Reprinted from the winter 2021 Issue of The Ohio Family Physician.
By: William J. Naber II, OMS-IV, Ohio University Heritage College of Osteopathic Medicine (OH-HCOM)
Growing up skating on the frozen ponds of western New York, I dreamed of playing hockey professionally. As my skills grew, so did my passion for health, fitness, teamwork, and helping others achieve their goals. While climbing the hockey ranks, I started working at a local hospital as a patient sitter and emergency medical technician. Before long, I fell in love with medicine, also known as the team sport of saving lives. Medicine integrated my love of working toward a common goal with my interest in health improvement. Witnessing what could be achieved when healthcare professionals collaborate with patients on the shared focus of improving health outcomes is not only rewarding, but inspiring. With this newfound passion, my efforts shifted towards attending medical school.
Once I started attending medical school, my medical knowledge expanded rapidly. And, because medical schools incorporate social determinants and health disparities into the regular medical curriculum, so too did my knowledge and awareness of how society can impact the health outcomes of others.1 Outside of class, I had many candid conversations with fellow students about bias and healthcare disparity, and how both impact patients mentally and physically. These were important conversations, because as a white male, I was often oblivious to my privilege.
Walking away from these conversations, I kept asking myself… “How can I be better? How can we be better? How can we make permanent change for the future of our team?” As vice president of my campus, I served as a liaison for students with faculty and administration so student feedback could be appropriately translated into positive change. As a student leader, I felt compelled to find a way to support my peers by stimulating conversation in the learning environment about bias and social determinants of health (race, culture, ethnicity, sexual orientation, etc.) without reinforcing stereotypes. This is when my small group coach showed me documents from the article, “Addressing Race, Culture, and Structural Inequality in Medical Education: A Guide for Revising Teaching Cases.”2
This guide includes a simple checklist that stimulates discussion around race and culture in patient case scenarios.2 Moreover, the handbook offers a process for critically reviewing how race is integrated into teaching cases. After reading the manual, I saw an opportunity to use my platform as a student leader to garner support for use of this tool in our curriculum. With the support of the faculty, we presented this guide to the college administration, received great support, and now hold regular workshops using the handbook. During our workshop sessions, facilitators walk faculty content experts through a review of their course cases focusing on how to address race and culture appropriately. Through these workshops, faculty content experts use this teaching tool to effectively enhance student learning with important and challenging discussions that heighten student-physician awareness of how healthcare disparities, bias, and stereotypes can detrimentally affect patient outcomes, thus creating real longitudinal change.
Talking about race, culture, and bias is not easy, but it is important. These discussions still open my eyes to the struggles of others, but they also teach me how I can be a better friend, future physician, and teammate to our medical community. I hope you take some time to review the guide and reflect on ways you can improve your teaching cases. I know my journey to help make the world around me a better place is far from over.
Thank you to Sharon Casapulla, EdD, MPH; Jennifer Gwilym, DO, FAAFP; and the OU-HCOM Case Review Tool team for the support, mentorship, and guidance with this paper and project.
References available on the Ohio Academy of Family Physicians website.