SHM Converge Scientific Abstract ePoster Gallery-From Rounds to Reflection: Student Observations of Race, Inequity, and Bias on the Medicine Wards

Pdf Summary

The article describes a clerkship curriculum at Icahn School of Medicine at Mount Sinai designed to help students identify racism, bias, and structural inequity on the medicine wards. Faculty identified a gap in teaching structural competency during clerkships, and created a Padlet-based activity to give students a safe, asynchronous, and anonymous way to record observations in real time.<br /><br />During a 15-minute orientation, students were introduced to the “4 Rs” framework and asked to post examples of racism or bias they observed while on rotation. At the end of the clerkship, they participated in a one-hour in-person debriefing session. Over three academic years, 294 students contributed 305 Padlet posts. The curriculum received strong evaluations, with an overall rating of 4.4 out of 5.<br /><br />Qualitative analysis of the posts found several major themes: inadequate use of interpreter services, prejudging patients based on perceived identity, social determinants of health limiting care options, and disparaging or stigmatizing language such as “non-compliant” or “pain seeking.” Minor themes included underrepresentation of providers and leaders, overworked clinicians using shortcuts that worsened inequity, barriers related to health literacy, and patient mistrust of the healthcare system.<br /><br />The authors conclude that Padlet helped students reflect on inequities as they happened and, combined with debriefing, promoted dialogue and learning about structural racism in healthcare. However, some students experienced emotional distress, and the tool did not provide immediate support. The curriculum also depended on local antiracist expertise, which may limit scalability. Overall, the project offers a promising model for integrating structural competency education into clinical training.

Asset Subtitle

Horatio Holzer

Meta Tag

Author List Ann-Gel Palermo, Eve R. Merrill, Horatio Holzer, Joseph Truglio, Leona Hess, Rex Hermansen

Category Research

Concept Racism

Concept Bias

Concept Health Inequity

Concept Structural Factors

Concept Social Determinants of Health

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai

Presenting Author Horatio Holzer

Track Education

Keywords

structural competency

racism in healthcare

medical clerkship

Padlet activity

bias observation

health inequity

interpreter services

social determinants of health

antiracist education

clinical debriefing

Racism

Bias

Health Inequity

Structural Factors

Social Determinants of Health