PM2076: Correcting Racialized Medical Mistruths Within the Medical School Curriculum: A Longitudinal Study Evaluating the Impact on Medical Student Education

Background: Efforts to address health inequities largely focus on physician behavior and ignore the medical education of students– the future stewards of the healthcare system. Longstanding curricular deficits perpetuate medical misinformation and medical disparities seen today. Thus, reforming medical education can precipitate substantive change by cultivating physicians who will provide equitable care for all, regardless of racial and/or ethnic background.

Methods: Two cohorts of first-year medical students at a single academic health center were assessed for their knowledge of racialized healthcare disparities, awareness of racialized medical mistruths, and expressed comfort-level with discussing racism. The study utilized a pre/postsurvey composed of elements adapted from pre-existing instruments which elicited a level of agreeableness using a 5-point Likert scale (1 – Strongly Disagree to 5 – Strongly Agree). A True/False section queried common medical mistruths about race. After the presurvey, students viewed a recorded lecture highlighting the history and impact of race-based medical mistruths. This lecture was followed by a case-based exercise demonstrating the clinical consequences of medical mistruths. Virtual discussions for the 2021 cohort transitioned to in-person interactions in 2022. At the conclusion of this intervention, students completed the postsurvey. The 2021 cohort was sent the survey again during their second year to assess this intervention’s long-term impact.

Results: The transition to in-person sessions allowed researchers to witness more robust engagement with the material and students’ attempts to reconcile harsh truths often excluded from the curriculum. Survey response rates increased in the second iteration of the intervention. In the 2022 cohort, 192 of 208 students filled out the presurvey with 146 completing the postsurvey while in the 2021 cohort, 141 of 209 students filled out the presurvey with 93 completing the postsurvey. In 2021, there was increased student knowledge regarding racialized medical mistruths, but student comfort-level discussing race and their attitudes towards race-related constructs remained unchanged. This was to be expected. Shifting established beliefs requires exposing people to substantive amounts of time in different cultural environments. While the data from 2022 is still in progress, we expect to see similar results.

Conclusion: This curricular intervention aimed to dispel the silence surrounding racism in medicine and to empower medical students with accurate information about the evolution of medical knowledge concerning race and racism. This intervention’s success was dependent on buy-in from institutional leadership and students’ willingness to engage in sensitive discussions. For substantive change to be seen, institution-led escalation of these efforts are necessary. This includes radical reform of medical education’s portrayal of race and racism with strategic ingraining of anti-racism teaching.