Learner Reactions to Activities Exploring Racism as a Social Determinant of Health

Racism's impact on health has been well documented. Health professional programs are beginning to help learners understand this social determinant of health through curricular integration of education related to racism. Yet educators are hesitant to integrate these concepts into curricula because of lack of expertise or fear associated with learner responses to this potentially sensitive topic. The purpose of this study is to describe the responses of learners to learning sessions on racism as a social determinant of health (SDOH) highlighting structural, personally-mediated, and internalized racism. Two separate groups-a family and community medicine (FCM) residency program (N=23) and a community health leadership program (N=14)-participated in lectures and workshops on internalized, personally-mediated, and structural sources of racism, and tours introducing them to the local community's historical roots of structural racism, including discussions/reflections on racism's impact on health and health care. Mixed-methods evaluation consisted of learner assessments and reflections on the experiences. FCM sessions received a positive reception with session averages of 4.15 to 4.75, based on a Likert-type scale (1=did not meet expectations to 5=exceeded expectations). Thematic analysis of community health leadership participant reflections showed thought processing connected to a better understanding of racism. Overall, themes from both programs reflected positive experiences of the sessions. Our preliminary study findings suggest that educators who encounter internal or external barriers to integrating racism-related concepts into curricula might find that these concepts are well received. This study lays the groundwork for further research into best practices for integration of curriculum on racism as an SDOH for medical schools, residency programs, and other related educational settings.