https://doi.org/10.1177/2382120520965246
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Journal of Medical Education and
Curricular Development
Volume 7: 1–6
© The Author(s) 2020
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/2382120520965246
Introduction
Abundant evidence demonstrates the existence of racial health
disparities in the United States, as well as the role of the
American medical system in perpetuating structural racism.
1
At present, many medical school curricula address race within
courses aimed primarily at increasing “cultural competency.”
2
Yet there is little existing research on medical school curricula
designed to address race and racism in medicine specifically.
Researchers have demonstrated that racial discrimination alone
is a risk factor for poor health outcomes.
1,3
As aptly described
by Metzl and Hansen, “We contend that medical education
needs to more systematically train health-care professionals to
think about how such variables as race, class, gender, and eth-
nicity are shaped both by the interactions of two persons in a
room, and by the larger structural contexts in which their inter-
actions take place.”
4
Metzl and Hansen argue for a curriculum
that can not only treat a patient’s physical complaints, but rec-
ognize how “social and economic determinants, biases, inequi-
ties, and blind spots shape health and illness long before doctors
or patients enter examination rooms.”
4
There is an urgent need
Toward an Anti-Racist Curriculum: Incorporating
Art into Medical Education to Improve Empathy
and Structural Competency
Bria Adimora Godley
*1
, Diana Dayal
*1
, Elizabeth Manekin
2
and Sue E Estroff
1
1
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
2
Ackland Art Museum,
Chapel Hill, NC, USA.
ABSTRACT
BACKGROUND: There is an urgent need for medical school curricula that address the effects of structural influences, particularly racism,
on health, healthcare access, and the quality of care for people of color. Underrepresented racial minorities in the United States receive
worse health care relative to their White counterparts. Structural competency, a framework for recognizing and understanding social influ-
ences on health, provides a means for understanding the structural violence that results from and perpetuates racism in classroom and clini-
cal education. Some medical schools have incorporated art into their curricula to increase empathy generally, yet few programs use art to
address racial disparities in medicine specifically.
OBJECTIVE: “Can We Talk About Race?” (CWTAR) aims to increase medical students’ empathy for racial minorities and increase the ease
and ability of students to address racial issues. CWTAR also provides a unique context for ongoing conversations about racism and struc-
tural inequality within the health care system.
METHODS: Sixty-four first-year medical students were randomly selected to participate in CWTAR. The on-campus Ackland Art Museum
staff and trained student facilitators lead small group discussions on selected artworks. A course evaluation was sent to all participants con-
sisting of 4 questions: (1) Likert scale rating the quality of the program, (2) the most important thing learned from the program, (3) any differ-
ences between discussion at this program versus other conversations around race, and (4) suggestions for changes to the program. Free
text responses were content coded and analyzed to reveal common themes.
RESULTS: Out of 64 students, 63 (98%) responded to at least one course evaluation question. The majority (89%) of participants rated the
program quality as either “Very Good” or “Excellent.” Of the 37 students who responded to the free text question regarding the most impor-
tant thing they learned from the program, 16 (44%) responses revealed students felt that they were exposed to perspectives that differed
from their own, and 19% of respondents reported actively viewing a subject through another’s perspective. Of the 33 students who responded
to the free text question regarding any differences between discussion at this program versus other conversations around race, 48% noted
an increased comfort level discussing race during the program. A common theme in responses to the question regarding suggested
changes to the program was a more explicit connection to medicine in the discussion around race.
CONCLUSIONS: Student responses to CWTAR suggest that the program is effective in engaging students in discussions of racial issues. More
investigation is needed to determine whether this methodology increases empathy among medical students for racial minorities specifically.
KEYWORDS: Art, racism, empathy, cultural competency, curriculum, medical education, race relations
RECEIVED: June 28, 2020. ACCEPTED: September 14, 2020.
TYPE: Methodology
FUNDING: The author(s) received no fnancial support for the research, authorship, and/or
publication of this article.
DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential
conficts of interest with respect to the research, authorship, and/or publication of this
article.
CORRESPONDING AUTHOR: Bria Adimora Godley, University of North Carolina School
of Medicine, 101 Songbird Lane, Chapel Hill, NC 27009, USA. Email: bria_godley@med.
unc.edu
965246MDE 0 0 10.1177/2382120520965246Journal of Medical Education and Curricular DevelopmentGodley et al
research-article 2020
*Te authors have informed the journal that they agree that both Bria Adimora Godley and Diana Dayal completed the intellectual and
other work typical of the frst author.