Leveraging the health equity implementation framework to foster an equity focus in medical education.

Autor: Ramadurai D; Division of Pulmonary, Allergy and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. Deepa.Ramadurai@pennmedicine.upenn.edu.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Deepa.Ramadurai@pennmedicine.upenn.edu., Shea JA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Advances in health sciences education : theory and practice [Adv Health Sci Educ Theory Pract] 2024 Jul; Vol. 29 (3), pp. 1047-1058. Date of Electronic Publication: 2023 Sep 05.
DOI: 10.1007/s10459-023-10277-0
Abstrakt: Teaching equitable clinical practice is of critical importance, yet how best to do so remains unknown. Educators utilize implementation science frameworks to disseminate clinical evidence-based practices (EBP). The Health Equity Implementation Framework (HEIF) is one of these frameworks, and it delineates how health equity may be concomitantly assessed and addressed in planning the implementation of an EBP. The HEIF therefore lays a strong foundation to understand and explain barriers and facilitators to implementation through an equity lens, making it well-suited for use by medical educators. Three equity-focused frames of reference within the model include (1) the clinical encounter, (2) societal context, and (3) culturally relevant factors, herein referred to as domains. The HEIF provides a structure for prospective and retrospective assessment of how EBP are taught and ultimately incorporated into clinical practice by trainees, with specific attention to delivering equitable care. We present three examples of common topics in internal medicine, contextualized by the three equity domains of the HEIF. We additionally acknowledge the limitations of this framework as a research tool with complex features that may not be suitable for brief teaching in the clinical environment. We propose a 360-degree learner assessment to ensure implementation of this framework is successful. By encouraging trainees to explore the narrative experiences of their patients and examine their own implicit biases, the HEIF provides a structure to address gaps in knowledge about delivering equitable care.
(© 2023. The Author(s).)
Databáze: MEDLINE
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