Teaching humanism and racial justice effectively in medical education with implementation of the Presence 5 for racial justice curricula

Anti-racism curricula in graduate medical education (GME) have expanded; evaluation gaps persist. Evaluate Presence 5 (P5) and Presence 5 for Racial Justice (P5RJ) curricula across GME programs, using RE-AIM framework. Mixed methods evaluation including pre- post- surveys and rapid qualitative analysis. Reach: Sixty-eight residents provided survey responses at pre- (n = 38, 55.9%), post- (n = 11, 16.2%), or both (n = 19, 27.9%) timepoints. P5 and P5RJ curricula were implemented in four internal medicine residency programs (academic year 2021–22). Presence 5 (P5) and Presence 5 for Racial Justice (P5RJ) curricula were developed to foster dialogue and promote racial justice in clinical care. Discussion moderators included faculty and residents. Pre-post-curriculum surveys assessed self-reported attitudes and behavior in domains related to P5, P5RJ, and burnout. Questions were adapted from the Consultation and Relational Empathy (CARE) Measure, The California Brief Multicultural Competence Scale, and The Professional Fulfillment Index. For qualitative data, rapid qualitative analysis was performed by coding the written feedback solicited from the P5 and P5RJ Curricula discussion moderators and workshop notes. Effectiveness: Top box results showed positive trends across all P5/P5RJ domains, with increasing reported behaviors around incorporation of patient values and priorities (pre = 19%, post = 50% p = 0.011), and inquiry around patient life stressors (pre = 26%, post = 53%, p = 0.028). Institutional adoption was supported by inclusion of both Underrepresented in Medicine (URiM) and non-URiM discussion moderators and leveraging existing curricular structures. Implementation involved the original curricula and discussion of institution-specific racial justice practices. Maintenance strategies included piloting the curricula with different PGY levels, creating new curricular structures, and utilizing interdisciplinary discussion moderators. P5 and P5RJ curricula hold promise for changing attitudes and behaviors to promote humanism and racial justice in GME. Institutions can adopt and adapt these curricula to serve diverse needs of their learner and patient communities and to advance more equitable patient care.