PM2093: Prioritizing Trainee Engagement: Assessing the Impact of New Health Equity Curricula on Medical Student Perceptions

Background: In 2020, our research team created, delivered, and analyzed a qualitative survey to assess medical student perceptions of health equity at Dell Medical School (DMS). Since then, the DMS administration developed and implemented health equity as a graduation competency domain, utilizing this data. The trainee response to associated changes is currently unknown.

Methods: A voluntary internet-based cross-sectional survey was administered to all students in 2020. Results from this survey informed the adoption of a health equity domain as a graduation requirement. This domain includes four competency areas - Historical and Current Context, Personal and Interpersonal, Community Awareness and Society, and Intentional Disruptive Action - and sixteen enabling objectives. A thorough curriculum mapping was conducted to highlight and add relevant health equity tie-ins to existing content, and a follow-up survey was administered to students in 2022. Statistical comparison tests will be used to analyze the longitudinal data.

Results: Response rate for the initial survey was 48.5% (n = 94) whereas response rate for the follow-up was 22.6% (n=44). In 2020, 30.1% of students were “very or completely satisfied” with the DMS health equity curriculum compared to 34.1% in 2022. 60% of students had “sometimes, often or always” faced dismissive attitudes about health equity from peers which remained the same from 2020 to 2022. For dismissive attitudes among residents and faculty, this proportion increased from 60% to 72.7%.

Conclusion: Students still overwhelmingly believe that health equity curriculum is important to their development as competent physicians, but is not effectively covered by the DMS required curriculum. Although administrators utilized student feedback to implement changes to improve the educational delivery, the results indicate that student perceptions have not significantly changed. This suggests that either the effects of the new curriculum are not yet realized, or change has not been sufficient to increase student satisfaction. These findings highlight the importance of utilizing an iterative and ongoing evaluation process for curricular development and implementation. When adopting a new health equity focus, other schools should measure trainee perceptions on health equity content and school-wide cultural climate while undertaking institutional change.