The Current State of Antiracism Curricula in Undergraduate and Graduate Medical Education: A Qualitative Study of US Academic Health Centers.

PURPOSE: We undertook a study to evaluate the current state of pedagogy on antiracism, including barriers to implementation and strengths of existing curricula, in undergraduate medical education (UME) and graduate medical education (GME) programs in US academic health centers. METHODS: We conducted a cross-sectional study with an exploratory qualitative approach using semistructured interviews. Participants were leaders of UME and GME programs at 5 institutions participating in the Academic Units for Primary Care Training and Enhancement program and 6 affiliated sites from November 2021 to April 2022. RESULTS: A total of 29 program leaders from the 11 academic health centers participated in this study. Three participants from 2 institutions reported the implementation of robust, intentional, and longitudinal antiracism curricula. Nine participants from 7 institutions described race and antiracism-related topics integrated into health equity curricula. Only 9 participants reported having "adequately trained" faculty. Participants mentioned individual, systemic, and structural barriers to implementing antiracism-related training in medical education such as institutional inertia and insufficient resources. Fear related to introducing an antiracism curriculum and undervaluing of this curriculum relative to other content were identified. Through learners and faculty feedback, antiracism content was evaluated and included in UME and GME curricula. Most participants identified learners as a stronger voice for transformation than faculty; antiracism content was mainly included in health equity curricula. CONCLUSIONS: Inclusion of antiracism in medical education requires intentional training, focused institutional policies, enhanced foundational awareness of the impact of racism on patients and communities, and changes at the level of institutions and accreditation bodies.

Leveraging Collective Impact to Promote Health Equity.

The purpose of this paper is to describe how the Academic Units for Primary Care Training and Enhancement (AU-PCTE) used the Collective Impact Model to promote health equity. The Collective Impact Model and its five conditions provided a framework for the Academic Units for Primary Care Training and Enhancement (AU-PCTE), representing multiple universities in the United States, to promote health equity. Through the establishment of shared measurement, continuous communication, mutually reinforcing activities, and the guidance of the backbone support organization, the work of each AU contributed to the collective impact on health equity. It is important to underscore that collective impact is an iterative process with both challenges and successes.

Academic Units for Primary Care Training and Enhancement: Improving Evidence and Training to Strengthen Primary Care.

The primary care workforce is an essential component of any high-functioning health care system. The Health Resources and Services Administration awarded six Academic Units for Primary Care Training and Enhancement grants in 2016. The overarching goal of the program is to improve primary care clinical teaching and research to strengthen the primary care workforce. Academic Units achieve this goal through 1) systems-level research to inform primary care training; 2) dissemination of best practices and resources; and 3) community of practice activities to promote the widespread enhancement of primary care training to produce a diverse, high-quality primary care workforce.