities background was significantly associated with increased knowledge of Latin American history (p=0.017). There was a positive, significant relationship between advocacy statements, such as “I have taken action” (p<0.001) and “I know the roots of racism” (p<0.001) with mean familiarity of historical events. Conclusions This study demonstrates that while students agree that racism has no place in healthcare, there remains a paucity of knowledge regarding many events and figures in the history of American race relations and civil rights, with implications for future physicians’ patient care and health equity efforts.

By Medical Students, for Medical Students: A Narrative Medicine Antiracism Program

“… 62 – 64 These programs have often focused on specific clinical scenarios without providing historical context in which bias, microaggressions, and mistreatment take place. 23 One strength of this curriculum was its breadth in providing sociopolitical and historical context, while providing space for practical and visionary discussions to navigate racial injustices along professional and patient relationships. Future programs may benefit from developing curricula that encourage deconstructive and reconstructive approaches to address the complexities of racism in medicine more holistically.…”

“… 19 , 20 Yet, there is an ongoing need for solutions to equip future physicians with adequate knowledge, reflective capacity, and sustainable tools for navigating and improving racialized structures during and beyond medical education. 21 – 23 …”

Racism and sexism in the trajectory of black female medical students: an integrative review

“…Racial prejudice is explicit among white students according to the studies by Burgess et al 13 and Dyrbye et al 15 , as it appears in interracial relations during the course. In addition, it is one of the factors of discrimination in medical care for the black population, increasing inequity in health, as pointed out by Sanky et al 16 and Pehlan et al 17 . 18 and other authors 19,20,23 , racial prejudice is based on negative stereotypes associated with black people and can lead to the exclusion of black students and micro-aggressions at university.…”

O racismo e o sexismo na trajetória das estudantes de Medicina negras: uma revisão integrativa

“…O preconceito racial é explícito entre estudantes brancos segundo os estudos de Burgess et al 13 e Dyrbye et al 15 , por se apresentar nas relações interraciais no curso. Além disso, é um dos fatores de discriminação no atendimento médico à população negra, aumentando a iniquidade na Saúde, conforme apontam Sanky et al 16 e Pehlan et al 17 .…”