Developing a curriculum in obstetric, gynecologic, and reproductive health care equity to bridge research and practice

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PROJECT SUMMARY Structural racism is a fundamental cause of health inequity. There is an urgent need to train health professionals on structural and social determinants of health, and the role of health care bias in perpetuating and exacerbating health disparities. Simultaneously, the US maternal health crisis has fueled increasing recognition of curricular gaps in sexual and reproductive health equity for obstetrics and gynecology (Ob/Gyn) practitioners, and specifically best practices in research on race, sex, and gender as they relate to quality of care and patient experience. Initiating this instruction early in medical training and establishing core competencies in unbiased and antiracist health care practice is critical to cultivating the next generation of clinicians. We aim to develop, implement, and evaluate a curriculum for medical school learners about the intersection of race, ethnicity, sex, and gender in Oby/Gyn health care equity. Specifically, we will develop didactic modules on topics including social and structural determinants of health, gendered racism, intersectionality, reproductive justice, health care discrimination, and care of gender diverse individuals, with cross-cutting themes of best practices in research, biologic mechanisms, and interventions (Aim 1). We will create a reflective learning community app to bridge didactic lectures to clinical clerkships (Aim 2). We will engage community representatives and medical school learners in co-design of curriculum and app content, including novel integration of narrative and graphic medicine tools to illustrate patient experiences and lessons for research and clinical care. Finally, we will implement the curriculum with 140 medical school learners in Ob/Gyn clerkship and elective didactics and evaluate program objectives through longitudinal learner surveys (Aim 3). At project completion, we will have a portable model for clinical training programs, using student-led, applied, and reflective learning to bridge research and practice. This model is responsive to the RFA-OD-22-015 goal to support creative educational activities that develop skills in multidimensional and intersectional health-related research and healthcare delivery and will fill a critical gap in physician training, with the expected impact of advancing equity in Ob/Gyn health care quality and outcomes.