Core Concepts of Anti-Racism
in Health Professions Education
Anti-Racist Pedagogy focuses on action and practice.
It seeks to “explain and counteract the persistence and impact of racism” and to “promote social justice for the creation of a democratic society…” It involves “inquiry, experimentation and reflection; thereby, providing the opportunity to make changes based on current conditions.” Kishimoto further describes anti-racist pedagogy as an “organizing effort for institutional and social change that is much broader than teaching in the classroom”, describing that faculty must not only be aware of their own social position, but must invest in the following components:
Incorporating the topics of race and inequality into course content,
Teaching from an anti-racist pedagogical approach, and
Anti-racist organizing within the campus and linking our efforts to the surrounding community.
What does this look like health professions education? Solomon and colleagues have set forth a framework for anti-racism in medical education: see, name, understand, act. They describe how each step of this framework mirrors concepts that are familiar in health professions education: “teaching clinical reasoning, confronting and learning from medical error, engaging in continuous quality improvement, and cultivating a growth mindset and adaptive expertise.”
“Anti-racist approaches in health professions education necessitate reflection and critique, welcome vulnerability, and demand action.”
Key definitions: arts and humanities
Key readings on the applicability of the arts and humanities to anti-racist pedagogy
Tips for implementation
Partners in curriculum development and instruction should include interprofessional colleagues, patients, scholars or educators in the arts, humanities or health humanities, museum educators, and your learners. Think outside of the box and be willing to engage people with different perspectives and lived experiences. while paying specific attention to the concept of voice.
The concept of voice, which entails “the privileging of marginalized persons’ contributions to discourses,” is critical to this work. The framework of the humanities provides an opportunity to include voices that are not usually heard in traditional health professions education or who may be heard from but not with equal weighting. Consider obtaining input from community members when designing this curriculum, and consider engaging with patients or caregivers, for instance, as co-teachers in this curriculum. Hearing from fresh and diverse perspectives will help to elevate the conversations and potentially illuminate critical blindspots.
"Twelve Tips for Starting a Collaboration with an Art Museum" — Williams R, Zimmerman C.
"The public health critical race methodology: praxis for antiracism research" — Ford CL, Airhihenbuwa CO.
Meet learners where they are
At any given time different learners in a group may experience different levels of psychological safety, may have variable needs or expectations and may be in different “zones” in the process of becoming anti-racist. Such “zones” include the “fear zone,” characterized by avoidance or denial; the “learning zone,” where increased discomfort is tolerated and accompanied by openness to vulnerability, self-critique, and diverse perspectives; and the “growth zone,” wherein one starts to assume responsibility and engage in advocacy and education. Learners’ readiness and receptiveness may vary, and those leading the curriculum may need to adapt to their specific learners and learning environment. Studies of anti-racism curricula among medical students have shown that students of color and White students have differing needs or experiences when participating in such curricula.
Build institutional engagement
We recognize that each institution and their respective cultures are distinct and require different approaches to gaining buy-in to engage in these important discussions. Potential ways to encourage buy-in may include partnering with your institutions department of equity and inclusion to trial a session, beginning with less emotionally charged topics/sessions (personal responses tour, mural arts tour), connecting a session to a patient complaint or clinical case discussion that features relevant issues, or inviting outside speakers to help begin these conversation.
Pair conversation with action
Being an anti-racist is not defined by a single action, but instead represents an iterative, sustained, and multi-faceted effort. Most importantly, words without action are of limited utility; it is important to pair these discussions with actions that address the issues and concerns that are unveiled through conversation.
self-awareness for faculty
Any educator seeking to implement any of the ShareTools modules or approaches should complete the Educator’s Self-Reflection Worksheet. Filling out the worksheet in advance allows educators to adapt these sessions to their strengths, needs, and specific learning environment, while reflecting upon their social positions, privileges and viewpoints.
Create engaging and vulnerable conversations in psychologically supportive spaces
The learning environment should maximize psychological safety, defined by Amy Edmondson as “shared belief held by members of a team that the team is safe for interpersonal risk taking.” Learners should feel empowered to speak their mind with mutual trust and respect.
We recommend starting each session with a statement of safety communicating expectations and community practices, to encourage comfort with discomfort, vulnerability, and intellectual candour. Possible statements include:
No art or literature expertise required
No right or wrong answers
Everyone is invited to participate
No one is obligated to participate
Art can evoke strong emotions
This is a learning experience for ALL of us
Additional strategies for facilitating such conversations are detailed by Acosta, et al.
Prepare strategies for
Debriefs and check-ins with learners should be conducted, and appropriate resources or outlets for debriefing or counseling should be made available to all participants. Educators must make it a priority to ensure that the content of sessions minimizes risks of retraumatization, or vicarious or secondary traumatization, of faculty and participants alike.
Apply an anti-racist lens to all curricula
We encourage educators to apply an anti-racist lens to all curricular materials, not simply to the portions of the curriculum that explicitly focus on anti-racism. Semantics and language matter, as does how race is represented in curricular materials, and whether the materials themselves are representative. We recommend reviewing the following resources and checklist.
Reading + Links:
"Misrepresenting Race - The Role of Medical Schools in Propagating Physician Bias" — Amutah C, Greenidge K, Mante A, Munyikwa M, Surya SL, Higginbotham E, Jones DS, Lavizzo-Mourey R, Roberts D, Tsai J, Aysola J
"Can a checklist ameliorate implicit bias in medical education?" — Caruso Brown AE, Hobart TR, Botash AS, Germain LJ.