A cancer disparities curriculum in a hematology/oncology fellowship program.
Curriculum
Fellowship
Health disparities
Hematology/oncology
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
17 Oct 2023
17 Oct 2023
Historique:
received:
26
08
2022
accepted:
20
06
2023
medline:
23
10
2023
pubmed:
18
10
2023
entrez:
17
10
2023
Statut:
epublish
Résumé
After George Floyd's murder in 2020, the Center for Disease Control and Prevention (CDC) called systemic racism a public health crisis. This health crisis is connected to the already-documented racial and socioeconomic disparities in cancer care. Ensuring hematologists and oncologists are aware of these disparities through their medical education can help to address these disparities. The authors implemented a healthcare disparities-focused curriculum in a Hematology/Oncology fellowship program during the 2020-2021 academic year at The Ohio State University Hematology/Oncology Fellowship Program. They implemented a pre- and post- survey to evaluate the efficacy of the program. Fifteen fellows completed the pre-curriculum survey and 14 completed the post-survey. Before the curriculum, 12 fellows (80%) noted a "Fair" or "Good" understanding of healthcare disparities, and 6 (40%) had a "Fair" understanding of disparities in clinical trials and access to novel therapies. Fourteen fellows (93.3%) had not previously participated in a research project focused on identifying or overcoming healthcare disparities. After the curriculum, 12 (85%) fellows strongly agreed or agreed that the information presented in the curriculum was useful for training as a hematologist/oncologist. Twelve fellows (85%) noted "Agree" or "Strongly Agree" that the information presented was relevant to their practice. Eleven fellows (92%) noted that they plan to incorporate healthcare disparities into a future research or clinical project. The majority of fellows, 11 (79%) recommended that the fellowship program continue to have a formal health disparities curriculum in the future. There is utility in incorporating cancer disparities education into a hematology/oncology academic curriculum. We recommend further analysis of such curricula to improve fellowship education and patient outcomes with these interventions.
Sections du résumé
BACKGROUND
BACKGROUND
After George Floyd's murder in 2020, the Center for Disease Control and Prevention (CDC) called systemic racism a public health crisis. This health crisis is connected to the already-documented racial and socioeconomic disparities in cancer care. Ensuring hematologists and oncologists are aware of these disparities through their medical education can help to address these disparities.
METHODS
METHODS
The authors implemented a healthcare disparities-focused curriculum in a Hematology/Oncology fellowship program during the 2020-2021 academic year at The Ohio State University Hematology/Oncology Fellowship Program. They implemented a pre- and post- survey to evaluate the efficacy of the program.
RESULTS
RESULTS
Fifteen fellows completed the pre-curriculum survey and 14 completed the post-survey. Before the curriculum, 12 fellows (80%) noted a "Fair" or "Good" understanding of healthcare disparities, and 6 (40%) had a "Fair" understanding of disparities in clinical trials and access to novel therapies. Fourteen fellows (93.3%) had not previously participated in a research project focused on identifying or overcoming healthcare disparities. After the curriculum, 12 (85%) fellows strongly agreed or agreed that the information presented in the curriculum was useful for training as a hematologist/oncologist. Twelve fellows (85%) noted "Agree" or "Strongly Agree" that the information presented was relevant to their practice. Eleven fellows (92%) noted that they plan to incorporate healthcare disparities into a future research or clinical project. The majority of fellows, 11 (79%) recommended that the fellowship program continue to have a formal health disparities curriculum in the future.
DISCUSSION/CONCLUSION
CONCLUSIONS
There is utility in incorporating cancer disparities education into a hematology/oncology academic curriculum. We recommend further analysis of such curricula to improve fellowship education and patient outcomes with these interventions.
Identifiants
pubmed: 37848877
doi: 10.1186/s12909-023-04465-0
pii: 10.1186/s12909-023-04465-0
pmc: PMC10583409
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
773Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666.
Williams DR, Lawrence JA, Davis BA. Racism and health: evidence and needed research. Annu Rev Public Health. 2019;40:105–25.
doi: 10.1146/annurev-publhealth-040218-043750
Bailey ZD, Feldman JM, Bassett MT. How structural Racism Works — Racist Policies as a Root cause of U.S. racial health inequities. N Engl J Med. 2020;384(8):768–73.
doi: 10.1056/NEJMms2025396
National Research Council(US) IoMU. U.S. Health in International Perspective: shorter lives, Poorer Health. Woolf SH AL. editor. Washington (DC): National Academies Press (US); 2013.
Ellis L, Canchola AJ, Spiegel D, Ladabaum U, Haile R, Gomez SL. Racial and ethnic disparities in Cancer Survival: the contribution of Tumor, Sociodemographic, Institutional, and Neighborhood characteristics. J Clin Oncol. 2018;36(1):25–33.
doi: 10.1200/JCO.2017.74.2049
Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, et al. Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004;54(2):78–93.
doi: 10.3322/canjclin.54.2.78
ASCO. Responding to Racism and Health Inequality as a Cancer Care Community. 2020. https://ascopost.com/issues/july-25-2020/responding-to-racism-and-health-inequality-as-a-cancer-care-community/ . Accessed 15 April 2022.
ASH/ASH RC/CMSS Statement on Racism in Healthcare. 2020. https://www.hematology.org/newsroom/press-releases/2020/ash-cmss-statement-on-racism-in-healthcare . Accessed 15 April 2022.
Dao DK, Goss AL, Hoekzema AS, Kelly LA, Logan AA, Mehta SD, et al. Integrating theory, content, and Method to Foster critical consciousness in medical students: a Comprehensive Model for Cultural competence training. Acad Med. 2017;92(3):335–44.
doi: 10.1097/ACM.0000000000001390
The AMA GME Competency Education Program., 2002. https://www.ama-assn.org/amaone/resident-membership-ama-gme-competency-education-program . Accessed 5 May 2022.
Stonington SD, Holmes SM, Hansen H, Greene JA, Wailoo KA, Malina D, et al. Case Studies in Social Medicine — attending to Structural Forces in clinical practice. N Engl J Med. 2018;379(20):1958–61.
doi: 10.1056/NEJMms1814262
Medicine Io. In: Smedley BD, Stith AY, Nelson AR, editors. Unequal treatment: confronting racial and ethnic disparities in Health Care. Washington, DC: The National Academies Press; 2003. p. 780.
Betancourt JR, King RK. Unequal treatment: the Institute of Medicine report and its public health implications. Public Health Rep. 2003;118(4):287–92.
doi: 10.1016/S0033-3549(04)50252-2
Weissman JS, Betancourt J, Campbell EG, Park ER, Kim M, Clarridge B, et al. Resident physicians’ preparedness to provide cross-cultural care. JAMA. 2005;294(9):1058–67.
doi: 10.1001/jama.294.9.1058
Mejia de Grubb MC, Kilbourne B, Zoorob R, Gonzalez S, Mkanta W, Levine R. Resident Physicians and Cancer Health Disparities: a survey of attitudes, knowledge, and practice. J Cancer Educ. 2016;31(3):541–6.
doi: 10.1007/s13187-015-0846-8
Dupras DM, Wieland ML, Halvorsen AJ, Maldonado M, Willett LL, Harris L. Assessment of Training in Health Disparities in US Internal Medicine Residency Programs. JAMA Netw Open. 2020;3(8):e2012757–e.
doi: 10.1001/jamanetworkopen.2020.12757