批判性地看待临床学习环境中的种族主义和抹杀 DEI 的努力。

IF 5.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Academic Medicine Pub Date : 2024-09-06 DOI:10.1097/ACM.0000000000005872
Patricia Poitevien, Sylk Sotto-Santiago
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引用次数: 0

摘要

摘要:长期以来,医学学术界一直承认多样性、公平性和包容性在追求健康公平方面的重要性。尽管认识到了这一点,但临床学习环境(CLE)一直在努力营造一个公平、包容的生态系统,以支持多样化的学习者和教师。努力消除医学中的种族主义是在临床学习环境中支持多样化学习者和教师的重要方法,但这些努力并未达到预期效果。失败的原因很复杂,可能包括对种族主义影响的理解有限,以及错误地认为对少数群体所受伤害的了解足以推动变革。为了加深理解并提高动力以拆除医学学术领域的种族主义制度,本文提出了两个框架,即利益趋同(IC)和关键白化研究(CWS)。IC 认为种族公平只有在与大多数人的利益一致时才能取得进步,而 CWS 则研究了白人作为一种社会建构是如何维护权力和特权的,而这往往会损害白人自身的利益。利用这些框架,作者详细阐述了白人是如何对白人的健康产生负面影响,以及如何阻碍中低收入、第一代白人学生进入医学院学习的。作者说明了以患者和家庭为中心的护理以及以能力为基础的医学教育等旨在改善所有人的护理和医学教育的实践是如何与多样性、公平性和包容性(DEI)原则完全一致和不可分割的。作者得出结论,种族主义和维护白种人会对多数人和少数人造成伤害,而多元化、公平和包容原则则为 CLE 的最佳实践奠定了基础,并能改善所有人的治疗效果。
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A Critical Look at Racism in the Clinical Learning Environment and the Erasure of DEI Efforts.

Abstract: Academic medicine has long acknowledged the importance of diversity, equity, and inclusion in the pursuit of health equity. Despite this recognition, the clinical learning environment (CLE) has struggled to foster an equitable and inclusive ecosystem that supports diverse learners and faculty.Efforts to dismantle racism in medicine represent an important approach to supporting diverse learners and faculty in the CLE, but they have fallen short of their intended impact. The reasons for this failure are complex and may include a limited understanding of the impact of racism and a misguided conviction that knowledge of harm suffered by minoritized groups is a sufficient driver of change.To advance understanding and increase motivation to dismantle racist systems within academic medicine, this paper posits 2 frameworks, Interest Convergence (IC) and Critical Whiteness Study (CWS). IC asserts that racial equity progresses only when it aligns with the interests of the majority, while CWS examines how Whiteness as a social construct upholds power and privilege, often to the detriment of White individuals themselves.Utilizing these frameworks, the authors detail how Whiteness negatively impacts the health of White people and impedes entry to medical school for low- and middle- income, first-generation White students. The authors illustrate how practices-such as patient- and family-centered care and competency-based medical education-which are intended to improve care and medical education for all, are fully aligned with and integral to diversity, equity and inclusion (DEI) principles. The authors conclude that racism and upholding Whiteness causes harm to majority as well as minoritized peoples while DEI principles provide the foundation for best practices in the CLE and improve outcomes for all.

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来源期刊
Academic Medicine
Academic Medicine 医学-卫生保健
CiteScore
7.80
自引率
9.50%
发文量
982
审稿时长
3-6 weeks
期刊介绍: Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
期刊最新文献
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