Using Learning Communities to Address Important Diversity Discussions.

Abstract

Purpose: A renewed call for antiracism pedagogy emerged in medical education in the wake of the COVID-19 pandemic and social unrest following several highly publicized incidences of police using excessive force with people of color. 1,2 To address the health care needs of increasingly diverse U.S. communities, medical students must be knowledgeable on topics of race, racism, and implicit bias. Our learning communities (LCs) provided a space for a diverse student body to engage in difficult conversations, including conversations on implicit bias. We discuss lessons learned in implementing the LC structure and developing its curriculum. Approach: Morehouse School of Medicine LCs were designed to discuss and develop relevant student skills and behaviors, foster a sense of community, improve peer-to-peer relationships, and encourage relationship development between students and faculty. Incoming medical students are divided into 8 LCs, named after school-specific values and culture (knowledge, wisdom, service, excellence, compassion, integrity, innovation, and leadership). LCs are longitudinal, with students continuing in these groups for all 4 years of medical school. In this model, rotating student leaders lead the interactive discussions with 2 faculty mentors, 1 clinician, and 1 basic science or public health, serving as facilitators for the sessions. Before each session, students are given discussion guides to serve as a framework and are encouraged to include other relevant information or activities. Outcomes: LCs provide students with opportunities to self-reflect, share, and engage with their peers and faculty on complex and challenging topics. Race, racism, and implicit bias are discussed in various LC sessions, with discussion questions and activities designed to apply the indicated topic with diverse cultures and communities. In the end-of-year student LC surveys, 80% (academic year 2018–2019; N = 71) and 86% (academic year 2019–2020; N = 70) of MD year 2 student respondents said that LCs helped them gain a better understanding of implicit bias concepts. Discussion: The curricular inclusion of discussions on race and implicit bias is crucial for the individual development of future doctors at this primary care-focused medical school. When integrated into the broader curriculum and culture of the institution, LCs can serve as a vehicle that builds relationships, establishes trust and safety, and provides the opportunity for students to critically think and self-reflect on race-related topics in a productive environment. Ultimately, these sessions aid in the production of physicians who will have the desire and the tools to work with a diverse patient base, addressing disparities in health care due to racism. Significance: To address the needs of diverse populations, the physician workforce must be knowledgeable of the social determinants of health and be demographically reflective of the communities they serve. Teaching and learning about racism and diversity are particularly significant following the revelations of the COVID-19 pandemic, coupled with the call for social and racial justice due to the disproportionate use of excessive force by law enforcement against people of color. To address the call for pedagogical concepts and practices explicitly focusing on racism and its impact on health and the promotion of racial justice, this article highlights LCs as our medical school’s vehicle for student interactions and conversations on race, using a session on implicit bias as an example. Our medical school small group LC sessions allowed for the relationship building, safe space creation, and self-reflection needed for effective discussions on race. Acknowledgments: The authors would like to acknowledge the learning community (LC) faculty, staff, students, and administrators who continue to see the role of LCs in training the next generation of physicians committed to health equity.