Guidelines for Creating Diverse Curricula and Inclusive Learning Environment

I. General Objectives of Curricular Review:

The overall goal of this self-assessment is to encourage faculty to assess their course curricula and apply the overall CAMED Curricular Recommendations presented by CAMED Racism in Medicine Vertical Integration Groups report, as follows:

1. Ensure culturally sensitive and appropriate language is used.
2. Equip faculty to teach how the historical and structural background of racism has shaped their scientific discipline and institutions, and how these constructs contributed to health disparities and societal biases.
3. Create additional opportunities for students, faculty, and staff to develop the skills to become allies to communities of color.
4. Critically examine the strength of evidence when promoting race-based science and medicine.
5. Create additional opportunities for students, faculty, and staff to reflect on how racism has impacted their lives.

II. Evaluating Course Learning Objectives:

Educators should strive to revise existing or create new content in their curricula that encompass and align with the following objectives.

Proposed Equity and Anti-Racism Student Learning Objectives:

1. Reflects on their personal biases and privilege and recognizes the implications of inequality on well-being.
2. Recognizes the historical context and current manifestations of inequity & systemic racism and its impact on science.
3. Identifies the effects of implicit racial bias and systemic racism in science.
4. Analyzes scientific literature with the historical understanding of racial inequity, identifies gaps in the literature, and is able to delineate where race is used or not used appropriately.
5. Employs evidence-based tools to recognize and mitigate the effects of personally held implicit racial biases.
6. Exhibits the scientific knowledge to understand the physiological and psychological response to racism and inequity.
7. Possesses the knowledge and practical skill to be an advocate for a more equitable environment in any academic setting.

III. Self-Assessment of Course and Curriculum Content:

When self-assessing course curriculum, educators should incorporate the above learning objectives and consider the following:

A. Questions to consider to understand historical racial inequity in specific professions/disciplines as adapted from Dr. Paula Austin:

1. When was my discipline professionalized (first professional organization/conference) and who were the leading figures? Who is missing? Why? What does that mean?
2. Who are the current leading figures for my profession?
3. What are the deeply held traditions and assumptions of my discipline (think about my own training: research standards, methods, course content, classroom approaches, assessment strategies, assessment tools)?
4. What do we ask people to give up in order to be successful in my discipline?
5. How do we repair the (historical and contemporary) damage done by our discipline?

For more detail, see Paula Austin’s Lightning Talk on “Building the Inclusive Classroom”

B. General Self-Assessment Questions for Evaluating Course Curricula and Content:

1. Do the current learning objectives align with promoting equity, inclusivity and anti-racism
2. Do you have course content that is incompatible with the current goals pertaining to equity, inclusivity and anti-racism?
3. How can you integrate the above learning objectives to foster equity in your curriculum?
4. What resources are required to make changes / accomplish these goals?
5. Is expertise outside of the Department necessary to achieve these goals?

C. Specific topics to consider when reviewing curricular materials for inclusivity, diversity, and bias-free instruction, suggested by Brown University:

Images

• Do the images included in my presentation portray individuals of varied sex and gender, age, and skin color?
• Are the images I include as examples of “typical” pathology diverse enough so as to prevent stereotyping? This may be especially important for pathology associated with social stigma.
• For example, only including images of young people when discussing STIs may give the impression that only young people are at risk and should be screened.

Language & Terminology

• Do I acknowledge that learners in my audience might have personal experience with the content I am presenting?
• For example, in a talk about mental illness, do I discuss patient behavior as what “they” do and provider behavior as what “we” do without acknowledging potential learner experience?
• Have I considered how my language and/or use of humor may be received by my diverse audience?
• For example, do my comments on current events assume that my audience is homogeneous for one particular political ideology?
• Is the language and terminology I use value-laden?
• For example, when talking about patients or patient behaviors (not laboratory values), could I substitute “differences” for “irregularities” or “typical” for “normal” or “patient who had a stroke” for “stroke patient?”
• Is the language I use over-generalizing? How can I be more precise?
• For example, when discussing Black research participants and patients, am I assuming ancestry (e.g., African American versus Caribbean American)?
• Is the terminology I use or reference up to date?
• For example, can I substitute “intellectual disability” for “mental retardation” or “transgender” for “transsexual”?
• Do I define the terminology precisely as I use it in lectures: for instance, define the use of “biologically female” as someone that “has a uterus and ovaries” etc.

Case Studies

• Do the cases I use include individuals of varied gender expression, gender identity, sexual orientation, age, ability, race and ethnicity? Do I indicate that the pronouns I use are the ones preferred by the patient/participant/student?
• When I include details about the gender expression, gender identity, sexual orientation, race or ethnicity of a patient/participant, am I able to explain its relevance to the topic at hand?
• Are the cases I include as examples of “typical” patient/participant presentations diverse enough so as to prevent stereotyping? This may be especially important for pathology associated with social stigma.
• When I include details about the race of a patient or population, am I conflating race with ethnicity (shared culture and language), race with country of origin, or race with skin color?
• When I mention race as a risk factor, are there socioeconomic factors, or issues of bias involved that are as, if not more, salient? For example, when discussing a case of preterm birth for a Black (African/Caribbean) American woman, do I make clear the role of chronic stress related to structural racism?

Research & References

• Is the research I cite up to date? Are the racial or other classifications used now considered outdated?
• For example, do the studies I cite account for individuals who identify as biracial or as “two or more races” (census category)?
• Can I explain if the studies I cite define race by self-report, census data, medical record review, or some other method, and the implications of each?
• Can I explain why race, and not socioeconomic factors, is the relevant influence in a particular study?
• For example, when discussing a study about the incidence of diabetes in certain populations, am I able to describe the role of genetics versus socioeconomic factors?

D. Adding Statements on Inclusivity and Accessibility in Course Syllabi and Materials:

When trying to create an inclusive classroom, instructors may consider including explicit statements on diversity, land acknowledgement and accessibility within their syllabi or presentations. Instructors can also consider stating, at the beginning of the course, their intent to implement an inclusive and diverse classroom, and openness for discussion regarding these important issues. Some guidelines for inclusive syllabi are presented by the BU CAS writing program. This resource shows examples of Land Acknowledgment Statement, Diversity Statement and Accessibility Statement for students who need accommodation for disability.

IV. Obtaining Educator and Course Feedback

Colleague Feedback

Ask a colleague to review the course curriculum based on the above guidelines.

Student Feedback

Incorporate questions pertaining to inclusivity and diversity of course contents in official student course evaluation forms given at end of semester.

• Did the faculty member use appropriate language and seem to be mindful of the diverse backgrounds within the classroom?
• Did the faculty member include inclusive content in their lectures?
• Was there any point within the course that you felt like the faculty member was not sensitive to individual differences (e.g., race, ethnicity, sexual orientation, gender identity, ability)?