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

项目总结 结构性种族主义是造成健康不平等的根本原因。迫切需要培训卫生专业人员 关于健康的结构性和社会决定因素，以及保健偏向在延续和加剧疾病方面的作用 健康差距。与此同时，美国的产妇健康危机促使人们对课程的认可度越来越高 妇产科(妇产科)从业者在性健康和生殖健康公平方面的差距，以及 特别是关于种族、性别和性别的研究的最佳实践，因为它们与护理质量和患者有关 经验。在医学培训中及早开始这一指导，并在无偏见的情况下建立核心能力 而反种族主义的医疗保健实践对于培养下一代临床医生至关重要。我们的目标是发展， 为医学院学习者实施和评估关于种族、民族、性别、 以及在妇幼保健公平中的性别。具体地说，我们将开发关于以下主题的教学模块 健康的社会和结构决定因素、性别种族主义、交叉性、生殖正义、保健 歧视和照顾不同性别的个人，研究中的最佳做法是贯穿各领域的主题， 生物机制和干预措施(目标1)。我们将创建一个反思性学习社区应用程序来搭建 临床见习讲授(目标2)。我们将邀请社区代表和医学院 共同设计课程和APP内容的学习者，包括叙事和图形医学的新颖整合 为研究和临床护理说明患者经验和教训的工具。最后，我们将实现 140名医学院学员在妇产科助理和选修课教学和评估计划中的课程 通过纵向学习者调查实现目标(目标3)。在项目完成后，我们将拥有一个可移植的模型 临床培训计划，使用学生主导的、应用的和反思性学习来架起研究和实践的桥梁。 该模式响应了RFA-OD-22-015支持培养技能的创造性教育活动的目标 在多维和跨部门的健康相关研究和医疗保健提供方面，将填补一个关键空白 在医生培训方面，提高妇产科保健质量和结果的公平性的预期影响。

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.