Improving and Sustaining Equity Content and Quality in Graduate Medical Education

Area of Science:

• Medical Education
• Health Equity
• Anti-Racism Interventions

Background:

• Medical education curricula can perpetuate health inequities and bias, negatively affecting patient care.
• Interventions are crucial to mitigate these unintended consequences and reduce health disparities.
• The Departmental Anti-Racism and Equity (DARE) initiative has demonstrated success in enhancing health equity content in residency conferences.

Purpose of the Study:

• To assess the long-term impact of the DARE initiative on maintaining health equity-related content in medical education.
• To evaluate the sustainability of DARE's positive effects on curriculum content over time.

Main Methods:

• The DARE initiative was implemented in an internal medicine residency program's noon conferences during the 2021-2022 academic year (AY22).
• A standardized rubric evaluated lectures on the same topics by the same speakers in AY21 (pre-intervention), AY22 (post-intervention), and AY25 (3 years post-intervention).
• Weighted rubric scores, normalized from -1 to +1, were compared across academic years to track changes in content quality.

Main Results:

• A significant improvement in weighted rubric scores was observed from AY21 to AY22 (0.07 to 0.34, P=.002).
• Scores in AY25 remained higher than in AY21 (0.06 to 0.25, P=.08), but this difference was not statistically significant.
• The decline in scores from AY22 to AY25 was not statistically significant ([-0.06], P=.41).

Conclusions:

• The DARE initiative initially enhanced health equity content in medical education.
• While improvements showed some persistence, the impact diminished three years post-intervention.
• Sustained efforts are likely necessary to maintain the gains in health equity education over the long term.