By Teresa Chan, MD, MHPE, FRCPC, DRCPSC and
Jennifer Bryan, MD, MA, MSPH, FRCPC
Column Editor: Eleftherios F. Soleas, PhD
Diversity, equity, and inclusion in medical education refer to the breaking down of systemic barriers that prevent the full participation of educators and learners from underrepresented groups. During the pandemic, we have seen increasing calls to address disparities due to racism, colonialism, gender bias, heteronormativity, and other forms of oppression. Educators have a range of experience in this area. In this piece, we would like to give you some tips as to how you might be able to incorporate equity into your work as a Continuing Professional Development (CPD) provider.
- Do your homework: DEI (Diversity, Equity, and Inclusion) is not new! There are a ton of excellent training resources out there to help you get familiar with the key concepts, challenge your own biases and better understand the impact of bias and discrimination on health. Three resources that you may find particularly useful are the AAMC DEI Initiatives site, the Stanford Anti-Racism and Allyship 7 Day Journey and San’yas Anti-Racism Indigenous Cultural Safety Training Program. As with most educational initiatives, if you’re thinking about it and you think it’s a new idea it’s probably just because you haven’t done a robust enough literature review! Instead of reinventing the wheel, we suggest that you hit Google Scholar or the major medical education journals and take a look to see what resources are already available. Build upon the work of others so that you can be more successful in a quicker and more efficient manner. There’s an extensive body of work on equity initiatives both inside and outside of medicine that you might draw as inspiration. Historically medical education has been called out for being too insular (Albert et al., 2022), let’s make sure that we know what else has come before us so that we can be faster and better together.
- Be SMART about your goals: As CPD providers, we may have very broad aims and goals. Creating SMART (specific, measurable, actionable, relevant, timely) process and outcome goals for your DEI initiative is essential for accountability. As one example of a process goal, you could adopt the “nothing about us without us” principle from the accessibility literature and commit to having representation on your education team from people with first-hand lived experience of your topic (e.g., doing a teaching session on falls in the elderly? Include older adults as patient reps on your planning committee and as educators). A SMART outcome goal could include standing by the no manels pledge, and committing to the inclusion of at least one female-identifying speaker on every panel of an education session. Once the specific goal is clear, barriers to achieving this goal can be identified and addressed, for example using strategies from the Gendered Conference Campaign.
- Consider (or reconsider) your delivery mechanisms: A recent paper in Nature noted that the very nature of traditional conferences (e.g. the ones where you have to travel to attend) may create barriers for who might be able to be present (Wu et al., 2022). For some the barrier to attendance is money, for others it is time. Virtual conferences have been found by some to attract a greater diversity of more diverse participants (Wu et al., 2022). Locally we have seen increased engagement with local rounds that are offered digitally, or mini-conferences that become international affairs – simply by going virtual (Yilmaz et al., 2022). Providing virtual conference alternatives or other hybridized delivery methods may make these learning or career opportunities more accessible. After all, we did learn how to do all these things during the pandemic – it would be a pity to simply revert without keeping the things that helped us during our time of need (Gottlieb et al. 2020; Yilmaz et al., 2022).
- Reinvent your leadership structures: Many of the structures that are currently in place reproduce the inequities that you are trying to address. Business leaders know that inclusive teams make better decisions (Larson, 2017). Who’s missing from your leadership team? For instance, recently in planning a national conference, we identified gaps in representation in past years’ education leadership groups. We prioritized establishing a leadership team diverse in gender, language, and geographic location and represented marginalized groups as part of the selection process. We did not employ a quota strategy, but instead established an open call approach for applications, collaborated with community allies in recruitment, and explicitly valued diverse lived experiences in the selection process to meet our goal and selected leaders who would be more representative of our target audience than in years past.
- Make a commitment…and back it up: Include a statement about the importance of DEI in the description of your CPD event and what your expectations are of educators and participants. This is about more than virtue-signalling or using buzzwords. Having an easily accessible statement about your commitment to DEI helps set the tone for your event and serves as a reminder for speakers. You might suggest DEI training opportunities for your educators, recommend they use inclusive language in their sessions (e.g., from the CDC’s Gateway to Health Communication) and provide resources on representative images (e.g., through The Disabled and Here Collection, the Centre for Ageing Better free library, the Gender Spectrum Collection, Brown Skin Matters, the SHADE group, and others). Consider soliciting feedback specific to your DEI objectives in your CPD evaluation.
CPD providers have an important opportunity to address barriers to diversity, equity, and inclusion in medicine. The tips outlined above are practical first steps for incorporating these principles throughout CPD initiatives for the betterment of healthcare for all.
Teresa Chan, MD is Associate Professor, Division of Emergency Medicine, Division of Education & Innovation, Dept. of Medicine, and Associate Dean, Continuing Professional Development,
Jennifer Bryan, MD is Assistant Professor, University of Toronto, Department of Medicine, Division of Emergency Medicine and Attending Emergency Physician, University Health Network.