Abstract
Inequity and marginalization of faculty historically underrepresented in academic medicine persist. As medical schools seek to increase the diversity and success of all their faculty, there is a need for effective change activities to address racism and sexism in medicine. We present an evaluation of an exercise aimed at enhancing cross-cultural awareness and valuing of diversity that was embedded in a faculty mentoring and leadership program in academic medicine. Most cross-cultural training fails to include opportunity to practice these difficult conversations in a diverse group.
Participants were 80 MD and PhD multidisciplinary medical school faculty who participated in five implementations of the yearlong C-Change Mentoring and Leadership Institute between 2018 and 2023. 43% of faculty were from underrepresented racial and ethnic groups, 60% were female, 65% were physicians and 35% had a PhD degree. We conducted a qualitative analysis of written and oral faculty responses to a collection of verbatim quotations of underrepresented minority and female faculty that described experiences of being discriminated against in the workplace. Thematic analysis of written and oral data was inductive, allowing themes to emerge from the data.
Themes that emerged in the data from these facilitated conversations were: increased awareness of racism, recognition of lack of knowledge; connection, shared experience, and empathy; blame, judgment, dismissiveness, and deflection; focus on solutions/paths for change; the nature of prejudice; and reflection on their role in the system. The themes in participant responses illustrated the developmental stages of identity awareness in White and underrepresented minority persons. Participating faculty were able to productively engage in difficult conversations across race, ethnicity and gender.
The facilitated exercise engendered reflection, dialogue and learning about racism, sexism and identity development. Such exercises can open spaces of possibility for change at the individual level as well as the creation of inclusive cultures necessary for systemic change to occur.