GHEARD: An Open-Access Modular Curriculum to Incorporate Equity, Anti-Racism, and Decolonization Training Into Global Health Education

Amy R L Rule¹, Heather A Haq², Adelaide Barnes³, DeMarco Bowen⁴, Msandeni Chiume-Kayuni⁵, Whitney Cameron⁶, S Aya Fanny¹, Elizabeth Groothuis⁷, Bethany Hodge⁸, Cindy Howard⁹, James C Hudspeth¹⁰, Sheridan Langford¹¹, Megan S McHenry¹², Ijeoma Nnodim Opara¹³, Beena D Kamath-Rayne¹⁴, Parminder S Suchdev¹⁵, Reena P Tam¹⁶, Franci Taylor¹⁷, Victor Musiime¹⁸

Affiliations

¹ is an Assistant Professor of Pediatrics, Emory University School of Medicine, and Attending Pediatrician, Divisions of Neonatology and Hospital Medicine, Emergency Medicine Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
² is an Assistant Professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
³ is an Associate Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Attending Pediatrician, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
⁴ is an Assistant Professor of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
⁵ is Chair of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
⁶ is an Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas, USA.
⁷ is an Assistant Professor of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁸ is a Professor of Pediatrics, Division of Hospital Medicine, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
⁹ is a Professor Emeritus of Pediatrics and Director, Global Pediatric Program, Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
¹⁰ is a Clinical Associate Professor, Department of Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
¹¹ is an Assistant Professor of Pediatrics, Division of Hospital Medicine, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
¹² is an Associate Professor of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹³ is an Associate Professor of Pediatrics and Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
¹⁴ is Vice President, Global Newborn and Child Health, American Academy of Pediatrics, Washington, DC, USA.
¹⁵ is a Professor of Pediatrics, Emory University School of Medicine, and Attending Pediatrician, Divisions of Neonatology and Hospital Medicine, and Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
¹⁶ is an Associate Professor of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹⁷ is a Professor Emeritus, University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹⁸ is an Associate Professor, Department of Paediatrics and Child Health, Makerere College of Health Sciences, School of Medicine, Kampala, Uganda.

PMID: 39980955
PMCID: PMC11838061
DOI: 10.4300/JGME-D-24-00264.1

GHEARD: An Open-Access Modular Curriculum to Incorporate Equity, Anti-Racism, and Decolonization Training Into Global Health Education

Amy R L Rule et al. J Grad Med Educ. 2025 Feb.

. 2025 Feb;17(1):28-37.

doi: 10.4300/JGME-D-24-00264.1. Epub 2025 Feb 14.

Authors

Affiliations

¹ is an Assistant Professor of Pediatrics, Emory University School of Medicine, and Attending Pediatrician, Divisions of Neonatology and Hospital Medicine, Emergency Medicine Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
² is an Assistant Professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
³ is an Associate Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Attending Pediatrician, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
⁴ is an Assistant Professor of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
⁵ is Chair of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
⁶ is an Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas, USA.
⁷ is an Assistant Professor of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁸ is a Professor of Pediatrics, Division of Hospital Medicine, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
⁹ is a Professor Emeritus of Pediatrics and Director, Global Pediatric Program, Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
¹⁰ is a Clinical Associate Professor, Department of Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
¹¹ is an Assistant Professor of Pediatrics, Division of Hospital Medicine, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
¹² is an Associate Professor of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹³ is an Associate Professor of Pediatrics and Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
¹⁴ is Vice President, Global Newborn and Child Health, American Academy of Pediatrics, Washington, DC, USA.
¹⁵ is a Professor of Pediatrics, Emory University School of Medicine, and Attending Pediatrician, Divisions of Neonatology and Hospital Medicine, and Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
¹⁶ is an Associate Professor of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹⁷ is a Professor Emeritus, University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹⁸ is an Associate Professor, Department of Paediatrics and Child Health, Makerere College of Health Sciences, School of Medicine, Kampala, Uganda.

PMID: 39980955
PMCID: PMC11838061
DOI: 10.4300/JGME-D-24-00264.1

Abstract

Background Global health (GH) interest is rising among graduate medical education (GME) trainees, yet GH engagement is marred by the impact of colonization or racism, and there remains a lack of training to confront these challenges. Objective To develop a modular, open-access curriculum that provides training in decolonization for GH GME and evaluate its feasibility and impact on learners' critical reflection on decolonization. Methods From 2019 to 2022, 40 GH educators, including international and indigenous scholars from diverse organizations, created the Global Health Education for Equity, Anti-Racism, and Decolonization (GHEARD) curriculum. Using Kern's 6 steps of curriculum development, critical gaps were identified and shaped into 8 modules, including a facilitator training module. Learning objectives and activities were developed using strategies grounded in transformative learning theory and trauma-informed educational approaches. The curriculum was peer-reviewed and piloted at multiple national conferences and institutions to assess feasibility and effectiveness in fostering critical reflection on decolonization. Results Pilot testing demonstrated GME implementation feasibility. Based on initial educator feedback, facilitator tools and an implementation guide were incorporated to enhance usability. Nearly all (59 of 61) trainees felt GHEARD was effective or very effective in encouraging reflection on decolonization, and 72% (32 of 44) felt GHEARD encouraged reflection on motivations for engaging in GH. GHEARD was launched as a free online resource in June 2023 and garnered 3192 views by December 2024. Conclusions To our knowledge, GHEARD is the first comprehensive decolonization curriculum designed specifically for GME. Program evaluation indicates GHEARD is feasible to implement and effective in promoting critical reflection on decolonization.

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Figures

**Figure 1**
GHEARD 8 Modules and Sample Activities, Drawn From Identified Curricular Gaps

**Figure 2**
Timeline of Development of GHEARD and Development Framework

**Figure 3**
GHEARD Modules Learning Objectives

**Figure 4**
Summary of the Global Health Equity, Anti-Racism, and Decolonization (GHEARD) Evaluation Toolkit and Post-Course Strategy for Fostering Individual and Collective Change

See this image and copyright information in PMC

References

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GHEARD: An Open-Access Modular Curriculum to Incorporate Equity, Anti-Racism, and Decolonization Training Into Global Health Education

Affiliations

GHEARD: An Open-Access Modular Curriculum to Incorporate Equity, Anti-Racism, and Decolonization Training Into Global Health Education

Authors

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Abstract

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Medical