Pushing for health equity through structural competency and implicit bias education: A qualitative evaluation of a racial/ethnic health disparities elective course for pharmacy learners

• Published in: Currents in pharmacy teaching and learning 2019-04, Vol.11 (4), p.382-393
• Main Authors: Avant, Nicole D., Gillespie, Gordon L.
• Format: Article
• Language: English
• Subjects: Active learning; Bias reduction; Cultural competency; Institutional racism; Social determinants; Teaching
• ISSN: 1877-1297; 1877-1300
• DOI: 10.1016/j.cptl.2019.01.013

Health equity attainment requires dismantling implicit bias and structural racism. Mitigating bias in clinical interventions and implementing structural interventions to impact where people live, work, play, and eat fosters optimal patient outcomes. Consequently, pharmacy students need exposure to these concepts. The objective of this project was to evaluate an elective course focused on exposing students to the root causes of health disparities, contemporary factors that perpetuate disparities, and evidence-based policies to reduce health disparities. This three-credit course emphasized critical thinking, robust discussions, and learning challenging constructs through self-discovery. Nine second-year and third-year learners were assessed by short-answer exams, learning management system discussion threads, weekly reflections, participation, and a class project. A qualitative descriptive design was used for this study. Weekly reflections were subjected to thematic analysis using a constant comparative analysis method to generate themes. Five themes were derived from the data underlying strategies to facilitate this course: (1) create and maintain a welcoming and inclusive learning environment; (2) utilize experiential learning for personal awareness development and knowledge expansion; (3) incorporate intergroup diversity to empower learners to create change; (4) anticipate and acknowledge emotions to facilitate learning; and (5) provide students with an opportunity to complete a final self-reflection paper. This course provided pharmacy learners with unique, differential skill sets and knowledge, potentially adding depth to their careers and impacting the way they will practice pharmacy.