Using dialogue to teach critical consciousness: An orientation to equity for postgraduate trainees

Residency and fellowship training programmes have started prioritising equity, diversity and inclusion (EDI) training for learners, with focus on increasing awareness. Awareness of EDI issues does not automatically translate into clinical practice change, including identifying and mitigating equity issues impacting care. Fostering critical consciousness supports the development of a reflective awareness of power differences and the inequities embedded in social relationships, strengthening one's commitment to social justice, anti-racism and anti-oppression in practice.

We developed and facilitated an educational session using dialogue as a pedagogical tool to foster critical consciousness in postgraduate trainees. The session was rooted in the principle of conscientisation, which involves unlearning previous assumptions and reorienting one's worldview towards social justice.

The session commenced with a clear statement of objectives: to develop an orientation towards social justice and address racism in clinical practice. Facilitators then overviewed key concepts such as anti-Black and anti-indigenous racism. Subsequently, participants shared narratives describing their experiences of racism in clinical care. Complex case examples fostered dialogue exploring equitable care and addressing racism while addressing critical tensions, including workplace pressures of efficiency and power differentials between healthcare providers and patients. Participants discussed potential practice changes.

Justin T.H. Lam: Conceptualization; methodology; writing—original draft; writing—review and editing; supervision. Victor Do: Conceptualization; methodology; writing—review and editing. Ashna Asim: Conceptualization; methodology; writing—review and editing. Caitlyn Hui: Conceptualization; writing—review and editing; methodology. Catherine Diskin: Conceptualization; writing—review and editing; methodology; supervision.