Thinking with two brains: Student perspectives on the presentation of race in pre‐clinical medical education.

Context: There is growing concern that during their education medical students come to believe that 'race' is a biological construct and that differential treatment of patients based on 'race' is clinically beneficial. How 'race' is presented to medical students may influence both their implicit bia...

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Publicado en:Medical Education Vol. 55; no. 5; pp. 595 - 604
Autores principales: Mosley, Marcus P., Tasfia, Nowshin, Serna, Kimberly, Camacho‐Rivera, Marlene, Frye, Victoria
Formato: research Journal Article
Publicado: Wiley-Blackwell May2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2021
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Thinking with two brains: Student perspectives on the presentation of race in pre‐clinical medical education.
      aug:
        au:
          Mosley, Marcus P.
          Tasfia, Nowshin
          Serna, Kimberly
          Camacho‐Rivera, Marlene
          Frye, Victoria
        affil: Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, CUNY School of Medicine, City University of New York, New York NY,, USA
      sug:
        subj:
          Education, Clinical
          Education, Medical
          Students, Medical
          Racism Education
          Race Factors Education
          Healthcare Disparities
          Student Attitudes
          Human
          Interviews
          Schools, Medical
          Urban Areas
          New England
          Conceptual Framework
          Thematic Analysis
          Student Knowledge
          Problem-Based Learning
          Student Experiences
          Curriculum
      ab: Context: There is growing concern that during their education medical students come to believe that 'race' is a biological construct and that differential treatment of patients based on 'race' is clinically beneficial. How 'race' is presented to medical students may influence both their implicit biases and future clinical practices, potentially widening racial disparities in care. Methods: We conducted in‐depth interviews with twenty‐two pre‐clinical mostly non‐White medical students attending a public medical school in a major metropolitan area in the northeastern United States. Interview content focused on how medical students experience the presentation of race in medical education, use race in their learning experiences, and envision using race as physicians in future clinical encounters. Transcripts were analysed using the framework method and emergent themes were identified. Results: Participants described being most aware of the presentation of race in board‐style questions and least aware of the presentation of race during lectures. They described being aware of race in problem‐based learning (PBL) modules if the case revolved around a likely race‐disease association. They identified imprecision in how race was presented during lectures and insufficient explanations of causes of racial disparities in health. Participants described feeling ill‐prepared to obtain racial self‐identification and receiving mixed messages around the utility of race in diagnosing a patient. Participants reported experiences of cognitive dissonance around the presentation of race in board‐style questions and lectures. Conclusions: Critical evaluation of the presentation of and instruction around 'race' is needed to address whether it is presented as a biological vs. social construct, the level of precision of racial categorisation in curricular content, and the causes of and mechanisms behind race‐disease associations. This has the potential to minimise false beliefs about race as a biological construct and the resultant negative impacts on clinical care. Future research could evaluate whether problem‐based or experiential (OSCE) learning, in contrast to board‐style questions and didactic lectures, are the most effective way to educate students around race in health and illness. Additionally, future research can investigate if the mission (ie social) and composition (Predominantly White Institution or Historically Black College/University) of the faculty impacts student experiences of the presentation of race. Mosley et al. demonstrate that non‐white medical students experience cognitive dissonance around the presentation of race and race‐disease associations in medical education.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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