Presentation Description
Brahm Marjadi1
Neville Chiavaroli2, Olanrewaju Sorinola3, Veronica Milos Nymberg4, Caroline Joyce1, Carl Parsons1 and Anna Ryan5
1 School of Medicine, Western Sydney University
2 Australian Council for Educational Research
3 Warwick Medical School, University of Warwick
4 Department of Clinical Sciences, Lund University
5 Melbourne Medical School, The University of Melbourne
Neville Chiavaroli2, Olanrewaju Sorinola3, Veronica Milos Nymberg4, Caroline Joyce1, Carl Parsons1 and Anna Ryan5
1 School of Medicine, Western Sydney University
2 Australian Council for Educational Research
3 Warwick Medical School, University of Warwick
4 Department of Clinical Sciences, Lund University
5 Melbourne Medical School, The University of Melbourne
Background:
The importance of teaching diversity in medical curricula has been well- established (1). However, the role of assessment for teaching and learning about diversity is still very much under-researched. Assessment questions may form part of the hidden curriculum (2) which either strengthens or undermines diversity teaching.
The importance of teaching diversity in medical curricula has been well- established (1). However, the role of assessment for teaching and learning about diversity is still very much under-researched. Assessment questions may form part of the hidden curriculum (2) which either strengthens or undermines diversity teaching.
Summary:
We audited pre-clinical and clinical multiple choice and short answer examination questions from the same year (2018) at three medical school at three western countries. The audit focused on patient portrayals in the examination question stems. We used an expansion of Critical Race Theory (3) in identifying a wide range of diversity characteristics: age, ethnicity, gender, sexual identity, marital status, residency status, geographic residence, socio- economic status, religion/spirituality, and ability. Both explicit and implicit diversity characteristics were included in the audit.
We audited pre-clinical and clinical multiple choice and short answer examination questions from the same year (2018) at three medical school at three western countries. The audit focused on patient portrayals in the examination question stems. We used an expansion of Critical Race Theory (3) in identifying a wide range of diversity characteristics: age, ethnicity, gender, sexual identity, marital status, residency status, geographic residence, socio- economic status, religion/spirituality, and ability. Both explicit and implicit diversity characteristics were included in the audit.
Results:
We audited 1,537 patient portrayals from 3,566 examination questions. Apart from age (89.4%) and binary genders (93.9%), other diversity characteristics were rarely portrayed (ethnicity 7.2%, relationship status 1.9%, sexual identity 1.1%, socio-economic status 0.5%, geographic residence 0.1%, disability 0.1%), or not at all (non-binary genders; residency status; religion/spirituality).
We audited 1,537 patient portrayals from 3,566 examination questions. Apart from age (89.4%) and binary genders (93.9%), other diversity characteristics were rarely portrayed (ethnicity 7.2%, relationship status 1.9%, sexual identity 1.1%, socio-economic status 0.5%, geographic residence 0.1%, disability 0.1%), or not at all (non-binary genders; residency status; religion/spirituality).
Discussion:
The three schools are embedded in highly diverse communities and teach about patients’ diversity, yet the vast majority of patients presented in written examination question stems were non-descript beyond their age and binary genders. While presenting excessive and unnecessary patient characteristics in examination questions should be avoided, the absence of many diversity aspects may reduce examination authenticity and undermine the teaching of diversity in the curriculum.
The three schools are embedded in highly diverse communities and teach about patients’ diversity, yet the vast majority of patients presented in written examination question stems were non-descript beyond their age and binary genders. While presenting excessive and unnecessary patient characteristics in examination questions should be avoided, the absence of many diversity aspects may reduce examination authenticity and undermine the teaching of diversity in the curriculum.
Conclusion:
There is room for improvement in diversity presentation in written examinations at the three audited schools.
There is room for improvement in diversity presentation in written examinations at the three audited schools.
Implications:
Medical schools should consider a routine audit and potential broadening of the diversity features of patients in examination questions to support teaching about diversity.
Medical schools should consider a routine audit and potential broadening of the diversity features of patients in examination questions to support teaching about diversity.
References (maximum three)
- Dogra N, Reitmanova S, Carter-Pokras O. Twelve tips for teaching diversity and embedding it in the medical curriculum. Med Teach. 2009;31(11):990-993.
- Mbaki Y, Todorova E, Hagan P. Diversifying the medical curriculum as part of the wider decolonising effort: A proposed framework and self‐assessment resource toolbox. Clin Teach. 2021;18(5):459-466.
- Zewude R, Sharma M. Critical race theory in medicine. Can Med Assoc J. 2021;193(20):E739-E741.