An integrated, longitudinal Health Equity curriculum to prepare socially responsible healthcare practitioners

Abstract

Objective To teach learners to identify and recognize structural causes of health disparities, design interventions, and engage in equitable, civil, and compassionate discussions. Background The racial injustices amplified by the COVID-19 pandemic have stressed the importance of educating healthcare practitioners to be advocates for social justice. Structural competency provides a framework for teaching students to be aware of structural causes of health disparities and design interventions to address them. We designed and implemented a ten-week Health Equity curriculum to promote structural competency and reduce implicit bias in healthcare providers. Here, we report on the design, implementation, student performance and student attitudes regarding this curriculum. Methods The Health Equity curriculum was a mandatory component of the Neuropsychiatric Theme for second year Pharmacy students. Students were assigned to subgroups of 5-6 and were distributed across self-identified gender and ethnicity. The curriculum was conducted remotely and consisted of didactic material, asynchronous online discussions, and synchronous Zoom discussions. Didactic material included videos, podcasts, journal articles, and faculty-created lectures. Asynchronous discussions were structured around the didactic content and open-ended prompts were provided to stimulate conversation. Three live discussions provided students with space to discuss the topics in real time. Four main topics were covered: (1) cultural and structural influences on mental health, (2) mental health and LGBTQ populations, (3) homelessness, deinstitutionalization and the mental health system, and (4) a student-identified topic. A survey was administered before and after the curriculum, and topics were assessed in OSCE (Objective Structured Clinical Examination). Results Student responses from pre- and post-surveys will be compared and quantitatively analyzed. A thematic qualitative analysis of student responses to open-ended questions will be conducted and compared. OSCE performance will be assessed for application of what was learned. Conclusion Given the challenges of integrating health disparities education into already impacted curricula, we believe our curriculum presents a rich learning experience with minimal in-class time and has potential for wide dissemination across health professional schools, with the opportunity for interprofessional collaboration. This curriculum has gone through one iteration with one cohort of students. However, given its innovative nature, we will gain insights into student engagement and performance in an online Health Equity curriculum.