Critical Consciousness as a Framework for Health Equity-Focused Peer Learning

Abstract

Introduction: Recognizing the need to teach concepts of health equity, diversity, and inclusion as a part of medical students' preclinical training, we developed a series of workshops in the first year of medical school that introduced students to issues of discrimination and inequity and their effects on health outcomes. This student-led, faculty-supported project, known as Critical Consciousness in Medicine (CCM), adopted critical consciousness as a guiding principle for student learning.

Methods: Over the course of the 2018-2019 academic year, student leaders developed and delivered five 2-hour workshops to 197 first-year students, with the assistance of student facilitators and input and guidance from faculty advisors. Workshops involved a mix of whole-class presentations and small-group discussions. Session topics included identity and interpersonal relationships, privilege, health disparities, and implicit bias.

Results: Paired t-test analysis showed statistically significant growth in student self-ratings related to CCM learning objectives as measured in the end-of-year pre-/postsurvey. Student comments in year-end reflections further suggested learning, self-assessment, growth, and appreciation for the workshops' place in the preclinical curriculum.

Discussion: This project modeled a student-faculty partnership for approaching diversity, inclusion, and health equity in medical education and highlighted the role of students as leaders in educating their peers. The CCM workshop series demonstrated high acceptability as a component of preclinical medical education and may increase student engagement around social issues in health care. CCM also illustrated the promise of using critical consciousness as an approach to educating medical students about equity, diversity, and inclusion.

Keywords: Critical Consciousness; Diversity; Diversity & Inclusion; Health Disparities; Health Equity; Implicit Bias; Inclusion; Student Leadership.

Figure.. Critical Consciousness in Medicine workshop pre/post self-evaluation results. Error bars represent the 95% confidence interval for students' average pre/post self-assessments.