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Critical Race Theory for Pharmacy Diversity Curriculum
... Pharmacy educators must be equipped to use evidence-based pedagogical strategies that can help instill cultural intelligence in pharmacy students. 10,13,15 To the best of our knowledge, our review is the most comprehensive scoping review of cultural intelligence in pharmacy educators and students to date. A scoping review of cultural competency training by Brottman and colleagues 16 included articles from health professions published between 2005 and 2016, finding that a majority of articles were from medicine and nursing and only 10 were from pharmacy. ...
Objective:
To review evidence-based pedagogical tools and strategies used to support the development of cultural intelligence in pharmacy education.
Findings:
An exhaustive list of search terms was included to capture the variety of terms for "cultural intelligence" (eg, cultural competence). The search was not limited to any publication year range. Search engines included PubMed, Embase, CINAHL, Scopus, ProQuest Dissertations and Theses, ERIC, and PsycInfo. A total of 639 articles were identified after removing duplicates. Eighty-two articles were included for full review after screening. Year of publication ranged from 2004 - 2021. Two articles (2.4%) described tools for educator development, whereas the rest (n = 80, 97.6%) focused on student development. Examples of tools reported included lectures and workshops. Twenty-seven articles (32.9%) described pedagogical tools for fostering cultural intelligence concurrently with interprofessional development; the remaining articles (n = 55, 67.0%) focused only on pharmacy. Thirty-two articles (39.0%) used quantitative analysis methods, and 13 articles (15.9%) used qualitative analysis methods. Sixty-four articles (78.0%) included outcomes of perceptions, 6 (7.3%) included outcomes of participation, and 33 (40.2%) included outcomes of performance. Although not every study addressed all 4 cultural intelligence framework domains (awareness, knowledge, practice, and desire), each domain was apparent within the included articles.
Summary:
Various pedagogical tools have been used to develop cultural intelligence in pharmacy students with some tools used more than others. Findings suggest that integrating various pedagogical methods throughout the curriculum aligns more closely with the dynamic nature of learning and continuous self-refinement required to develop cultural intelligence.
... In addition to scholarly research, calls for CRT mushroomed in health education in the latter half of the 2010s. Critically engaging lecture materials on race and racism, or the lack thereof, students and educators from such health fields as psychology (Watkins et al., 2018), medicine (Braun, 2017;Krishnan et al., 2019;Tsai & Crawford-Roberts, 2017), nursing (Valderama-Wallace & Apesoa-Varano, 2020), and pharmacy (Bush et al., 2018;Rockich-Winston, 2018) have sought to reform curricula to address and redress racial injustice that has been embedded therewithin. ...
In higher education institutions, critical race theory (CRT) is known to be associated with fields that study racial disparities or systemic oppression such as law, education, and ethnic studies. The impression that CRT is unrelated to fields like business or computer science may have led scholars and practitioners from these disciplines to put their focus on elsewhere than on racial inequality and its implication in their research and practice, despite apparent need. To counter such fallacy, this review article—focusing primarily on the US context—discusses CRT literature in fields where its presence is less known which are nevertheless among the major domains of higher education institutions: health sciences, computer science and information technology, sports, business, and religion. By discussing example research of how scholars have utilized CRT in different fields to challenge the race-neutral thinking that often obscures structural racism, this paper exposes racism’s ability to alter manifestations and to appear through various shapes and forms within the higher education context. Initial recommendations on how educators may engage in further discussions or actions will also be considered. This paper concludes that racist ideologies are often hidden behind discipline-specific vocabulary or technical language, and it is by tackling the ideologies at work underneath the technicalities can we address the chameleon-like nature of racism more effectively.
In this clinical pharmacy forum, an argument is presented that clinical pharmacists and their respective institutions must be self‐reflexive about race, racism, and implicit bias in treating patients. Drawing on the Public Health Critical Race praxis and self‐reflexivity practices, this forum provides a critical review of a widely utilized medical guideline and tool, the American College of Cardiology (ACC) and American Heart Association (AHA) Clinical Practice Guideline on the Primary Prevention of Cardiovascular Disease and its respective Arteriosclerotic Cardiovascular Disease Risk Estimator, as an example of how self‐reflexive practices on race, racism, and implicit bias can be accomplished. This critical review offers clinical pharmacists entry points of considerations and actions that can more robustly aid themselves and their institutions to enact racial justice policies and practices in medical contexts. This article is protected by copyright. All rights reserved.
Introduction
The objective of this study was to explore pharmacy students' emotional reaction to the concept of White fragility and garner ideas about improving pharmacy curriculum to initiate constructive patient engagement across racial divides.
Methods
An online questionnaire was distributed to 160 first-year pharmacy students after reading the article “White Fragility” for a Foundations of Pharmaceutical Care Course. Class prep questions included (1) How can the college and you improve the capacity and stamina of Whites, so they are prepared to teach and initiate constructive patient engagement across racial divides? and (2) Recognizing that emotions play a critical role in learning, how does the information in the “White Fragility” article make you feel? Responses were analyzed using a constant comparative method by all three authors; discrepancies were resolved by consensus.
Results
Of the 160 students across two campuses, 157 submitted responses. Four major categories of college culture, curriculum, educational topics, and educational suggestions or enhancements emerged “to improve the capacity and stamina of Whites.” With regard to the observed feelings after reading “White Fragility,” seven categories of feelings (frequency) emerged, including awareness (49%), discomfort (38.2%), empathy (19.7%), defensiveness (16.6%), frustration (15.9%), empowerment (11.5%), and curiosity (8.3%).
Conclusions
This student cohort is at the beginning of their intercultural journey in pharmacy. Many indicated that more emphasis on and discussion about issues like White fragility and racism would benefit their ability to care for people from a wide variety of cultures to optimize patient outcomes.
The Research in Medical Education (RIME) Program Planning Committee is committed to advancing scholarship in and promoting dialogue about the critical issues of racism and bias in health professions education (HPE). From the call for studies focused on underrepresented learners and faculty in medicine to the invited 2016 RIME plenary address by Dr. Camara Jones, the committee strongly believes that dismantling racism is critical to the future of HPE.
The evidence is glaring: Dramatic racial and ethnic health disparities persist in the United States, people of color remain deeply underrepresented in medical school and academic health systems as faculty, learner experiences across the medical education continuum are fraught with bias, and current approaches to teaching perpetuate stereotypes and insufficiently challenge structural inequities. To achieve racial justice in HPE, academic medicine must commit to leveraging positions of influence and contributing from these positions. In this Commentary, the authors consider three roles (educator, faculty developer, and researcher) represented by the community of scholars and pose potential research questions as well as suggestions for advancing educational research relevant to eliminating racism and bias in HPE.
Because no distinction is made in the Council on Social Work Education's educational standards about the frequency, intensity, or pervasiveness of the various forms of oppression, social work education affirms what may be called the equality-of-oppressions paradigm. This article contends that, although the equality-of-oppressions paradigm is a valuable perspective, its ascendancy in social work education may be placing the coverage of people-of-color content at risk of being diminished. This article examines two implications of the equality-of-oppressions paradigm for people-of-color content: (1) the expanded definition of diversity, and (2) racism's persistence in social work education. The article also offers a model of differential vulnerability to help prioritize the various forms of oppression important to social work education.
Work (NASW) Code of Ethics, and it is pro-moted in numerous practice textbooks. His -torically, cultural competence with diverse populations referred to individuals and groups from non-White racial, ethnic, or cul-tural origins. However, the term has evolved to encompass group differences pertaining to gender, sexuality, religion, age, ability, lan-guage, nationality, and others. Knowledge about the complexity of personal and social identity formation as well as the intersection-ality of multiple axes of oppression that underscore social work problems, practices, and interventions led to the broadening of cul-tural competence beyond racial and ethnic categories (Razack, 1999; Rothman, 2008). Scholars note several challenges associated with the dominant cultural competence Cultural competence is a fundamental tenet of social work education. Although cultural competence with diverse populations historically referred to individu-als and groups from non-White racial origins, the term has evolved to encom-pass differences pertaining to sexuality, religion, ability, and others. Critics charge that the cultural competence model is largely ineffective and that its ten-dency to equalize oppressions under a "multicultural umbrella" unintentional-ly promotes a color-blind mentality that eclipses the significance of institution-alized racism. In this article we argue that critical race theory (CRT) can be used to address some of these noted problems with the cultural competence model. We define the major tenets of CRT and analyze its benefits and limitations for social work pedagogy around race, racism, and other oppressions.
In 1994, the concept of marginalization was explored in an article in Advances in Nursing Science. This is a revisitation of the concept incorporating new scholarship. This update is founded on feminism, postcolonialism, critical race theory, and discourse deconstruction, all viewpoints that have been explicated in nursing. The purpose of this analysis is to look at new scholarship and concepts useful to applying marginalization in nursing knowledge development from the standpoint of Bourdieu's macro, meso, and micro levels. New scholarship includes globalization, intersectionality, privilege, microaggressions, and implicit bias. Implications for decreasing health disparities through this new scholarship are discussed.
Objective. To review and categorize published educational research concerning diversity within colleges and schools of pharmacy. Methods. The Three Models of Organizational Diversity Capabilities in Higher Education framework was used to guide the review efforts. Of the 593 documents retrieved, 11 met the inclusion criteria for review. Each included article was individually reviewed and coded according to the framework. Results. The reviewed articles were primarily influenced by contemporary drivers of change (eg, shifting demographics in the United States), focused on enhancing the compositional diversity of colleges and schools of pharmacy, examined the experiences of underrepresented groups, and suggested process improvement recommendations. Conclusion. There is limited published educational research concerning diversity within schools and colleges of pharmacy. Contemporary drivers of change are influencing this research, but more attention must be given to the focus of the research, individuals targeted, and recommendations suggested. © 2017, American Association of Colleges of Pharmacy. All rights reserved.
Richard Delgado and Jean Stefancic are completing a Tenth Anniversary Edition of Critical Race Theory: An Introduction for NYU Press. This best-selling primer explains the movement's organizational history, major themes, central figures, and likely future. The new edition contains material on developments that have taken place over the past decade, including the rapid growth in the Latino population, nativism against that group, the election of the nation's first black president, and the advent of right-wing populism in the form of the Tea Party Movement. The volume will be available in paperback in early 2011.
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Commentary: racism and bias in health professions education: how educators, faculty developers, and researchers can make a difference
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Childbirth is killing black women in the US, and here’s why. CNN
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Racism in medicine: an 'open secret
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Commentary: racism and bias in health professions education: how educators, faculty developers, and researchers can make a difference
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Racism in medicine: an ‘open secret.’ CNN
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