Abstract

Background In 2018, the Accreditation Council for Graduate Medical Education(ACGME)updated its Common Program Requirements to include training in caring for diverse populations and understanding social determinants of health. In our large pediatric residency program, we implemented a formal equity, diversity and inclusion (EDI) curriculum in 2018 after a needs assessment. The curriculum includes monthly didactic sessions and two half- day skill-building sessions on EDI fundamentals and responding to microaggressions. Objective: To describe how curriculum implementation changed residents self-perceived knowledge, attitudes and behaviors when delivering patient care to diverse patient populations. Methods Two focus groups (n=13) were conducted by trained facilitators with senior pediatric residents using a structured question guide. Written notes and audio transcripts were recorded. Four project members coded the notes and transcripts using a codebook. Discrepancies were resolved by consensus. The full project team reviewed and discussed common themes. Results Of the 13 residents, 61% (8/13) were R2s. 31% (4/13) were residents of color and 77% (10/13) were female. Four major themes were identified (Table 1. First, residents described a sense of importance and empowerment to engage in EDI issues after the curriculum. Second, residents reported gaining specific skills to recognize and address microaggressions. Third, residents described attitude and behavior shifts from increased awareness of biases in patient care. The fourth theme was a limitation in providing equitable care due to availability and appropriate use of interpreters. Conclusions Pediatric residents reported increased awareness and improved skills when providing care to diverse populations after implementation of an EDI curriculum. Residents described how this curriculum provided language to properly recognize and address witnessed inequities. Next steps in curricular efforts include a follow-up quantitative survey of all residents, focus groups with interns and direct observation of resident behaviors to assess impact.

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