Exploring the intersection of structural racism and ageism in healthcare.

The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought into the forefront of the collective public consciousness at different points throughout history. The COVID-19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID-19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and to guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism.

Fostering empathy and self-efficacy in pharmacy students through service learning.

BACKGROUND: Pharmacy student proficiency in direct patient interactions is an integral component of the doctor of pharmacy curriculum. Service-learning experiences offer pharmacy students valuable opportunities to develop self-efficacy and empathy while serving communities with unmet needs. The objective of this review is to evaluate the impact of service-learning experiences on the self-efficacy and empathy of pharmacy and other health professions students. METHODS: A narrative literature review was conducted using PubMed, ERIC, and CINAHL databases. Articles were included if they described the relationship between any health professions student service-learning experience and changes in self-efficacy and empathy. Articles were excluded if they involved simulation experiences, standardized patients, or international experiences. RESULTS: A total of 11 relevant articles were identified, seven examined changes in student self-efficacy and six assessed student empathy. Articles included students representing seven health professions, with one eligible article in pharmacy. All articles investigating self-efficacy reported a positive impact of service learning on student confidence. Most articles focusing on empathy found that service learning had a positive impact on student empathy, and only one article noted a negative trend. Students with limited prior direct patient care experience had the greatest improvement in clinical confidence and empathy. IMPLICATIONS: This review adds a new perspective to the literature by evaluating evidence-based service-learning models in pharmacy education. Offering additional structured service-learning opportunities for pharmacy students fosters self-efficacy and empathy while supporting communities with unmet needs. Future studies evaluating innovative service-learning models and methods of continuous assessment within the pharmacy curriculum are warranted.