When it comes to spreading a concept in medical education, it makes sense to teach it to the teachers first. That’s the thinking behind an anti-racism effort undertaken by two faculty members at the University of Kansas School of Medicine-Wichita.

Colleen Loo-Gross, M.D., MPH, FAAFP, and Samuel Ofei-Dodoo, Ph.D., MPA, M.A., CPH, GCPH, CNPM, led training of faculty in the school’s family medicine residency programs to address issues such as systemic racism and the use of race in medicine.

“What we hope is that we have planted a seed that continues to grow, opening up these conversations in a way that wasn’t happening before,” Loo-Gross said. “We know that physicians need to understand systemic racism and its effects on health in order to improve health equity, and a lack of faculty training has been identified as a barrier to implementation of this teaching into residency education. We want to help our faculty feel better prepared to teach these important topics.”

“The goal was for these faculty members to acquire knowledge that they could pass on to residents, impacting not only their education but also influencing clinical decisions,” Ofei-Dodoo added.

Loo-Gross and Ofei-Dodoo were among 20 dyads chosen from medical institutions nationwide to participate in the Academic Family Medicine Antiracism Learning Collaborative, presented by the Society of Teachers of Family Medicine.

Over the course of 20 months, Loo-Gross and Ofei-Dodoo attended virtual and in-person training sessions (the latter in Kansas City and St. Louis), formulated and carried out a project for the family medicine residency programs, and then shared the results with other collaborative dyads.

Loo-Gross and Ofei-Dodoo conducted interactive 90-minute training sessions for 28 faculty members involved in teaching at the family medicine residency programs of Ascension Via Christi Health-Wichita, Wesley Medical Center and Salina Family Healthcare Center. The sessions encompassed anti-racism concepts, shared language and terminology, and clinical relevance context (including the use of race in medical decision-making such as race-based calculations, implicit bias in diagnostic considerations, and research and interpretation of literature).

“An important topic we discussed during the sessions was racial disparities in chronic kidney disease,” Ofei-Dodoo said. “For instance, a study conducted by Ahmed et al. (2021) revealed that Blacks in the U.S. experience three times the incidence of end-stage renal disease compared to whites. Additionally, the study highlighted that Blacks are more prone to rapid progression from early to late-stage chronic kidney disease, and individuals from the Black community with CKD tend to face delayed referrals to nephrologists. The authors concluded that eliminating race correction would reclassify one-third of Blacks to a more severe stage of kidney disease.”

“As a Black man, my health-conscious lifestyle includes refraining from smoking and alcohol and participating in activities such as jogging and cycling,” said Ofei-Dodoo. “Rather than focusing solely on my race, these lifestyle choices should be the primary considerations guiding my primary care physician's decision-making regarding my health.”

The training in shared language centered on the concept that people can communicate more effectively when they are mindful of how their words may be interpreted by others. For example, the preference for the term ‘people of color’ over ‘minority’ reflects a deliberate choice by individuals who identify with this term. It serves as an inclusive identity that unites various racial and ethnic groups, sharing a common experience of racial oppression. This term is favored over ‘minority’ due to the potential dehumanization associated with the latter and the fact that, globally, people of color constitute the majority of the population.

Loo-Gross and Ofei-Dodoo surveyed faculty members before and after the training session in five areas and found improvement in three of them. For instance, participants were asked if they were familiar with shared language and had understanding around the concept of race. Following engagement in the faculty development session, there was a statistically significant improvement in familiarity with shared language and comprehension of the concept of race. Moreover, there was an improvement in self-assessed knowledge and confidence related to instructing concepts of anti-racism and the utilization of race in medicine. This indicates that a targeted faculty development initiative yields promising outcomes for enhancing faculty knowledge and confidence in teaching these concepts.

“Talking about race and racism can be uncomfortable for people,” Ofei-Dodoo said. “It's not necessarily that people are racist, but rather the topic itself can evoke discomfort. When individuals are well-informed and confident in addressing race-related conversations, they are more likely to impart that knowledge to others.”

Loo-Gross and Ofei-Dodoo noted that KU Wichita has several ongoing DEI (diversity, equity and inclusion) initiatives taking place but that faculty with primarily clinical responsibilities haven’t been as involved as some other groups, perhaps because they are busy with clinical responsibilities, or may have felt that those initiatives are not directly relevant to their work. The overall feedback about the anti-racism training was positive, they said.

Loo-Gross said she hopes similar training can be made available in more programs at KU Wichita.

“It would be great to have ongoing learning opportunities and continued growth in these areas. The goal is to empower our faculty to incorporate increased knowledge of racism in medicine concepts into their roles as educators, as well as to provide better care for patients from all backgrounds. It would be a step toward repairing some of the negative health outcomes attributable to systemic racism and would help impact much needed change on health inequities. Ultimately, it’s all about achieving equitable health outcomes for our patients.”

Hearing about projects conducted by other dyads was enlightening, she added.

“There were so many inspiring ideas. Some were at the residency level, some were at the medical school level. Learning about the great work of others in this arena helped open our minds to approaches that are outside of what we’re doing here.”