Teaching Anti-Racism in the Clinical Environment: The Five-Minute Moment for Racial Justice in Healthcare

Teaching Anti-Racism in the Clinical Environment: The Five-Minute Moment for Racial Justice in Healthcare

Dismantling racism in healthcare is a crucial step in promoting racial justice and achieving health equity. In order to address racial bias in the clinical setting, it is essential to develop an anti-racism curriculum that identifies and challenges practices that perpetuate racial bias and contribute to healthcare disparities. However, the development and delivery of effective anti-racism education in healthcare has been limited due to a lack of recognition of racial bias in practices that may not be explicitly racist or unjust.

Racism itself is a structural determinant of health and a driver of healthcare disparities. While many health systems and universities have implemented mandatory anti-bias or diversity training, these trainings often overlook institutionalized racism and oppression and have been found to be ineffective in isolation. There is a need for a structured curriculum that explores and addresses the historical roots of scientific exploitation, implicit biases, and institutionalized practices and policies that contribute to health disparities.

Current efforts to teach anti-racism in clinical medicine have focused on workshops and case-based conferences, which require designated time outside of clinical practice. While these efforts are important, there is a need for a teaching modality that can effectively identify, teach, and change practice in real-time. The 5-Minute Moment for Racial Justice in Healthcare is a framework that aims to address this need.

The 5-Minute Moment for Racial Justice in Healthcare is adapted from the widely used 5-Minute Moment teaching framework for teaching physical examination skills at the bedside. This framework incorporates concise teaching moments during patient care rounds to routinely teach anti-racism. It emphasizes the use of historical narratives to highlight the historical roots of structural racism in medicine and its contributions to existing health disparities. The framework provides language for educators to initiate and engage in discussions around race in clinical decisions with learners.

The framework consists of five steps. The first step is to acknowledge the clinical and learning context of the discussion and create a nonjudgmental space for dialogue. The second step is to describe the current standard of diagnostic evaluation or treatment and its limitations before transitioning to a historical narrative. This narrative aims to promote material retention through storytelling and highlight the history of racial bias in medicine. The fourth step is to illustrate how the current standard and structural factors contribute to healthcare disparities. Finally, the fifth step is to recommend concrete steps to practice more equitably and invite learners to share their reflections.

This framework has proven to be useful in training clinical faculty and has received positive feedback in conference workshops. It fills the gap in anti-racism training in medical education by addressing clinical issues and racial disparities seamlessly. While 5 minutes may not be sufficient for an in-depth discussion, timely and brief educational interventions can leave a significant impact on learners. With practice and familiarity, faculty can develop their own 5-Minute Moment for Racial Justice teaching moments and integrate anti-racism into their routine teaching repertoire.

Dismantling systemic racism in medicine requires systemic change. It involves restructuring recruitment, leadership, teaching, and practice in the field of medicine. Within medical education, a nuanced and multi-pronged approach is needed to address the various aspects of anti-racism. The 5-Minute Moment for Racial Justice in Healthcare is just one example of a pedagogical framework that can shape future generations of physicians committed to anti-racism and ultimately contribute to health equity.

Actionable Advice:

1. Incorporate anti-racism education into routine teaching moments: Take advantage of clinical encounters to teach learners about racial bias and its impact on healthcare disparities. Use concise teaching moments to engage in meaningful discussions around race and encourage learners to share their knowledge.
2. Use historical narratives to highlight the historical roots of racism in medicine: By incorporating historical narratives into teaching, educators can provide context and promote material retention. This helps learners understand how racial bias has influenced medical practices and contributes to health disparities.
3. Recommend concrete steps to practice more equitably: In addition to raising awareness about racial bias, provide learners with actionable steps to practice more equitably. Encourage reflection and invite learners to share their own reflections and experiences.

In conclusion, teaching anti-racism in the clinical environment is crucial to dismantling racism in healthcare and promoting health equity. The 5-Minute Moment for Racial Justice in Healthcare is a framework that allows educators to address racial bias in real-time and engage learners in meaningful discussions. By incorporating historical narratives and recommending concrete steps to practice more equitably, educators can shape future generations of physicians committed to anti-racism and contribute to the course of health equity.