Design of a Social Justice Curriculum to Expand Critical Consciousness Among Resident Trainees.

Abstract

Health equity curricula emphasizing critical pedagogy and centering perspectives of those with marginalized identities, both in curriculum design and execution, have yet to be described in interdisciplinary graduate medical education settings. The application of public health critical race praxis (PHCRP) in the redesign and evaluation of a social medicine immersion month (SMIM) curriculum. A mandatory, 4-week course within the Residency Program for Social Medicine in the Bronx, NY. First-year residents in internal medicine, family medicine, pediatrics, and clinical psychology fellows between 2019 and 2020. Residents and faculty underrepresented in medicine employed PHCRP to ground SMIM in critical pedagogy and structural competency with the goals of increasing critical consciousness, sensitizing trainees to structural barriers faced by patients, and promoting meaningful engagement in advocacy. SMIM was evaluated pre- and post-curriculum using a validated critical consciousness and intersectionality survey, with additional questions to assess competency and behaviors. Participants also provided course feedback. Participants demonstrated significant increases across all domains of the measure (Racism + 1.62 (p < .01), Classism + 1.62 (p < .05), Heterosexism + 1.06 (p < .05)). Participant feedback was positive. PHCRP is a valuable model for designing health equity curriculum. SMIM provides insights for incorporating this framework into GME curricula.