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Michalec B, Xyrichis A, Arenson C. "Professional humility": introducing a new framework to advance interprofessionalism. J Interprof Care 2024; 38:587-592. [PMID: 38501441 DOI: 10.1080/13561820.2024.2326974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Affiliation(s)
- Barret Michalec
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK
| | - Christine Arenson
- National Center for Interprofessional Practice & Education, Department of Family Medicine and Community Health, School of Medicine University of Minnesota, Minneapolis, Minnesota, USA
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Mawdsley A, Magola-Makina E, Willis SC. Towards addressing the awarding gap-Using critical race theory to contextualise the role of intersectionality in Black pharmacy student attainment. MEDICAL EDUCATION 2024. [PMID: 38938192 DOI: 10.1111/medu.15460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/01/2024] [Accepted: 05/29/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION The awarding gap between White and Black students in UK health curricula is well established. Critical race theory (CRT) is a lens to deconstruct pedagogic practice and consider the intersectionality of Black student lived experience to provide a realist critique of the phenomenon of Whiteness in higher education and the impact this has on Black attainment. Using one UK pharmacy programme as a case study, this paper aims to explore Black lived experience as a means of problematising and disrupting structural oppressions. METHODS Sixteen Black students from one UK pharmacy degree programme were purposively recruited to the study. Love and breakup letter methodology (LBM) was used to facilitate sharing experiences of intersectionality in relation to their undergraduate education, with data thematically analysed through the lens of CRT. RESULTS Two meta-themes (identity and inclusion; and cultural capital) and four subthemes (social capital; access; family expectations; and help-seeking) were identified. The intersectionality of Black students was articulated as not possessing the social capital and the 'language' to succeed within the White structures of the curriculum. The conflict of capital and the absence of Black culture gave rise to confined help-seeking behaviours. Whilst Black students experienced equality of access to the curriculum, an absence of rights to legitimate involvement (inclusion) worked to diminish participation in the curriculum. DISCUSSION This is the first study to consider the intersectionality of Black pharmacy students in relation to academic awarding gaps and has found that oppressive educational structures marginalise and other Black experience. Black students experience the curriculum as a place where their social and cultural capital is undervalued, and as a White space where they lack the artefacts to succeed, leading to peripheral participation and detachment. The approach used in this study can be adopted across medical and health education as a means to problematise racial inequality through the exemplar of White:Black awarding gaps.
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Affiliation(s)
- Andrew Mawdsley
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | | | - Sarah C Willis
- Alliance Manchester Business School, University of Manchester, Manchester, UK
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Ogunyemi D, Thind BS, Teixeira A, Sams CM, Ojo M, Dinkins GAE, Serseni D. Integrating Cultural Humility into Medical Education Using a Structured and Interactive Workshop. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:575-583. [PMID: 38911069 PMCID: PMC11193470 DOI: 10.2147/amep.s460970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/01/2024] [Indexed: 06/25/2024]
Abstract
Background Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient-physician relationships and developing mutually trusting beneficial partnerships. Objective The objective of this study was to determine the feasibility and efficacy of cultural humility training. Methods From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions. Results There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p<0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p<0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of -8% by female participants (P<0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p<0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p<0.001). Conclusion An interactive educational workshop can increase participants' knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.
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Affiliation(s)
- Dotun Ogunyemi
- DIO, Associate Dean of Graduate Medical Education; Charles R Drew University, College of Medicine, Los Angeles, CA, USA
| | - Birpartap S Thind
- Medical Student, California University of Science and Medicine, Colton, CA, USA
| | - Amir Teixeira
- Medical Student, California University of Science and Medicine, Colton, CA, USA
| | - Clarence M Sams
- Medical Student, Charles R Drew University, College of Medicine, Los Angeles, CA, USA
| | - Matthias Ojo
- Medical Student, Charles R Drew University, College of Medicine, Los Angeles, CA, USA
| | - Grace Anne E Dinkins
- DIO, Associate Dean of Graduate Medical Education; Charles R Drew University, College of Medicine, Los Angeles, CA, USA
| | - Dragos Serseni
- DIO, Associate Dean of Graduate Medical Education; Charles R Drew University, College of Medicine, Los Angeles, CA, USA
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Draper-Rodi J, Abbey H, Hammond J, Thomson OP, Brownhill K, MacMillan A, Fabusuyi Y, Vogel S. Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study. BMC MEDICAL EDUCATION 2024; 24:468. [PMID: 38671395 PMCID: PMC11055260 DOI: 10.1186/s12909-024-05404-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change. METHODS A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings. RESULTS A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students. CONCLUSION Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.
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Affiliation(s)
- Jerry Draper-Rodi
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK.
- National Council for Osteopathic Research, 275 Borough High Street, SE1 1JE, London, UK.
| | - Hilary Abbey
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - John Hammond
- School of Allied and Public Health Professions, North Holmes Road, CT1 1QU, Canterbury, Kent, UK
| | - Oliver P Thomson
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Kevin Brownhill
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Andrew MacMillan
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
- University of Portsmouth, University House, Winston Churchill Ave, PO1 2UP, Hampshire, Portsmouth, England
| | - Yinka Fabusuyi
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Steven Vogel
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
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Kaljo K, Braun MT, Maddula R, Ferguson CC, Bonifacino E, Farkas A. Undergraduate College Pathway Programs Designed to Attract and Matriculate Students from Underrepresented Groups into Medicine. South Med J 2023; 116:942-949. [PMID: 38051167 DOI: 10.14423/smj.0000000000001631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Undergraduate college pathway (or pipeline) programs support students' interests as they explore advanced degree and career pathways. Many programs aim to diversify the medical workforce by reducing barriers that may have otherwise prevented desired academic and career goals; however, variability in structure, expectations, benefits, and outcome data exist. This systematic review was conducted to identify and evaluate undergraduate college pathway programs designed to increase the diversity of medical school matriculants. METHODS We searched Ovid Medline, PsycInfo, Scopus, and the Education Resources Information Center for peer-reviewed, original research publications (1996-2019) describing US pathway/pipeline programs designed for undergraduate-level college students from underrepresented groups to apply and enter medical school. Data extraction included application processes, participant demographics, curricular components, social support systems, mentorship, funding, and program/participant outcomes. We reviewed the journal impact factor to inform us about where articles are being published. RESULTS Our full-text review included 137 articles; 25 articles met the inclusion criteria. All of the papers were descriptive, requiring an application, minimum grade point average, letters of recommendation, and personal statements. All of the programs aimed to diversify medicine, yet some could not request identification of race/ethnicity because of changes in affirmative action or legal restrictions when reporting demographics. Women represented the majority of enrollees. The program length varied; all reported having one or a combination of academic enrichment, research, field observation/experience, and mentorship. All of the programs included career development and various supplemental social supports. Only two programs provided comparison data; four reported no outcomes. CONCLUSIONS Pathway programs support the acquisition and enhancement of professional skills. Lacking longitudinal or comparison data leads to questions of the long-term impact on diversifying the medical workforce. This article highlights a need for rigorous data collection methods and transparent reporting of participant outcomes to inform programmatic efficacy.
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Affiliation(s)
- Kristina Kaljo
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
| | - Michael T Braun
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
| | - Ragasnehith Maddula
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
| | - Catherine C Ferguson
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
| | - Eliana Bonifacino
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
| | - Amy Farkas
- From the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee
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Brondfield S, Kiel L, Florez N. Evolution of the Oncologist Clinician Educator. JCO Oncol Pract 2023; 19:700-703. [PMID: 37379500 DOI: 10.1200/op.23.00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Today’s oncologist clinician educator must promote DEI, well-being, and educational scholarship.
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Affiliation(s)
- Sam Brondfield
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Narjust Florez
- Division of Hematology/Oncology, Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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Reynolds CW, Shen MR, Englesbe MJ, Kwakye G. Humility: A Revised Definition and Techniques for Integration into Surgical Education. J Am Coll Surg 2023; 236:1261-1264. [PMID: 36735639 DOI: 10.1097/xcs.0000000000000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | - Mary R Shen
- the Department of Surgery, University of Michigan Medical School, Ann Arbor, MI (Shen, Englesbe, Kwakye)
| | - Michael J Englesbe
- the Department of Surgery, University of Michigan Medical School, Ann Arbor, MI (Shen, Englesbe, Kwakye)
| | - Gifty Kwakye
- the Department of Surgery, University of Michigan Medical School, Ann Arbor, MI (Shen, Englesbe, Kwakye)
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Adam P, Mauksch LB, Brandenburg DL, Danner C, Ross VR. Optimal training in communication model (OPTiCOM): A programmatic roadmap. PATIENT EDUCATION AND COUNSELING 2023; 107:107573. [PMID: 36410312 DOI: 10.1016/j.pec.2022.107573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Teaching primary care residents patient communication skills is essential, complex, and impeded by barriers. We find no models guiding faculty how to train residents in the workplace that integrate necessary system components, the science of physician-patient communication training and competency-based medical education. The aim of this project is to create such a model. METHODS We created OPTiCOM using four steps: (1) communication educator interviews, analysis and theme development; (2) initial model construction; (3) model refinement using expert feedback; (4) structured literature review to validate, refine and finalize the model. RESULTS Our model contains ten interdependent building blocks organized into four developmental tiers. The Foundational value tier has one building block Naming relationship as a core value. The Expertize and resources tier includes four building blocks addressing: Curricular expertize, Curricular content, Leadership, and Time. The four building blocks in the Application and development tier are Observation form, Faculty development, Technology, and Formative assessment. The Language and culture tier identifies the final building block, Culture promoting continuous improvement in teaching communication. CONCLUSIONS OPTiCOM organizes ten interdependent systems building blocks to maximize and sustain resident learning of communication skills. Practice Implications Residency faculty can use OPTiCOM for self-assessment, program creation and revision.
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Affiliation(s)
- Patricia Adam
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Larry B Mauksch
- Emeritus - Department of Family Medicine, University of Washington, Home, 6026 30th Ave NE, Seattle, WA 98115, USA.
| | - Dana L Brandenburg
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Christine Danner
- Department of Family Medicine and Community Health, University of Minnesota, Bethesda Clinic, 580 Rice St, St Paul, MN 55103, USA.
| | - Valerie R Ross
- University of Washington Department of Family Medicine, Family Medicine Residency Program, Box 356390, 331 N.E. Thornton Place, Seattle, WA 98125, USA.
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Garrett SB, Simon MA. The Social Contexts of Birthing People with Public- and Private-Payer Prenatal Care: Illuminating an Understudied Aspect of the Patient Experience. Health Equity 2022; 6:898-908. [PMID: 36636111 PMCID: PMC9811847 DOI: 10.1089/heq.2021.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose In pursuit of more equitable and person-centered health care, patients and professional medical societies increasingly call for better clinician understanding of patients' perspectives and social contexts. A foundational but understudied aspect of patients' social contexts are the ideas they encounter about health-related behaviors. We investigated this aspect of the social contexts of birthing people, comparing those with public versus private insurance to discover setting-specific insights. Methods Based on ethnographic fieldwork, we created an original survey featuring 29 statements about 12 prenatal, perinatal, and postpartum health behaviors (e.g., drinking alcohol, epidural use, breastfeeding). Participants were 248 individuals receiving prenatal care in Northern California in 2009-2011, split evenly between public- and private-payer coverage. Participants reported whether they were familiar or unfamiliar with each statement. Results Ninety-eight percent of all participants had heard contradictory ideas about ≥1 health behavior (mean=3.9 behaviors for public- and 5.4 for private-coverage respondents). For 20 of the 29 behavior-related ideas, exposure varied significantly by coverage type. Among other differences, public-coverage respondents were much more familiar with ideas related to risk and constrained autonomy (e.g., that serious perinatal complications are common; that new mothers should try to breastfeed even if they do not want to). Conclusions Birthing people are exposed to a wide range of ideas about health behaviors, many of which vary by the structural systems in which they are embedded. Understanding and engaging this complexity can help clinicians to provide more respectful, person-centered, and equitable maternity care.
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Affiliation(s)
- Sarah B. Garrett
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.,*Address correspondence to: Sarah B. Garrett, PhD, Philip R. Lee Institute for Health Policy Studies, 490 Illinois Street, Floor 7, San Francisco, CA 94158, USA,
| | - Melissa A. Simon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Jindal M, Thornton RL, McRae A, Unaka N, Johnson TJ, Mistry KB. Effects of a Curriculum Addressing Racism on Pediatric Residents' Racial Biases and Empathy. J Grad Med Educ 2022; 14:407-413. [PMID: 35991090 PMCID: PMC9380619 DOI: 10.4300/jgme-d-21-01048.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/22/2022] [Accepted: 04/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Racism is a longstanding driver of health inequities. Although medical education is a potential solution to address racism in health care, best practices remain unknown. OBJECTIVE We sought to evaluate the impact of participation in a curriculum addressing racism on pediatric residents' racial biases and empathy. METHODS A pre-post survey study was conducted in 2 urban, university-based, midsized pediatric residency programs between July 2019 and June 2020. The curriculum sessions included Self-Reflection on Implicit Bias, Historical Trauma, and Structural Racism. All sessions were paired with empathy and perspective-taking exercises and were conducted in small groups to facilitate reflective discussion. Wilcoxon signed rank tests were used to assess changes in racial bias and empathy. Linear regression was used to assess the effect of resident characteristics on racial bias and empathy. RESULTS Ninety of 111 residents receiving the curriculum completed pre-surveys (81.1%), and among those, 65 completed post-surveys (72.2%). Among participants with baseline pro-White bias, there was a statistically significant shift (0.46 to 0.36, P=.02) toward no preference. Among participants with a baseline pro-Black bias, there was a statistically significant shift (-0.38 to -0.21, P=.02), toward no preference. Among participants with baseline pro-White explicit bias, there was a statistically significant shift (0.54 to 0.30, P<.001) toward no preference. Among all residents, there was a modest but statistically significant decrease in mean empathy (22.95 to 22.42, P=.03). CONCLUSIONS Participation in a longitudinal discussion-based curriculum addressing racism modestly reduced pediatric residents' racial preferences with minimal effects on empathy scales.
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Affiliation(s)
- Monique Jindal
- Monique Jindal, MD, MPH, is Assistant Professor, Department of Medicine, University of Illinois Chicago
| | - Rachel L.J. Thornton
- Rachel L.J. Thornton, MD, PhD, is Associate Professor, Department of Pediatrics, Johns Hopkins University School of Medicine, and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health
| | - Ashlyn McRae
- Ashlyn McRae, MD, is a Resident Physician, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Ndidi Unaka
- Ndidi Unaka, MD, MEd, is Associate Professor, Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine
| | - Tiffani J. Johnson
- Tiffani J. Johnson, MD, MSc, is Assistant Professor, Department of Emergency Medicine, University of California, Davis
| | - Kamila B. Mistry
- Kamila B. Mistry, PhD, MPH, is Senior Advisor for Child Health and Quality Improvement, Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, US Department of Health and Human Services, and Assistant Professor, Department of Pediatrics, Johns Hopkins University School of Medicine
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Palmer NR, Smith AN, Campbell BA, Andemeskel G, Tahir P, Felder TM, Cicerelli B. Navigation programs relevant for African American men with prostate cancer: a scoping review protocol. Syst Rev 2022; 11:122. [PMID: 35701771 PMCID: PMC9195379 DOI: 10.1186/s13643-022-01993-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 05/27/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The excess incidence and mortality due to prostate cancer that impacts African American men constitutes the largest of all cancer disparities. Patient navigation is a patient-centered healthcare system intervention to eliminate barriers to timely, high-quality care across the cancer continuum and improves health outcomes among vulnerable patients. However, little is known regarding the extent to which navigation programs include cultural humility to address prostate cancer disparities among African American men. We present a scoping review protocol of an in-depth examination of navigation programs in prostate cancer care-including navigation activities/procedures, training, and management-with a special focus on cultural context and humility for African American men to achieve health equity. METHODS We will conduct comprehensive searches of the literature in PubMed, Embase, Web of Science, and CINAHL Complete, using keywords and index terms (Mesh and Emtree) within the three main themes: prostate cancer, patient navigation, and African American men. We will also conduct a search of the gray literature, hand-searching, and reviewing references of included papers and conference abstracts. In a two-phase approach, two authors will independently screen titles and abstracts, and full-text based on inclusion/exclusion criteria. All study designs will be included that present detailed data about the elements of navigation programs, including intervention content, navigator training, and/or management. Data will be extracted from included studies, and review findings will be synthesized and summarized. DISCUSSION A scoping review focused on cultural humility in patient navigation within the context of eliminating disparities in PCa care among African American men does not yet exist. This review will synthesize existing evidence of patient navigation programs for African American prostate cancer patients and the inclusion of cultural humility. Results will inform the development and implementation of future programs to meet the unique needs of vulnerable prostate cancer patients in safety net settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2021 CRD42021221412.
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Affiliation(s)
- Nynikka R. Palmer
- Division on General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, UCSF mailbox 1364, San Francisco, CA 94143 USA
| | - Ashley Nicole Smith
- Division on General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, UCSF mailbox 1364, San Francisco, CA 94143 USA
| | - Brittany A. Campbell
- University of California San Francisco, 1450 3rd Street, San Francisco, CA 94143 USA
| | | | - Peggy Tahir
- UCSF Library, University of California San Francisco, 530 Parnassus Ave, San Francisco, CA 94143 USA
| | - Tisha M. Felder
- College of Nursing, University of South Carolina, 1601 Greene Street, Room 620, Columbia, SC 29208 USA
| | - Barbara Cicerelli
- Zuckerberg San Francisco General Hospital, 995 Potrero Ave, Building 80, Room 8000N Lower Level, San Francisco, CA 94110 USA
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Liu CZ, Wang E, Nguyen D, Sun MD, Jumreornvong O. The Model Minority Myth, Data Aggregation, and the Role of Medical Schools in Combating Anti-Asian Sentiment. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:797-803. [PMID: 35703909 DOI: 10.1097/acm.0000000000004639] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has resulted in an alarming increase in hate incidents directed toward Asian Americans and Pacific Islanders (AAPIs), including verbal harassment and physical assault, spurring the nationwide #StopAsianHate movement. This rise in anti-Asian sentiment is occurring at a critical time of racial reckoning across the United States, galvanized by the Black Lives Matter movement, and of medical student calls for the implementation of antiracist medical curricula. AAPIs are stereotyped by the model minority myth, which posits that AAPIs are educated, hardworking, and therefore able to achieve high levels of success. This myth acts as a racial wedge between minorities and perpetuates harm that is pervasive throughout the field of medicine. Critically, the frequent aggregation of all AAPI subgroups as one monolithic community obfuscates socioeconomic and cultural differences across the AAPI diaspora while reinforcing the model minority myth. Here, the authors illustrate how the model minority myth and data aggregation have negatively affected the recruitment and advancement of diverse AAPI medical students, physicians, and faculty. Additionally, the authors discuss how data aggregation obscures health disparities across the AAPI diaspora and how the model minority myth influences the illness experiences of AAPI patients. Importantly, the authors outline specific actionable policies and reforms that medical schools can implement to combat anti-Asian sentiment and support the AAPI community.
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Affiliation(s)
- Clifford Z Liu
- C.Z. Liu is an MD-PhD candidate, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: https://orcid.org/0000-0003-1783-299X
| | - Eileen Wang
- E. Wang is a first-year resident, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Don Nguyen
- D. Nguyen is an MD-PhD candidate, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mary D Sun
- M.D. Sun is an MD-MSCR candidate, Icahn School of Medicine at Mount Sinai, New York, New York, and an MA candidate, Harvard University, Cambridge, Massachusetts
| | - Oranicha Jumreornvong
- O. Jumreornvong is a fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York
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Jindal M, Mistry KB, McRae A, Unaka N, Johnson T, Thornton RLJ. "It Makes Me a Better Person and Doctor": A Qualitative Study of Residents' Perceptions of a Curriculum Addressing Racism. Acad Pediatr 2022; 22:332-341. [PMID: 34923147 DOI: 10.1016/j.acap.2021.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Explore how pediatric residents perceive the impact of a curriculum addressing racism on their knowledge, motivation, skills and behaviors, and investigate the contextual factors that promote or impede the curriculum's effectiveness. METHODS Open-ended, semistructured interviews were conducted at 2 academic medical centers between August 2019 and 2020 among pediatric residents who participated in the curriculum. Interviews were recorded, transcribed, and analyzed by using inductive content analysis. RESULTS Pediatric residents (n = 16) were predominantly white (66.7%), female (86.7%) interns (60%) from the Midwest (40%). Six major themes emerged describing the perceived impact of the curriculum on: knowledge - (1) Understanding of race and racism as structural forces in a historical context; motivation - (2) Owning the issue of racism, (3) Having the curriculum makes a statement; skills - (4) Critical self-reflection, (5) Perceived development of skills to mitigate biases; and action-planning - (6) Turning insight into strategies to combat racism and improve patient care. Two additional themes emerged describing contextual factors that promoted or impeded the curriculum such as the content of the curriculum itself, the racial demographics of the participants, the implementation infrastructure and environmental factors such as the culture of the training program. CONCLUSIONS Medical education addressing racism can facilitate the perceived acquisition of foundational knowledge regarding race and racism; motivation and skill-building to combat racism; and action planning aimed at improving patient care. Contextual factors should be considered when developing and implementing such curricula to not only promote racial equity but avoid unintended harms.
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Affiliation(s)
- Monique Jindal
- Division of General Pediatrics, Department of Pediatrics (M Jindal, KB Mistry, RLJ Thornton), Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Kamila B Mistry
- Division of General Pediatrics, Department of Pediatrics (M Jindal, KB Mistry, RLJ Thornton), Johns Hopkins University School of Medicine, Baltimore, Md; Office of Extramural Research, Education, and Priority Populations (KB Mistry), Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Md
| | - Ashlyn McRae
- Division of General Pediatrics, Department of Pediatrics (M Jindal, KB Mistry, RLJ Thornton), Johns Hopkins University School of Medicine, Baltimore, Md
| | - Ndidi Unaka
- Division of Hospital Medicine (N Unaka), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (N Unaka), University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tiffani Johnson
- Department of Emergency Medicine (T Johnson), University of California, Davis, Calif
| | - Rachel L J Thornton
- Division of General Pediatrics, Department of Pediatrics (M Jindal, KB Mistry, RLJ Thornton), Johns Hopkins University School of Medicine, Baltimore, Md; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society (RLJ Thornton), Baltimore, Md
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