Teaching of the Black Population’s Health: Anti-Racist Lenses for a Paradigm Shift to Address Racial Inequities

Carrijo, Ana Paula Borges; Moura, Anna Luísa Dias Bastos de; Oliveira, Augusto Cézar Polveiro e; Rodrigues, Lígia Villela; Oliveira, Janaína de; Castro, Thiago Figueiredo; Torres, Odete Messa; Poças, Kátia Crestine; Deusdará, Rodolfo

doi:10.3390/ijerph192416784

Cited by 5 publications

(8 citation statements)

References 17 publications

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“…For most staff, attending Ask the Specialist Plus was the first time they had committed to, and connected with, training which was previously perceived as a tick-box exercise with no relevance to delivering clinically safe healthcare. In an era when online training modules are considered satisfactory and economically prudent, we argue there is value in investing in pedagogical practices which contribute to positive change [ 80 , 81 ]. Our research provided evidence that counterstories [ 37 ] from First Nations Elders, interpreters and leaders can disrupt the dominance of Whiteness in healthcare, thereby contributing to the creation of a culturally safe hospital service.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Kerrigan,

McGrath,

Doig

et al. 2024

BMC Health Serv Res

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Background First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. Methods Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia’s Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick’s evaluation model. Results Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. Conclusion The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.

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Section: Discussionmentioning

confidence: 99%

“…Secondly, the receptiveness of staff to discussing racism was noteworthy considering racism is commonly denied in healthcare [ 29 , 81 , 86 ]. Health staff who call out racism are often silenced, ignored or alienated [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Kerrigan,

McGrath,

Doig

et al. 2024

BMC Health Serv Res

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“…The Brazilian Institute of Geography and Statistics defines skin color with the following categorizations: white, black, brown, yellow, and indigenous. In Brazil, poorer health outcomes (mainly higher mortality 16,17 and non‐communicable chronic diseases 18,19 ) and higher inequalities are associated with non‐white individuals 20,21 . It is important to highlight that only 35 non‐white individuals were included in the present study, 12 black and 23 brown.…”

Section: Methodsmentioning

confidence: 99%

“…In Brazil, poorer health outcomes (mainly higher mortality 16,17 and noncommunicable chronic diseases 18,19 ) and higher inequalities are associated with non-white individuals. 20,21 It is important to highlight that only 35 non-white individuals were included in the present study, 12 black and 23 brown. The independent variables were age (in years); sex (male or female); skin color (white or non-white [including those who reported as black, brown, yellow, or indigenous]); regular physical activity (yes or no); monthly family income (in thousand reais); sexual orientation (heterosexual or other [including those who identified as lesbian, bisexual, gay, transgender, two-spirit, queer, questioning, intersex, asexual, nonbinary, gender nonconforming, or non-heteronormative, commonly abbreviated as LGBTQIA+]); remunerative work (yes [which included a formal job or a paid scholarship] or no); use of alcohol, cigarettes, or illicit drugs (yes or no); dentistry as the first choice for undergraduate study (yes or no); the DASS-21 scale domains of depression, anxiety, and stress (categorized as normal/mild, moderate, or at least severe); and the question related to COVID-19 (yes or no [which included those who answered "no" or "unaware"]).…”

Section: Independent Variablesmentioning

confidence: 99%

“…15 In Brazil, research has reported that non-white individuals (which include those who are black, brown, yellow, or indigenous) experience both higher mortality rates and poorer health. [16][17][18][19] Therefore, skin color is considered an important proxy of inequalities in the country, 20,21 which may have several impacts on the academic performance of dental students.…”

Section: Introductionmentioning

confidence: 99%

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Association between history of academic failure during dental school and self‐reported depression, anxiety, and stress: A retrospective cohort

García

Casarin

Silva

et al. 2023

Journal of Dental Education

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ObjectiveTo investigate the association between history of academic failure (HAF) and self‐reported depression, anxiety, and stress among undergraduate dental students.MethodsThis study involved 244 dental students from one university. An online questionnaire collected information on the following variables: socioeconomic status, behavior, use of licit/illicit drugs, and the choice of dentistry as an undergraduate field of study. The 21‐item Depression Anxiety Stress Scale (DASS‐21) was applied. HAF in at least one subject during a participant's undergraduate tenure was defined as the main outcome. Bivariate and multivariate analyses were performed using Poisson regression with robust variance. In addition, a subgroup analysis was performed for the variable “dentistry as the first choice for undergraduate studies.”ResultsThe prevalence of HAF was 25.00% (n = 61). Among those students, the mean number of academic failures was 5.41 ± 6.38 (range: 1–33). Higher rates of HAF were observed among older and non‐white dental students. Moreover, those who self‐reported at least severe depression presented a 79% higher HAF prevalence ratio (PR) (95% confidence interval [95% CI]: 1.15–2.80). Similar findings were detected among those who reported (PR: 1.79; 95% CI: 1.06–4.46) or did not report (PR: 2.21; 95% CI: 1.10–4.46) interest in dentistry as a first undergraduate option. Conversely, among women and students who did not choose dentistry as their first option, HAF was significantly lower (PR: 0.41; 95% CI: 0.21–0.80).ConclusionHigher HAF rates are observed in students who are older, non‐white, and self‐report at least severe depression. However, dentistry as a first option for undergraduate studies was not associated with HAF.

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Anti-oppression pedagogy in health professions: a scoping review

Smith,

McGuire-Adams,

Eady

2024

Adv in Health Sci Educ

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Health professional learners are increasingly called to learn about health inequity to reduce inequities and improve patient care and health outcomes. Anti-oppression pedagogy (AOP) addresses the need for health professional learners to understand multiple health inequities and the structures and systems that produce inequities. However, the inclusion of AOP in health professions education varies and there is a lack of clarity in its conceptualization and integration. A scoping review was conducted to address this gap and to understand how AOP is conceptualized and integrated in health professions education. Thirty-six articles met the inclusion criteria. The articles demonstrated that AOP is not commonly utilized terminology within health professions education. When AOP is integrated, it is not consistently conceptualized but is generally viewed as a broad concept that focuses on antiracism; decoloniality; intersectionality; and supporting learners to understand, critically reflect on, and act against structural and systemic forms of oppressions. In addition, there is variation in the integration of AOP in health professions education with the most common methods consisting of discussions, cases, reflection, learning through lived experiences, and the incorporation of humanities within a longitudinal curriculum. The results of this scoping review highlight the need for health professions education to develop one clear concept that educators use when teaching about anti-oppression, which may reduce working in silos and allow educators to better collaborate with each other in advancing this work. In addition, this review suggests that health professional programs should consider incorporating AOP in curricula with a broad and longitudinal approach utilizing the common methods of delivery. To better support programs in including AOP in curricula, further research is required to emphasize the benefits, provide clarity on its conceptualization, and determine the most effective methods of integration.

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Teaching of the Black Population’s Health: Anti-Racist Lenses for a Paradigm Shift to Address Racial Inequities

Cited by 5 publications

References 17 publications

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Association between history of academic failure during dental school and self‐reported depression, anxiety, and stress: A retrospective cohort

Anti-oppression pedagogy in health professions: a scoping review

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