Meeting a need for anti-racism curricula in medical residency programs: A pilot study and results for implementation and future research

Abstract

Background: Racism contributes to health disparities and is a serious threat to public health. Teaching physicians about racism, how to address it in medical practice, and developing quality, sustainable curricula are essential. Objective: This study aimed to (1) describe the experience of racism and anti-racism teaching in residency programs, and elicit recommendations, and (2) use data formative research to develop recommendations for residencies when considering the creation, implementation, and evaluation of anti-racism curricula. Methods: From May to July 2023, 20 faculty/residents were recruited via convenience sampling for key informant interviews conducted via Microsoft Teams. Interviews were audio recorded, transcribed, and coded, and themes were developed deductively using implementation science frameworks and inductively via a grounded-theory approach. Results: Eighty percent (20/25) of participants approached were interviewed. Seventy-five percent (15/20) answered a brief optional demographic survey. Seven themes emerged: (1) Racism in medicine is ubiquitous; (2) anti-racism teaching in medicine ranges widely; (3) Sustainability strategies should be multifaceted and include recruitment, resources allocation, and outcome measures; (4) Resources are widely available and accessible; (5) Outcomes and metrics should include resident- faculty-, patient- and system-focused outcomes; (6) Curricular strategies should be multilayered, longitudinal, and woven into the curriculum; and (7) Other considerations including self-reflection and discomfort are necessary . Conclusions: This work is the first to qualitatively examine perspectives of key stakeholders invested in anti-racism curricula for residents. Utilizing models for implementation of anti-racism curricula for residents can guide design, implementation, and evaluation of curricula to facilitate effectiveness and sustainability of such efforts.