Teaching Diverse Learners: Strategies for Inclusive and Anti-Racist Teaching for Medical Education

Welcome everyone welcome to today's Health Professions educator series it's so good to see everyone um albeit virtually on this Monday morning um we are excited today to have Dr duramo from Virginia Tech with us to talk about teaching diverse Learners um strategies for inclusive and anti-racist teaching for medical education as our learner populations continue to become more diverse it is so critical that we all equip ourselves with Knowledge and Skills to better connect and teach all types of learners Dr Michelle geramo is associate Vice Provost for diversity education and engagement in the office for inclusion and diversity at Virginia Tech um throughout the presentation Dr duramo has said it's uh feel free to post any questions or comments in the chat and we'll make sure to field those to her as we go or if you would prefer please unmute or raise your hand to share in the chat Deb will also be sharing a session evaluation so please take a few minutes to share your feedback um without any further Ado I will pass things over to Dr duramo to get us started today thank you uh and hello everybody and hello my friend Dave music who I see is here uh Dave and I are working on another project together uh so um Mariah gave a good introduction and so I'm just going to move ahead to the objectives uh just very quickly uh we're going to begin by discussing um experiences and perceptions of underrepresented minority students in higher education then we're going to look at identifying and describe identifying behaviors that might be considered problematic and describing strategies for mediating those and what to do instead and then in the final piece we're going to recognize some positive interventions for creating that inclusive anti-racist classroom environment so I want to begin first by ident uh defining some terms that I'm using to set this up and the first is inclusive teaching or inclusive pedagogy and what that is very high level definition is it's a learner-centered instructional approach it's built on the principles of respect inclusion and cultural responsiveness and the belief that all students can learn so much of inclusive uh teaching inclusive mindset really comes out of the movement for inclusion of students with disabilities and to be a traditional classroom and we have since adapted that in diversity education to think of inclusion broadly um building on inclusive pedagogy is this idea of anti-racist teaching and anti-racist teaching has been a long round for a very long time um from from ever since in the United States children were segregated and black families were trying to make sure that their children received education even when they were segregated or excluded but we've started hearing about anti-racist teaching and it's become more codified since uh 2020 uh and so anti-racist teaching again building on these ideas of a respect and inclusion and cultural responsiveness but going a step further by making an active commitment to counteract the persistence and impact of of racism and cultivating the conditions in the classroom that create constructive change so today we're talking about inclusive teaching and then at the very end I'm going to really look how do we deliberately make this not just inclusive teaching but anti-racist as well so let's begin then uh with what is the experience of being an underrepresented minority student on a predominantly white campus again going to identify some terms urm or underrepresented minority um is a term it's a contested term there are people who find the term very problematic but it is a term used by the United States Department of Education to identify and count a specific groups of students specific demographic and according to the U.S Department of Education the group that would be considered underrepresented are domestic black African-American Hispanic latinx Native American Alaskan native and Hawaiian Pacific Islander you'll note that this definition does not include Asian of Beyond Hawaiian Pacific Islander there are some campuses that are for example out in California that also consider students from Vietnamese among or Filipino backgrounds is to be included in this underrepresented minority category so this is a contested term but basically we're talking about students who are um historically not just counting in terms of numbers but also in terms of their experiences in the history of the United States as being underrepresented um and we're not talking about underserved but that's a different category that typically includes first generation veteran low economic socioeconomic status okay pwi predominantly white institution I have a colleague who says historically white institution or institutions created in their founding who had the intent of preserving the white status quo most institutions are moving away from that Legacy but still are considered predominantly white so this is language that it's important that we we think about the cultural contexts as we move forward okay so what is the experience and I'm going to begin by talking about um something an essay written by lashira Nolan uh this is a photograph of her in a white lab coat in front of a Harvard Medical School of pylon uh in June of 2020 she wrote an essay called what I want to say when you ask me how I'm doing and uh it's an essay about being a black woman and medical student in the often lonely world of higher education and that is a direct quote from her essay I want to share some excerpts from that and I think her particular there's lots of different content that talks about the experience of being underrepresented in a predominantly white I want to look at Dr Nolan's because she is a medical student and she's talking about that specific kind of experience and she talks about that throughout her as an undergraduate and then also as a medical student she learn to respond to the question of how are you doing with a smile uh and fine how about you and set and I'm going to be quoting from this article now I try my best to focus on their words but no matter what I do the suffering of my community is often heavy on my mind while I was in my classes learning how to heal my future patients I was also learning that even the power of medicine isn't enough to quell the deadly effects of systemic racism and because this was written in the fields of the covid-19 uh lockdown as I learned about research for a cure for covid-19 at one of the best medical and schools in the world deep down I knew that if a cure were discovered my family would not be able to afford it how's it going my professors asked terribly because covid-19 and her sister's systemic racism are ravaging my community and threatening the lives of the people I love that's what I wanted to respond but in those I didn't and in those moments I once again left my black experience at the door for the sake of my professionalism as a medical student my entire experience in higher education has involved centering my professors and colleagues white Comfort often at the expense of my own mental Wellness I know this is a harmful practice but the hierarchical nature of academic medicine and white fragility don't lend themselves to Safe honest conversations about racism and in these kinds of environments it feels impossible to answer the question how are you with honesty when you're afraid to provoke why guilt or worse threaten or damage your academic success and so I've learned to pick and choose my battles she then goes on to say that by the end of May though this this became impossible for her that she the fear and the pain and the concern about family and seeing what was going on in the world um and particularly on the on the heels of the George Floyd's shooting uh she couldn't separate them out and so she writes she told the truth and she then says something remarkable happened my professor took the time lapse and listened to me and she talks event about the value of that experience of sharing the truth and being heard but then saying you know this though this needs to um I shouldn't have had to ask this needs to be there needs to be more awareness there needs to be more understanding um and she ends her essay then with here's what we need from you and you being Health Educators like all of you medical Educators to see us to see our Blackness to help us fight to protect it to see us Beyond Bei committees to watch the news to care about black news be outraged by black suffering just as we are to cry with us to Care About Us now the interesting thing when we look at this what we need from you some of it is what has we have been taught to not do you know in many ways we've been taught that as Educators we need to keep things professional we need to um you know treat all the students the same we need to just focus on the subject matter but what we're hearing here is what students need and this is Dr Nolan's experience but in many ways it can be generalized to many different kinds of students saying we need you to understand where we come from that we bring our whole selves that we're going to learn better and we're going to be better students and better and better professionals if that education is embedded in care so broadly going out Beyond this one particular student um there's been research on what are the costs of balancing academics and and racism but we also know that we can exchange that with sexism or ableism um ageism and so forth but we're really focusing on at this particular moment in history racism being the most Salient um what are the costs and so research is telling us that many students not all but many students of color not only have to battle um institutional racism but also stereotype threat you know this sense of I'm carrying around the stereotypes of my people what people you know maybe you don't have that stereotype about me but I don't know that and I'm worried about it and it's Weighing on my shoulders so I'm dealing with this in the classroom and in addition to wanting to excel as a student um I also feel like I need to disprove these stereotypes and oftentimes students are working themselves to the point of illness to prove their intellectual work um we hear a lot about grit and the importance of grit that's a that's quality we admire um in that there's even great researchers researchers study this idea of grit working hard pushing through being resilient um but research is showing that higher education often requires black students in particular to employ even more grits than their peers if they want to achieve in the classroom and out of it and what research is not looking at is that toll that it takes so students then in an addition of continually having to activate this grit to be successful or experiencing higher levels of anxiety and Trauma so now we have a new Factor entering in now there is the toll on mental health and mental Wellness and we also know then that students of color are less likely than their white counterparts to Avail themselves of Mental Health Resources on campus they're less likely to undergo and to seek out psychological treatment and some of that unwillingness to take advantage of Mental Health Services often reflects their cultural Mistress of the institution um or perhaps not finding a cultural match to deal with something as sensitive as mental health and so we see then how this is all this creates this web um um that students aren't able to navigate and the racism and and this is a quote now the racism that students experience on their campuses suggests that colleges and universities are systems that perpetuates their pain so let me repeat that and let that reflect on that the racism that students experience on their campuses suggests that colleges and universities are systems that perpetuate their food so you're here uh because you want to make a difference you've elected to come to this session and um so what do we do that's the next question so first of all how can we win in our own we always have to look at what can I do within my sphere of influence so how can I look at how I am in the classroom um what might I be doing that actually is perpetuating a negative environment it doesn't have to be blatant oftentimes sometimes it can even be these subtle actions um and what can I do differently so what I'm going to do is I've identified um well not just me personally but based on the work that I've done I've there's seven problematic practices um we're going to look at each one of these we're going to say why are they problematic because obviously when you look at these on the surface they don't necessarily seem like you're doing anything really bad in fact some of these you know we we've always thought were good things to do um why are they problematic what can we do instead and I try to give a little bit of really just concrete practice with each one of those so let's look at those one by one at any time you are welcome to ask request clarification um I'm going to be focusing mostly so one of um the coordinators of the session will help to cue me alert me if there is a question but please know that you can interject so let's look at this idea of altering expectations so first of all what do I mean by that so one of the most common ways that racism or ableism more sexism can enter teaching practice is through our expectations of student ability and achievement now this might be a bigger problem when we're dealing with students like pre-college but it nonetheless you know pre-college sets the path or all the way into graduate and professional education so um we make it an impression we have impression of a student based on their appearance or their gender their race their accent maybe the way they're dressed maybe the way their habits um and we form an association between that impression and maybe behaviors or characteristics and what we then expect from them or how we interpret what we receive from them and of course this then this uh is what I call the bias equation assumption plus Association which then leads to differential treatments um so altering expectations then can be tied to implicit bias so what do we do instead well of course first before we even get into practices we always you know we check our biases we do the process of self-reflection we understand what where do am I making these associations and so forth we're going to be talking about that repeatedly but what we can do is in the classroom Implement practices that will reduce the influence of implicit bias some examples might be improving conditions for interacting with students in and Beyond the classroom so one thing we know about the science behind implicit bias is that whenever we're feeling rushed or stressed or there's lots of distractions we are more likely to default to um implicit bias or those shortcut ways of thinking and I'll oftentimes implicit bias is based in those shortcuts you know we see something we immediately have a uh we fill in the blanks we immediately come to a conclusion now it's when we have more time to be thoughtful that our actions and beliefs are more aligned with what we declare that we think is true okay so oftentimes implicit bias is not necessarily what we would declare as this is what I believe to be true but when we're stressed or or tired or we're distracted we take that shortcut how can we create our interactions that don't you know that are distraction free that are more thoughtful so whatever we can improve those conditions we are going to be less likely to be influenced by implicit bias when we interact with students and I'm going to jump to the third bullet there that may also be that if we do have a question or we do see something that doesn't seem right instead of just resting on this conclusion that we get more information so if we see a student is making a lot of Errors if we see a student who's arriving late or a student seems to be less attentive or they're falling asleep you know instead of making uh an assumption of why that might be happening we get more information we reach out we ask a question we bring it up and then getting more information helps us to come to the correct conclusion rather than one that is an assumption and then also using those consistent and transparent methods for responding to and assessing students work um here are the expectations for what you will do and here's how you get there another is problematic practice is being colorblind or another way of doing it is um saying why treat all students equally I treat all students the same well we we think that's isn't that the way it should be that and and kind of an inherent in that is the idea of the difference the presence of difference is somehow divisive um so students though who feel like when you say something like well people are people we're all human beings you know I don't see race we should be a colorblind Society or anyhow any attitude that says listen I don't you know circumstances don't matter I don't care who you are this is the way we do things what it does is it ignores students lived experiences and to even to outright say something like I don't see race is actually perceived as a microaggression it's it's perceived as saying you don't see me um so what to do instead is to adopt culturally responsive practices now what does that mean culturally responsive practices are ones that incorporate students cultural references into all aspects of teaching and learning so it might be how do we activate students prior knowledge what do students bring to the classroom that will be relevant to how they learn and interact with the material how can we make the learning contextual to what students already know how do we enable students to leverage their cultural capital in the process of interacting with the material one thing you can do then is take inventory of your content and the sources you use so that's a great first step to being culturally responsive whose voices are included who's are left out whose perspective is given Authority do sources include experts from various races ethnicities genders and sexualities our images and media likewise representative of the fullness of group social diversity so even when we think we're what we're dealing just with facts here how that is conveyed how they are interpreted in fact can be representative of the group social um any questions or anything at this point I'm just moving forward here the next problematic practice is Playing devil's advocate now this may not be as relevant for medical education okay but um we all know that the people who want to like to do the devil advocate like well I'm going to present an office of point of view just just to you know keep things interesting just to challenge our thinking um but Marcia chatelin who's a professor of history at Georgetown says that um this you know it's used oftentimes to show the value of both sides okay um and to urge students to think critically about their positions and to be familiar with different perspectives okay that's all fine um but it's premised on this notion that every intellectual idea has an equally rigorous opposite so the pedagogical limitation is that it teaches students that an issue may have a point Counterpoint construction so you get to them well some people believe that um we're all equal you know that there's no biological um differences around something like race other public people believe that certain races um are better at certain things okay so that's like a point Counterpoint um yes these are two sides of an issue but in fact um the impact and consequence of the ideas are completely overlooked and it's so rather than engaging in this Reckless game of Devil's Advocate it's probably better to identify what's non-negotiable or debate in the discipline um specifically not every intellectual idea has an equally rigorous opposite but it's more important to focus on evidence and analyze nuance and to discuss how and why new evidence and research in fact render some ideas as Incorrect and complete or harmful okay so just because some people like don't believe in climate change doesn't mean that that's equally uh rigorous in terms of a position okay similar to that is the problematic practice of claiming objectivity that and again this is one I I am interested in a stem field like in medical and health profession that's this is something we'll play what does that mean what does this look like why how can this be a problematic um practice in stem Medical and this is the idea that empirically proven facts established in this beautiful Universal principles now Daryl doing Sue uh writes about uh he writes a lot about microaggression he's an education professor and he talks that in the academic protocol it establishes standards and norms for the learning environment and says that oftentimes this um it's deeply rooted in white Western Notions of science that emphasize empiricism over experience reason and rationality over emotion and reductionism over narrative complexity so professors claim to present content as if it were an object that were separate and abstracted from themselves okay so the idea of it's objective that that there's no emotion there's no subject what to do and said is what we you know in the social sciences Humanities call identify your positionality now what does this mean first of all is that we interrogate the assumption that empirically proven facts establish indisputable Universal principles and instead reflect on how the complexity of our identities and lived experiences might inform how we interpret data so it's not saying well this data is wrong or this data isn't you know that you know it's there's not just one way to think about data that may come out of of research that who we are where we come from um the kind of things we deal with every day May in fact influence what that data means and so bringing that to the Forefront um is another strategy for this problematic practice another one obviously avoiding real time um or I'm sorry avoiding real-time issues not obviously avoiding real-time issues ignores impact so uh this is the compulsion to stay on the topic uh and I'm thinking of um I'm thinking of for example when 9 11 happened you know and um how many times did students may you know go into class and class started and no one acknowledge this is this huge thing happened in the country okay so there's always times where um real life issues may be compelling enough that can we begin class without acknowledging that they may impact students that they may impact students differently okay so what to do is Sid is of course to pause to acknowledge and to recognize that students do come to the class with their whole selves and if we fail to acknowledge events that deeply impact the communities from which our students come that we are missing an opportunity to model support in a space where we have power so this is something we of course we need to gauge if you're you know um teaching in a community where a shooting just happened um that probably needs to be acknowledged before the class begins maybe it's a major world event that happened and everyone's talking and thinking about it you know maybe if you have international students in your class and you know that something's happening you have an Ukrainian student who right now is impacted by the war that's going on or a Russian student for that matter so um this is an example of what we mean that our compulsion is to stay focused on you know there's too much to cover we need to keep moving forward um but actually avoiding real-time issues can ignore how our students are experiencing the world and what that means when they come to the classroom this is where I'm at my obviously obviously leading microaggressions unchallenged is perceived this tacit approval um microaggressions or a stereotypical statement something that um is clearly some people are going to feel offended by or something that's not quite right that a student says and maybe it's said in a sense maybe uh it is not said in innocence what we do instead is promptly address the issue when it arises oftentimes folks in classrooms they're just first of all it's one of these things where it happens quickly and maybe you're just stunned or maybe you don't have the tools I don't know what to do and so the easiest thing to do is to just keep going uh in fact students notice that you have kept going um and I have heard students underrepresented students say we want and need our faculty to say something we don't want to have to be the ones who raise our hand and say hey what that's a problem we need our professors to be the ones so how do you do that how do we do that and this is where I I find a lot of people really struggle fortunately some colleagues have come up with something they call you take action and this little acronym gives us a script words and tools to how how to how to intervene when something comes up that is problematic so begin a ask clarifying questions okay so that to help you understand intention so I want to make sure that I understood what you were saying were you saying that dot dot dot so ask clarifying's questions carefully listen is it in fact someone maybe didn't Express themselves well and maybe would benefit say well did you mean this or are they using the statement to um code something else that that needs to be addressed the next tell others what you observed in a factual manner I noticed that you know when I heard that this is what I noticed the other is impact exploration or inquire um what do you think people think when they hear this type of comment okay invite the students as a whole to think more about what's being said own your own thoughts and feelings around impact when I hear your comment this is what I think or this is what I Feel Again of course also using the I language as opposed to you um or like accusatory language using the I language and then finally next steps what needs to be done request appropriate action for Seth appropriate action is determined by what was said the conversation that that clarifying conversation that's followed um one example is our class is a learning community such comments make it difficult for us to focus on learning because some students feel offended so I'm going to ask you to refrain from such comments in the future can you do that please um keeping things in a particular or it might be I think we need to talk about this a little further or I suggest that we all do this so that we can learn more about this so there could be a number of but the point is next steps is that you something you said you ask clarifying questions you you you listen you use I statements to describe the response and potential impact and then there's next steps you don't let it lie and the final one um is what I call uh privileging whiteness now what I like to do here is actually share one of my own experiences when I recognized that I had brought um this into the classroom but I was privileging certain kinds of students and their behaviors over others uh and why it actually can penalize students if we don't pay attention so many years ago um probably like 20 years ago uh I was teaching in a a class where students were developing a project and the class was predominantly young white women first-year students there were a few guys and there were three black women and the guys were all white guys um so the young women were were definitely the ones setting the tone for the class they were very enthusiastic they were very they smiled a lot they talked a lot and without paying attention I was attributing academic qualities to those behaviors so the students turn in a proposal for their project and I gave a preliminary grade and a lot of them you know oh I was just handing off the A's you know the black one black student shared her project which involved um going and mentoring children from the community where she came from who said this is a good project but I gave her a b why I don't know that first of all it was a while ago but second of all I think why did I give her a b well because probably I was using those implicit biases of cheerfulness and talking a lot in class and really kind of building this classroom Community probably I was favoring those without really paying attention to it this student came to me and she asked why did I not give her a grade as high as these other students in the class and the fact is I really did not have a good answer for why I did not braid her as well as the other students and it forced me to reckon with biases that I had brought in biases that were based on privileging whiteness so what do we do when we recognize that we've done something like this when we've done something that advantages certain students not because that of of the Course Mission but because of these other qualities and what we do is we need to embrace cultural humility now what is that cultural humility is really the willingness to examine your practices the willingness to recognize you know what I didn't do something right or you know what I need to learn more uh and when the first thing to do when we Embrace cultural humility when students come to us and say we need more from you we need you to do better is we thank them for raising that concern banking rather than apologizing and let's this is why when we apologize oh I'm so sorry I didn't know blah blah blah sometimes we're actually placing the burden back on the student when we say them we're saying you know what uh we're in this together I appreciate you helping me to learn more and this is what I'm going to do now based on what you've said I'm going to think about how I did this and what I learned to do differently was I learned that I needed to um do a better job of aligning my practices and assessment methods with content objectives this was a very highly subjective type of course and so it'd be really easy to be influenced by Impressions through students that seem more likable or students who are more like me I'm gonna I'm gonna reward them better I had to do extra work to make sure I didn't fall into that track and if I said here's the objectives of the course here's how I'm going to measure them I'm going to stay Mission focused and and that's what I need to do so these are the problematic practices have you identified other problematic practices I'm going to take a pause and ask do you have any questions about any of these does any of it resonate with you or is there anything that maybe you've seen as problematic that I'm not included here I think there's a question in the chat Mariah from Dr onward yes I see that I was going to let people react to the question first and then um bring that one up but if nobody has any thoughts there we can jump into the question in the chat um so Dr Unwin asks do you recommend that the faculty member go through all the action steps publicly with the entire group or as an alternative make some sort of statement and conduct the action conversation in private with the student that's a good question so excuse me um I think that first of all I think for all of this um I can't ever give a absolute response I think you do kind of have to judge the climate um who the individual student is um I think that as in any kind of typology we adapted for the circumstances so going through each of these steps may not be appropriate to do live in class I think you would at least want to do the first and second one you know what did you mean or can you clarify what there did I hear you correctly and um based on what you heard from the student in the kind of the the clear after the clarifying question deciding what the next action is so the next action might be let's talk about this more offline okay and then after class following up with that student or it might be let's pursue this a little further um off sometimes other students in the class will come forward depends on the class depends on the student so I guess my response is um definitely you wanna you wanna do something and the first is always ask that clarifying question and then listen to what the student responds how you navigate the rest of the steps then it depends on the context thank you that was very helpful are there any other questions or comments uh feel free to type something in the chat or you can unmute raise your hand we can move forward and you can continue to think and there will be another questions um and this is I want to move into the what I'm calling the positive interventions is moving towards that anti-racist learning environment and again you know it's that deliberate decision on the part and you may not want to you're not may not be at the place you're going to make that decision but this is moving to that next where I'm going to make this a classroom that creates the conditions for ending racism which begins then with asking the question what is race okay so sometimes we say well race is a social construction it's not real I remember the first time I heard that I'm there how could race not be real how can we just not see it and because the fact is that for many people race very much defines their lived experience how they move through the world it also had very much about how they identify that people are attached to that community that where they have that shared quality so what is race and what do we mean by it's a social construction um there's an article and I'm going to share the reference with you at the very end and I encourage you to if you're really wanting to move to an anti-racist classroom I would strongly encourage you to read it um and it's coming out of the race Works project in Stanford but I'm going to read a few excerpts from it one is people often think that race is a thing or and this is important and essential characteristic that people have or are okay so we're thinking of the being the idea of being in essence and um it works that people start referring to another group in a way that portrays them as inherently deficient inferior or lesser in some ways okay so whenever we say something like you know all Asians are bad drivers or um you know all blacks are slow and always like to meetings etc for things like that you're talking in terms of Essence character inherent characteristics and that's what's not true that's when we talk about it's made up that's what we mean um next comes the inference that those people are lesser because of their biological or cultural makeup that they're ancestry their DNA their blood whatever it's fundamentally different and cannot be changed so here's what once again we're we're taking things that are about who a person is biologically or culturally and attaching it to behaviors or ways of being and it's this view of race as a thing that fuels institutions loss and policies that can then justify the past or current oppression of so-called inferior groups things like slavery Jim Crow laws the Chinese explosion act the Indian Removal Act Japanese internment Mexican refried creation etc those are all laws and policies that are outcomes of thinking that race is a thing that race is a way of being um but in fact and we know that all of those of course have multi-generational impacts even after we are overturned Jim Crow law the impact reverberates across Generations Okay so there's a large body of interdisciplinary research though over decades that it's more important it's better more effective to fix a race as a doing okay race is something we do it's not racial differences and racial characteristic disparities are not caused by essential characteristics such as biology or culture but rather because people are situated differently in society that they have different kinds of experiences because of that different kinds of social interactions and it's our differing experiences that shape us into diverse kinds of people with varying backgrounds perspectives and lived experiences so we do race through our everyday actions and activities but these doing is motivated by unspoken and often deeply about assumptions about who counts who we trust who we care about who we should include and why and so this is how race is social constructive it's not just about skin color hair texture body shape um you know what you look like or things like that so we all participate in doing race now let's break this down individual interactional institutional ideological individual level we do race through our biases stereotypes feelings attitudes okay the example why you braids I was doing race in that class when I valued certain students ideas over others even though when I step back and applied criteria the student that I disadvantaged actually had a better project okay so individually we do race through our biases and stereotypes interactional we do race by how we interact with other people and also how we interact with media messaging that we receive in the world advertisements how that how we interact with that is another way that we do race institutionally through schools law enforcement financial institutions the medical establishment is institutionally how we do race and then ideologically are those um kind of broad sort of um amorphic narratives about race and racial difference so we're all participating in race all the time for each of those levels so the first thing we need to do is really build our racial literacy better understand what it is how it operates in society um how deeply embedded it is how invisible it can be once we build our racial literacy we then discovered the power for how to undo racism okay there's three points that we want to talk about here one is we recognize that we all have a shared history so it those of you who are affiliated with Virginia Tech you know that we are celebrating our Cisco Centennial a very important part of the cesplus Centennial celebrations of Virginia Tech have centered on telling the full story of who we are where we come from that historically we've told a story about Virginia Tech you know the students who walked we were the land grant Story the student the farm student who walked many miles to come to campus the military school but there are also aspects of our history that we have not told and so yep we're all a part of the same history we just have different ways of experience and telling it so telling that and recognizing our shared history is one way that we can under racism it's sort of like a a precursor the next is taking responsibility for our role on perpetuating races so we talked about the problematic practices are there things that we do are there things that we advance ideas that we advance beliefs that we hold on to things that you know traditions we don't want to give up but that in fact do harm to certain people so what's our responsibility for how we may do racism and allow them to continue and then finally learning to talk about it because as long as we avoid it as long as we change the subject uh it's going to continue we need to become comfortable with looking at the questions having a conversation now one way to do that of course is by learning more so one of the things that came up um and this was after George Floyd So if you're familiar with jstor they have something they call the syllabus project and whenever there is something um happening in the world they create a syllabus around it so after George Floyd they created the institutionalized racism syllabus they also created the Charlottesville syllabus after the event in Charlottesville um when they wanted to take down the statue um and of the Civil Rights or not civil rights but Civil War uh person and um anyhow I looked at the institutionalized racism syllabus and I thought there were four articles in there that were of particular interest to people in medical and Health Professions okay each of these are about doing race but specifically doing race in health and Medicine so there was an article about the flexner report there was an article about the Tuskegee experiment and the lasting impact of that there was um an article about health insurance and uh it's intersections with Grace and then of course an article about covid-19 and the differential impacts in black and poor communities so we learn more about how race is operated in history but we also learn more about how it we do race in our own spheres and in your case it would be in Medical Education Health Professions we also want to always apply the lens of intersectionality so what we have here is the definition of intersectionality by Kimberly Crenshaw who who defined the idea as the interconnected nature of social social categorization such as race class and gender as they apply to a given individual or group which creates overlapping and interdependent systems of discrimination or disadvantage that's a very academic an easy way to think about it is that we are made up of many identities some are more Salient than others but we don't experience the world as just a woman or just the black person or just a gay person but rather all of these identities so that there are unique experiences unique forms of discrimination that a poor white man from Appalachia may experience as compared to an older Muslim man or a woman or a black woman who is disabled Etc that these different categories categorizations of identity inform how we experience the world so um and create unique forms of discrimination and disadvantage so we always apply the lens of intersectionality especially like last week I was on a panel I was on a panel as someone who's absolutely not an expert in it but on a panel on black maternal health and so they were talking about maternal health and the unique ways or the the ways that black maternal health is unique as compared to other forms of maternal Health other people who are having babies and experiencing um maternity applying that lens of intersectionality and then asking yourself these questions before you move how have my experiences shaped my perspectives and biases so we really need to understand where we come from what were the what's the messaging that we each of us have heard over time whether it be begin starting back from our families that where we've come from the communities that we each come from um and how does that impact us now how does it hang around even if we may have left or gone somewhere else absorb new ideas how does the accumulation of our experiences shape how we think and what we believe have I learned enough to confidently support this conversation and if your answer is no then the option is to continue to learn more okay have I learned enough how can I continue to learn more how will I handle challenging scenarios so earlier on I talked about the take action strategy for dealing with microaggressions I can assure you there will be times that strategy will not work that you will get more pushback how do you handle it we need to become fluent or at least um build enough competencies that we're going to be navigating we're going to be going into territories where even our best strategies may not work and we need to figure out how to respond and then finally am I truly ready to do this work even when it becomes uncomfortable really doing that self-preparation now I have a feeling that we need to come to a conclusion here so I'm going to slip go right to our want to learn more slide and ask are there any questions and I recognize we're almost at the hour everyone so um feel free to jump off if you have to get turned on their meeting or feel free to stay on with Dr duramo I'm sure she would be happy to answer questions in the next couple of minutes um or you can email us and we'll pass any questions along this uh the slide deck will be posted on the teach website with drama's permission so that those resources will be available to you guys there so um probably within the next couple of days yeah so there was a lot of content so I'm providing you with some of the articles that I use and also if you want to do more know more we have some online self-paced courses yeah thank you for your attention all right yeah one question in the chat um from Dr millionaire uh are there any recorded scenarios that would demonstrate some of these skills um there are and um I'm trying to think I don't have any uh in the courses that I have shared with you but that is something we've received or that we've heard had requested quite often and so that's something that we'll look for but yeah to see it model is is very helpful one thing I do have so I do have a course on handling difficult conversations okay and what we do is we provide a lot of scenarios that um you know and and different ways to respond and that oftentimes there's multiple ways to respond and what you want to do is find what's the most inclusive what's the most effective way to respond and why some might be more problematic to others so that so I have scenarios I think what I'm hearing is how can we actually watch it and that's something I'll be looking out for so I can provide that all right there's no further questions I think we can wrap things up for the day thank you so much Dr Geronimo uh for this wonderful presentation and sharing your experiences and um lots of uh really enjoyed thank you so very much coming through on the chat um and we will make sure to send you your evaluation feedback uh shortly as well so please uh make sure that you guys fill out an evaluate CME evaluation um the link has been posted in the chat by Deb and have a wonderful rest of your Monday thank you everyone bye-bye.