Anti-Racist Transformation in Medical Education

Like all American institutions, medicine has been shaped by a legacy of racial injustice. Racism permeates clinical practice and biomedical research, public health policy, and academic advancement. Its influence on medical education is even more profound. Dismantling racism in medical school settings requires a strategy that is broadly transformative, ongoing, people-dependent, and responsive to the world around us.

The Josiah Macy Jr. Foundation funded a three-year Anti-Racist Transformation in Medical Education project to replicate Icahn School of Medicine at Mount Sinai’s change-management strategy at 11 partner medical schools in the United States and Canada.

The aims of the project were to:

Develop the capacity of medical schools to dismantle systemic racism and bias in their work and learning environments.
Promote shared learning on how to dismantle racism within and across medical schools.

Through an interactive virtual learning platform, participating medical schools established and maintained their capacity for transformational change, while building a community of practice within and across participating schools. Students, staff, and faculty engaged in experiential learning, assessments, outcome and performance monitoring sessions, and coaching, allowing them to move beyond knowledge transfer to change that is systemic and adaptive.

Cohorts progressed through the learning path and developed the capacity to implement the modules of Icahn Mount Sinai’s multi-phased change management strategy. For each phase, cohorts participated in the following virtual sessions, as well as occasional in-person site visits:

Introduction to phases with all cohorts
Dialogue and framing with the Anti-Racist Transformation in Medical Education team and each cohort
Individual courses with content videos, activities, resources, and assessments
Coaching and outcome mapping with the Anti-Racist Transformation in Medical Education team and each cohort
Community of practice with all cohorts

map

Participating schools will participate in the program throughout a series of phases.

Phase 1: Onboarding and Assessment
We will work directly with selected institutions to identify and onboard cohort members from faculty, staff, students, and leadership. After each cohort has been identified, we will conduct an assessment to determine readiness for transformational change at the individual (cohort members) and school levels. We will also assess the landscape and effectiveness of existing efforts to address racism that have been implemented at each institution.

Phase 2: Preparing for Change
Cohorts will be introduced to the transformational change phased approach: engage in learning opportunities to level-set knowledge; envision a future state of transformational change; identify elements of change; conduct internal assessments; develop a change management strategy; and prepare leadership to sponsor the change.

Phase 3: Creating a Climate for Change
Cohorts will continue to build a sense of urgency to change from current to future state; engage in racial dialogue (see Chats for Change description below); be the change and become deeply committed to the change process; continue to practice and learn while eliciting feedback from those most affected by the change; build a powerful, enthusiastic group of change leaders (see Guiding coalition description below) to oversee the change strategy and process; and communicate the vision for change, strategy, and process across their institution.

Phase 4: Engaging and Enabling the Institution for Change
Cohorts will develop change targets, tactical plans, and outcome and performance monitoring frameworks; empower broad-based action by building awareness; generate short-term wins; communicate their plans clearly and consistently with stakeholders; and create team learning labs (see description below) to increase knowledge of key concepts and application to job functions that will support the change targets.

Phase 5: Implementing and Sustaining Change
Participating institutions will aim to embed the change and ensure that it sticks by actively pursuing information and feedback; learning from wins and mistakes; and turning that learning into appropriate course corrections. This process is not a fixed or formulaic methodology but rather one that accelerates success by building the capacity to be agile and effectively operate within a state of uncertainty.

Phase 6: Building a Community of Practice
In order to promote shared learning on how to dismantle racism within and across medical schools, we will build a community of practice within and across the cohorts starting as soon as the cohorts are identified. Throughout the project, we will establish and support the knowledge management cycle of the community of practice, schedule in-person site visits, and host an inaugural conference.