Community Voices in Medical Education: Building Anti-Racist Capacity in Future Physicians: Q&A and Discussion

Proposal: Background
More medical education programs include content about socially disadvantaged populations, but the ‘hidden curriculum’ persists, reinforcing whiteness and erroneously characterizing macro social conditions as individual risk behaviors (Bridges et al., 2017; Cross, 2019; Tsai & Crawford-Roberts, 2017).

Significance
Honest classroom discussions that inform sustainable solutions for community trust and health depend on the voices of local residents who understand the impact of racism on the health and safety of their communities. And yet too often, community expertise is not considered in the foundational content or narratives medical students learn. Elevating experiential knowledge in the classroom is a vital step towards building cultural responsiveness, advancing population health, and restoring community trust.

Methods
Researchers at an academic medical center in Washington, DC piloted a community-centered structural racism course in Spring 2023 for medical students in a urban and community health scholarly concentration. The course, “Community Expertise on Racism & Health in Washington, DC,” introduced first- and second-year medical students to six community experts and included three 60-minute live sessions focused on asynchronous video modules centering community members most impacted by inequities and working to upend racism. Their community expertise provided learners with local and historic context to understand how health disparities are linked to racism. Module content were co-determined by a community advisory board of DC residents, medical faculty, and students with diverse perspectives and knowledge regarding racism, health, and barriers to care.

Results
Thirty-six medical students participated in this pilot curriculum, with a median age of 24. Seventy five percent of students identified as cisgender women (25.0% as cisgender men), 33.3% as LGBTQIA+, and 61.1% as students of color. Student reflections demonstrated gains in knowledge about the credibility and value of community voices and the need to question heuristics and problematic scientific norms. Students felt challenged in how to build relationships with historically minoritized groups, disrupt discriminatory behaviors from superiors, and identify their role in opposing racism in medicine.
Conclusions
The results of this pilot highlight the readiness of medical students to unlearn implicit bias and challenge their beliefs about race and racism in medicine. This curricular innovation represents an important opportunity to rethink which voices and messages are amplified in medical school curricula. Preparing medical students to routinize anti-racism in their learning and practice requires prioritizing community expertise as we live out our social mission. The presenter is an award winning DEIJ practitioner, curriculum developer and disruptor.