Diversity and Inclusion
Journal Articles on Community Educators / Engagement
Click the Links Below for Full Article Information.
Crampton, P., Dowell, A., Parkin, C., & Thompson, C. (2003). Combating Effects of Racism Through a Cultural Immersion Medical Education Program. Academic Medicine, 78(6), 595-598. http://dx.doi.org/10.1097/00001888-200306000-00008
Abstract: The purpose of this paper is to provide a perspective from New Zealand on the role of medical education in addressing racism in medicine. There is increasing recognition of racism in health care and its adverse effects on the health status of minority populations in many Western countries. New Zealand nursing curricula have introduced the concept of cultural safety as a means of conveying the idea that cultural factors critically influence the relationship between carer and patient. Cultural safety aims to minimize any assault on the patient's cultural identity. However, despite the work of various researchers and educators, there is little to suggest that undergraduate medical curricula pay much attention yet to the impact of racism on medical education and medical practice. The authors describe a cultural immersion program for third-year medical students in New Zealand and discuss some of the strengths and weaknesses of such an approach. The program is believed to have great potential as a method of consciousness raising among medical students to counter the insidious effects of non-conscious inherited racism. Apart from the educational benefits, the program has fostered a strong working relationship between an indigenous health care organization and the medical school. In general, it is hoped that such programs will help medical educators to engage more actively with the issue of racism and be prepared to experiment with novel approaches to teaching and learning. More specifically, the principles of cultural immersion, informed by the concept of cultural safety, could be adapted to indigenous and minority groups in urban settings to provide medical students with the foundations for a lifelong commitment to practicing medicine in a culturally safe manner.
Girotti, J., Loy, G., Michel, J., & Henderson, V. (2015). The Urban Medicine Program. Academic Medicine, 90(12), 1658-1666. http://dx.doi.org/10.1097/acm.0000000000000970
Abstract: Purpose: Medical school graduates are poorly prepared to address health care inequities found in urban, underserved communities. The University of Illinois College of Medicine developed the Urban Medicine Program (UMed) to prepare students for the roles of advocate, researcher, policy maker, and culturally competent practitioner through a four-year curriculum integrating principles of public health with direct interventions in local, underserved communities. This study assessed the program’s effectiveness and evaluated early outcomes.
Method: The authors analyzed data for UMed students (graduating classes 2009–2013) from pre- and postseminar assessments and longitudinal community project progress reports. They also compared UMed and non-UMed outcomes from the same classes, using graduation data and data from two surveys: Medical Students’ Attitudes Toward the Underserved (MSATU) and the Intercultural/Professional Assessment.
Results: UMed students were more likely than non-UMed students to endorse MSATU constructs (“Universal medical care is a right” [P = .01], “Access to basic medical care is a right” [P = .03], “Access is influenced by social determinants” [P = .03]); to be selected for the Gold Humanism Honor Society (P < .0001); to complete joint degrees (P < .0001); and to enter primary care residencies (P = .002).
Conclusions: Early outcomes reveal that a longitudinal, experiential curriculum can provide students with competencies that may prepare them for leadership roles in advocacy, research, and policy making. Contact with diverse communities inculcates—in medical students with predispositions toward helping underserved populations—the self-efficacy and skills to positively influence underserved, urban communities.
Gonzalez, C., Fox, A., & Marantz, P. (2015). The Evolution of an Elective in Health Disparities and Advocacy. Academic Medicine, 90(12), 1636-1640. http://dx.doi.org/10.1097/acm.0000000000000850
Problem: Health disparities remain pervasive in the United States. Training future physicians to address health disparities requires attention to both systemic and provider causes of disparities, but comprehensive curricula are lacking.
The authors evaluated the course in 2010–2013 by comparing students’ summary scores for knowledge, attitudes, and self-reported confidence on pre- and postintervention tests. They investigated associations between students’ sociodemographic characteristics and changes in summary scores
Outcomes: Scores increased significantly in each domain: Mean knowledge scores increased from 63.6 (± 10.0), out of 100, to 76.4 (± 12.8); mean attitudes scores increased from 16.7 (± 1.9), out of 20, to 18.2 (± 1.1); mean confidence scores increased from 10.7 (± 1.5), out of 16, to 14.4 (± 1.7). Younger students (< 24) had greater changes in confidence than older students. Other sociodemographic characteristics were not associated with changes in any domain.
Next Steps: Exposure to health disparities instruction is important for medical students. The authors’ experience provides insights for incorporating such material into the compulsory curriculum. Future evaluation of outcomes from similar curricula should include measures of clinical behaviors (e.g., through clinical examinations).
Kumagai, A. (2009). The Patient’s Voice in Medical Education: The Family Centered Experience Program. Virtual Mentor, 11(3), 228-231. http://dx.doi.org/10.1001/virtualmentor.2009.11.3.medu1-0903
Within the intimacy of the patient-doctor relationship, there is a deceptively simple but profound interaction: one human being uses his or her training, knowledge, and skills to alleviate the suffering of another. Profound, but not simple. Misunderstandings and mistrust abound.
“He’s angry and noncompliant.”
“My doctor’s a quack.”
“She doesn’t seem to care what happens to her.”
“My doctor never listens to me.”
Difficult clinical interactions may arise in part from problems in communication, but that’s not the whole story. An even greater barrier to common understanding exists. Patients and doctors often see the same thing—the problem with which the patient is afflicted—from two very different perspectives. For doctors, it is a disease, a physiological disturbance that can be understood and treated through biomedical theories and their applications. For the patient, it is an illness, the subjective experience of being sick . These two perspectives are frequently expressed in very different languages: the language of disease is dry, scientific, statistical, rational, and impersonal; the language of illness is intensely personal and individual and expresses itself in terms of discomfort, suffering, and loss.
Impact of an Academic–Community Partnership in Medical Education on Community Health: Evaluation of a Novel Student-Based Home Visitation Program
Rock, JA, Acuna, JM, & Lozano, JM (2014). Impact of an academic–community partnership in medical education on community health: Evaluation of a novel student-based home visitation program. South Med J, 107, 203-211. DOI: 10.1097/SMJ.0000000000000080
Objectives: Current US healthcare delivery systems do not adequately address healthcare demands. Physicians are integral but rarely emphasize prevention as a primary tool to change health outcomes. Home visitation is an effective method for changing health outcomes in some populations. The Florida International University Herbert Wertheim College of Medicine Green Family Foundation NeighborhoodHELP service-learning program assigns medical students to be members of interprofessional teams that conduct household visits to determine their healthcare needs.
Methods: We performed a prospective evaluation of 330 households randomly assigned to one of two groups: visitation from a student team (intervention group) or limited intervention (control group). The program design allowed randomly selected control households to replace intervention-group households that left the program of their own volition. All of the households were surveyed at baseline and after 1 year of participation in the study.
Results: After 1 year in the program and after adjustment for confounders, intervention group households proved more likely ( P ≤ 0.05) than control households to have undergone physical examinations, blood pressure monitoring, and cervical cytology screenings. Cholesterol screenings and mammograms were borderline significant ( P = 0.05 and P = 0.06, respectively).
Conclusions: This study supports the value of home visitation by interprofessional student teams as an effective way to increase the use of preventive health measures. The study underscores the important role interprofessional student teams may play in improving the health of US communities, while students concurrently learn about primary prevention and primary care.
- Last Updated: Jun 28, 2021 12:10 PM
- URL: https://guides.upstate.edu/Diversity-Inclusion
- Print Page