How can diversity and inclusion be improved in the medical curriculum?

Improving Diversity and Inclusion in the Medical Curriculum

To effectively improve diversity and inclusion in the medical curriculum, institutions should implement an intensive, experiential curriculum that integrates diversity concepts into fundamental communication skills training, coupled with faculty development and structural changes that support underrepresented students. 1

Key Strategies for Implementation

Curriculum Design and Content

• Develop an intensive orientation curriculum (like a 2-day program) that emphasizes relationship-building among peers while introducing core concepts in diversity, equity, and inclusion (DEI) 1
• Incorporate personal narratives from diverse faculty and students to promote individuation and decrease implicit bias 1
• Include relationship-centered skills practice to improve communication across differences and mindfulness skills to help respond to bias when it occurs 1
• Design curriculum content that reflects diverse dietary habits, cultural practices, and includes role models from various ethnic backgrounds 2
• Create standardized assessment rubrics focused on multiple domains beyond academic metrics, including experiences, attributes, and competencies 3

Faculty Development and Representation

• Invest in intensive faculty development to train educators who can effectively facilitate discussions on equity and inclusion 1
• Address disparities in faculty representation by actively recruiting diverse educators who can serve as role models 2
• Require unconscious bias training for all faculty and residents involved in teaching and evaluation 3
• Shift away from majority-serving ideals toward building an informed infrastructure that helps all trainees succeed 4

Institutional Support and Structure

• Establish departmental DEI committees with clear goals and benchmarks for recruitment and retention of diverse staff 5
• Develop and utilize DEI toolkits to increase knowledge, skills, awareness, and self-efficacy among program directors 3
• Secure adequate financial investment for DEI initiatives to avoid performative allyship 4
• Create early mentorship programs specifically targeting underrepresented in medicine (URiM) students 5

Implementation Challenges and Solutions

Common Pitfalls to Avoid

• Recognize that uncomfortable conversations about privilege and marginalization require expert facilitation 1
• Avoid focusing solely on recruitment without addressing retention and creating an inclusive environment 4
• Prevent lack of vision alignment between institutional leadership and educational programs 4
• Move beyond performative allyship to substantive structural changes 4

Evidence-Based Solutions

• Measure outcomes of DEI initiatives to demonstrate effectiveness and guide improvements 3
• Recognize the intersectionality of diversity factors beyond race and ethnicity 1
• Create standardized scoring rubrics for evaluations that minimize bias 3
• Develop a structured approach with achievable goals and targeted benchmarks for recruitment and retention 5

Addressing Student Perspectives

• First-year and white ethnicity students often perceive the curriculum as more representative than second-year students and those from other ethnic backgrounds 2
• Female students (67%) demonstrate a deeper comprehension of sociocultural factors influencing health behaviors, suggesting targeted approaches may be needed for different student groups 2
• Students consistently recognize the importance of sociocultural factors in patient care, providing a foundation for further DEI education 2

Institutional Approach to Change

• Shift from isolated recruitment efforts to comprehensive strategies that prepare the environment before diverse trainees arrive 4
• Implement changes at individual, departmental, and institutional levels simultaneously 4
• Align with accreditation requirements, such as the ACGME diversity standards for systematic recruitment and retention 3
• Focus on creating an inclusive training environment that has been thoughtfully constructed before diverse trainees arrive 4