Increasing Trust and Communication in Medical Education Through a Student-Led Social Justice Initiative

Abstract

To the Editor: Distrust in the health care system by minority patients contributes to health disparities. Care from racially concordant physicians improves patient satisfaction and access to care; however, barriers exist in the recruitment and retention of diverse individuals.1 These barriers stem from institutional structures, including poor university cultural climates.2 Consequently, diverse medical students may develop feelings of isolation and mistrust in their educational systems. In our experience, these feelings are underreported due to a lack of confidence in the administration to provide resources to actively address issues such as poor faculty diversity and microaggressions. Collaboration between medical students and administration can ensure that institutions recognize diverse students’ experiences. Medical students should be empowered to engage academic administrators to identify areas for improvement. At our institution, students developed a strategic model to enhance the sense of belonging and trust. Through this experience, these students set goals, identified key stakeholders, developed strategy, reached out to university administrators, and leveraged follow-up to create sustainability. Establishing a goal: Students organized meetings to discuss the campus climate—specifically, diversity, cultural competency, and resources for support. Students evaluated the effectiveness of past diversity initiatives and assessed potential barriers to enacting change. Identifying key stakeholders: Medical education administrators’, teaching faculty members’, and students’ voices were represented among those on campus who provided direction and feedback to the student leaders. Developing strategy: Using findings from a comprehensive literature review and cross-institutional discourse, students developed an open-access document, so interested individuals could provide recommendations to improve cultural climate and communication at the institution. Reaching out to university administrators: High-priority recommendations were presented to the university’s president during a formal meeting with students and administrators in order to establish action items to achieve the university-wide goal of creating a sense of belonging. Leveraging follow-up to create sustainability: Correspondence with administration continued subsequent to the initial meetings. This communication, including meetings, guaranteed that students and administrators were equally invested in the enhancement of diversity and inclusion. Outcomes achieved included a revision of the mission statement to include a commitment to diversity, creation of the medical center’s first gender-neutral bathroom, and enhanced curriculum review to improve inclusiveness. Student-led collaboration with administrators ultimately improved the sense of trust and belonging for diverse groups at the institution. Eva Williams, MSFourth-year medical student, University of Miami Miller School of Medicine, Miami, Florida; [email protected]i.edu; ORCID: https://orcid.org/0000-0002-1651-9152.Misha ArmstrongFourth-year medical student, University of Miami Miller School of Medicine, Miami, Florida.