Design, implementation, and evaluation of the first year of an anti-racism curriculum for a family medicine residency program in Atlanta, GA

Abstract

Abstract Background: Racism in medicine is a recognized problem that contributes to health care disparities. Objectives: This curriculum was designed to educate primary care residents by providing the historical perspective to understand racism in medicine while also giving them the tools to work towards deconstructing and reconstructing the systems that propagate racism. Methods: To evaluate the curriculum, from 2021-2023, a mixed-methods approach was used consisting of (1) pre- and post-curriculum surveys for learners, (2) focus groups discussions (FGDs), and (3) examination of change in change in hemoglobin A1c (HbA1c) values among patients of color. Results: Four FGDs (24 residents/faculty) indicated that although residents felt an anti-racism curriculum would be useful, some were doubtful about how effective it would be. Most requested that any teaching be evidence-based and action-oriented. Twenty-five of 27 (93%) of residents and students rotating with the program at that time responded to the pre-curriculum survey, and 18 of 25 (72%) participated in the late-curriculum survey. Aftercompleting the curriculum, residents had greater awareness of the problem. Most felt more prepared to deal with racism in their practice. With respect to patient-oriented outcomes, HbA1c did not change among black vs non-black patients but did decrease for Hispanic vs non-Hispanic patients. Conclusions: Based on this preliminary evaluation, implementation of an anti-racism curriculum for primary care residents was perceived to be effective by the residents at teaching anti-racism concepts and may have led to small improvements in the health of patients in the residency clinic. Discussion: Ongoing quality improvement and sustainability efforts are needed.