Anti-racism curricula in undergraduate medical education: A scoping review

PURPOSE: Medical educators have increasingly focused on the systemic effects of racism on health inequities in the United States (U.S.) and globally. There is a call for educators to teach students how to actively promote an anti-racist culture in healthcare. This scoping review assesses the existing undergraduate medical education (UME) literature of anti-racism curricula, implementation, and assessment. METHODS: The Ovid, Embase, ERIC, Web of Science, and MedEdPORTAL databases were queried on 7 April 2023. Keywords included anti-racism, medical education, and assessment. Inclusion criteria consisted of any UME anti-racism publication. Non-English articles with no UME anti-racism curriculum were excluded. Two independent reviewers screened the abstracts, followed by full-text appraisal. Data was extracted using a predetermined framework based on Kirkpatrick's educational outcomes model, Miller's pyramid for assessing clinical competence, and Sotto-Santiago's theoretical framework for anti-racism curricula. Study characteristics and anti-racism curriculum components (instructional design, assessment, outcomes) were collected and synthesized. RESULTS: In total, 1064 articles were screened. Of these, 20 met the inclusion criteria, with 90% (<em>n</em>&thinsp;=&thinsp;18) published in the past five years. Learners ranged from first-year to fourth-year medical students. Study designs included pre- and post-test evaluations (<em>n</em>&thinsp;=&thinsp;10; 50%), post-test evaluations only (<em>n</em>&thinsp;=&thinsp;7; 35%), and qualitative assessments (<em>n</em>&thinsp;=&thinsp;3; 15%). Educational interventions included lectures (<em>n</em>&thinsp;=&thinsp;10, 50%), multimedia (<em>n</em>&thinsp;=&thinsp;6, 30%), small-group case discussions (<em>n</em>&thinsp;=&thinsp;15, 75%), large-group discussions (<em>n</em>&thinsp;=&thinsp;5, 25%), and reflections (<em>n</em>&thinsp;=&thinsp;5, 25%). Evaluation tools for these curricula included surveys (<em>n</em>&thinsp;=&thinsp;18; 90%), focus groups (<em>n</em>&thinsp;=&thinsp;4; 20%), and direct observations (<em>n</em>&thinsp;=&thinsp;1; 5%). CONCLUSIONS: Our scoping review highlights the growing attention to anti-racism in UME curricula. We identified a gap in published assessments of behavior change in applying knowledge and skills to anti-racist action in UME training. We also provide considerations for developing UME anti-racism curricula. These include explicitly naming and defining anti-racism as well as incorporating longitudinal learning opportunities and assessments.