As experts in the medical education space, we are constantly evolving our approach to create the most impactful educational experience for HCPs. We carefully evaluate new technologies and innovative approaches to learning, we diligently highlight the newest data to incorporate into our scientific content, and we apply principles of behavioral science to ensure the content resonates with its intended target audience of HCPs.

Sure, all of this is essential to developing effective, high-impact medical education. But how can we also ensure our work remains patient-centered – so that it ultimately improves patient care -- with an underlying foundation of health equity and inclusivity?

Why a focus on health equity is so important to medical education

Health equity matters. Socioeconomic and environmental factors are thought to contribute close to 50% towards an individual’s overall health outcomes.¹ In other words, improvements in population health will inherently depend on addressing social determinants of health.

On an individual level, there is also a documented correlation between a patient’s sense of comfort and acceptance and their willingness to be open and honest with their HCP or to accept their HCP’s medical advice.² All people – regardless of demographics or community -- wish to feel accepted.  And if they don’t, they may avoid seeking medical care. This is why cultural competence is so essential to the practice of medicine.

What is cultural competence?

Loosely defined as the “ability to understand, appreciate and interact with people from cultures or belief systems different from one's own,”³ cultural competence can help us collaborate effectively and ultimately improve overall healthcare experiences and outcomes.

Medical education offers us a unique “upstream” opportunity to improve cultural competency by promoting culturally appropriate health education and ultimately better serve the needs of a diverse patient population. Ensuring cultural competency and healthcare diversity in our medical education content could influence HCPs at the medical student, resident, attending, management, and even leadership levels of healthcare.⁴

What happens when we fail to communicate in a culturally competent, inclusive manner?

It can lead to real-life health consequences.  Here’s an example in an excerpt from an article written by Usha Lee McFarling, National Science Correspondent for STAT:⁵

“When dermatologist Jenna Lester learned that rashes on skin and toes were a symptom of Covid-19, she started searching the medical literature for images of what the rashes looked like on Black skin so she’d recognize it in her Black patients. She couldn’t find a single picture.

“I was frustrated because we know Covid-19 is disproportionately impacting communities of color,” said Lester, an assistant professor of dermatology at the University of California, San Francisco who recently published her analysis.⁶ “I felt like I was seeing a disparity being built right before my eyes.”

The dearth of images in the Covid-19 literature is just the newest example of the glaring lack of representation of Black and brown skin that has persisted in dermatology research journals and textbooks for decades. The issue is coming under closer scrutiny now as dermatologists, like many physicians, grapple more openly with systemic racism and the health disparities it is causing in their field.”

There is a lot of work to be done here. So what are some practical, incremental ways we as medical marketers can critically examine our work in the HCP communication / medical education space?

Here is a selection of helpful recommendations from the AMA Journal of Ethics that can be applied to our space, with many more outlined in the full report:⁷

• Provide adequate cultural context in case-based educational content, challenging learners to think about the complete patient rather than isolated medical ailments
• Discuss how systemic racism and bias may result in health disparities
• Actively discuss the demographics table when sharing evidence from clinical research, to highlight diversity in the populations studied and explore how that diversity, or lack thereof, affects the quality of the study
• Practice inclusion by providing diverse visual examples in case-based learning. Show a range of patients and cases and include patients from diverse backgrounds
• Consider the roles that current events and popular culture play in understanding diverse patients, acknowledging the interplay among culture, disease prevalence, disease management, and adherence

In Conclusion:

Today’s healthcare model faces persistent challenges when it comes to addressing disparities across cultures, races, genders, ethnicities, and social determinants of health. And in the medical education space, there can be ramifications for treatment and diagnosis when underrepresentation occurs.  Let’s critically examine our work and identify opportunities to ensure representation and inclusion for all.

REFERENCES:

1. https://www.ajpmonline.org/article/S0749-3797(15)00514-0/fulltext
2. https://www.ahrq.gov/cahps/quality-improvement/reports-and-case-studies/index.html
3. https://www.apa.org/monitor/2015/03/cultural-competence#:~:text=Cultural%20competence%20%E2%80%94%20loosely%20defined%20as,practice%20for%20some%2050%20years.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571328/
5. https://www.statnews.com/2020/07/21/dermatology-faces-reckoning-lack-of-darker-skin-in-textbooks-journals-harms-patients-of-color/
6. https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.19258
7. https://journalofethics.ama-assn.org/article/integrating-health-equity-content-health-professions-education/2021-03