Walls Are Mirrors: Messages Delivered in Physical Environments.

Area of Science:

• Medical Education
• Health Professions Education
• Social Sciences in Medicine

Background:

• Establishing diverse, equitable, and inclusive (DEI) environments is crucial for success in academic medicine.
• The congruence between physical environments and institutional DEI values in medical schools remains under-explored.
• This study examined how the physical environment of a medical school communicates DEI principles.

Purpose of the Study:

• To investigate the representation of diversity, equity, and inclusion (DEI) values within the physical environment of a medical school.
• To identify discrepancies between institutional DEI values and their physical manifestations.
• To understand the impact of the physical environment on perceptions of DEI.

Main Methods:

• Employed an autophotography research methodology, incorporating participant-generated photographs and reflective group discussions.
• Collected 190 photographs depicting various elements of the physical environment (artwork, statues, space arrangements) across clinical, administrative, and teaching sites.
• Conducted thematic analysis on recorded discussions from four reflection sessions involving researchers from diverse backgrounds.

Main Results:

• The physical environment primarily reflected historical achievements and dominant group values, contrasting with the school's stated DEI principles.
• Subtle indicators of power inequality were observed, including disparities in the prominence of images and text related to gender, race, and position.
• Certain physical spaces were perceived as sterile or unintentionally exclusionary, negatively impacting identity, relationships, and the overall sense of inclusion.

Conclusions:

• The physical environment significantly influences the creation and maintenance of inclusive learning environments in academic medicine.
• Inconsistent messaging within the physical space can undermine stated DEI values and hinder progress.
• The study prompted tangible changes, emphasizing the ongoing need to align physical spaces with DEI principles.