Justice in Educational Content: A Guide to Racial and Cultural Representation in Academic and Clinical Teaching and Assessment

Background and Purpose. Case-based instruction is broadly used in health professions education, including physical therapy education. Case-based instruction can support achievement of higher-order, applied, learning objectives and clinical reasoning. Instructors strive to represent the diversity of the clinical population in case studies and may have explicit intercultural competency objectives. The inclusion of cultural, racial, and ethnic characteristics in cases or assessments can potentially reinforce stereotypes or inaccurately emphasize these characteristics as direct predictors of health profile. Furthermore, as most physical therapy faculty creating cases are from a white majority stance, there is a risk that inclusion of cultural elements risks inappropriate and biased representation. Position and Rationale. Well-intentioned instructors risk substituting cultural, racial, and ethnic characteristics for social and structural determinants of health. Race is a social, not biologic construction and should not be confused. Informed instructors guided by evidence-based strategies can achieve rich case depictions that do not convey inaccurate risk or alienate learners. Discussion and Conclusion. A curriculum design strategy is offered for case development that brings explicit attention to representation of race and culture. This tool serves as a self-reflective and improvement tool. Continued community and student engagement is necessary to achieve high-quality and instructive case studies.