Born from Emory student advocacy and response to reckoning with persistent systemic racism and bias in medicine, the Diversity, Equity, Inclusion and Racial Advocacy (DEIRA) thread was approved in 2020 by the Emory University School of Medicine's Executive Curriculum Committee, commenced in 2021 and led by inaugural director Dr. Tracey Henry to ensure the MD curriculum reflects the School of Medicine's mission for diversity, equity, inclusion and racial advocacy in all aspects of patient care and the medical profession equipping students to become not only effective physicians but leaders and advocates.
As future physicians, it is imperative that learners understand both the history and presence of systemic racism in medicine and how it affects our current healthcare delivery, policy and outcomes of our patients and communities. We believe it is important to deliver a strong message to incoming and current learners that racism in medicine is a salient issue the SOM deeply cares about and is committed to working against. We are working to lay a foundation for understanding systemic inequities that starts during orientation through required readings, implicit bias awareness, education and training. Our goal is to foster a culture of racial awareness among students starting from day one of your medical training.
The importance of training students to become more aware and understanding of the values, beliefs and views of people from different cultures other than their own is also paramount. This thread is woven into all phases of the existing School of Medicine curriculum from the foundations of medicine phase throughout the translation of medical sciences phases.
The DEIRA curricular thread is being implemented in the following phases:
Phase 1
Building the Infrastructure and Curriculum Inventory
Appointed a thread director. Created a faculty advisory committee. Created a new Student Physicians Activity (SPA) or learning outcome that learners must demonstrate prior to graduation, focusing on DEI and equity, while also updating the other SPAs to incorporate an equity lens. Conducted curriculum review for bias. Provided feedback to course/clerkship directors with the results of curriculum review for bias and recommendations to address the bias. Developed and implemented Patient Interview Recommendations. Decided metrics for evaluation of thread. Developed and implemented framework for mitigating bias in medical education. Developed framework for mitigating bias in clinical evaluations.
Phase 2
Content Development
Addressed and incorporated DEIRA concerns from student evaluations, bias in the curriculum reporting system, bias in the curriculum and exams from the curriculum inventory, and DEIRA concerns directly reported by learners. Redistributed existing health equity, SDOH, and related content to appropriate courses/clerkships. Added new DEI content based on identified gaps. Provided Implicit Bias Recognition and Management Training for all MD learners, along with Upstander Training for all MD learners.
Phase 3
Implementation, Evaluation and Refinement
We continue to implement new DEI curriculum while refining our current curriculum with an equity-focused lens. We encourage ongoing faculty educational development and continue to evaluate educational interventions through surveys, focus groups, and tracking DEI-related concerns, along with implementing curricular recommendations to course/clerkship directors. Course/clerkship directors conduct annual self-assessments of their curriculum for bias and update their content with an equity-centered approach.
How to Create a Diversity, Equity, and Inclusion Curriculum: More Than Checking a Box
In this article in The Annals of Family Medicine, inaugural thread director Tracey Henry and colleagues highlight the stepwise approach used at Emory's SOM to systematically develop and implement medical educational curriculum content with a DEI and equity-focused lens. This article serves as a blueprint to prepare institutional leadership, medical faculty, staff, and learners on how to effectively begin or scale up their current DEI curricular efforts.
