Improving and Sustaining Equity Content and Quality in Graduate Medical Education.

Abstract

Background: Medical education curricula may reinforce health inequities and bias, impacting clinical care. Interventions are needed to address these unintended consequences that contribute to health disparities. The Departmental Anti-Racism and Equity (DARE) educational initiative has been shown to improve the health equity-related content of residency educational conferences.

Objective: This study evaluates the impact of DARE in sustaining equity-related content in medical education overtime.

Methods: DARE was implemented in an internal medicine residency program's noon conferences in academic year 2021-2022 (AY22). A standardized rubric was used to evaluate lectures with the same topic and speaker pre-intervention (AY21), post-intervention (AY22), and 3 years post-intervention (AY25) to see if rubric scores for each session changed over time. Mean rubric scores across lectures were compared between AYs. The weighted rubric score was used to normalize total rubric scores between -1 and +1 (total score/number of rubric components scored) to account for different number of rubric components between conferences.

Results: All lectures with the same topic and speaker in AY21, AY22, and AY25 were evaluated. The weighted rubric score significantly improved from AY21 to AY22 in this subset of conferences (0.07 to 0.34 [+0.27]; P=.002; possible scores -1 to 1). Weighted rubric score remained higher in AY25 compared to AY21 (0.06 to 0.25 [+0.19]; P=.08) but was no longer statistically significant. The decrease in weighted score between AY22 and AY25 was also not statistically significant ([-0.06]; t₉=-0.86; P=.41).

Conclusions: Improvement in the health equity-related content of medical education curricula appeared to continue but was diminished 3 years after DARE.