218 - Reflecting On Our Biases: A 30-Day Curriculum to Address Pediatric Health Disparities

Publication Number: 218.6298

Ashley Nmoh, Duke University School of Medicine, Durham, NC, United States; Brigette Obokhae, St. George’s University School of Medicine, Brooklyn, NY, United States; Amundam S. Mancho, Boston Children's Hospital, Boston, MA, United States; Kendra D. Moore, University of North Carolina at Chapel Hill School of Medicine, Durham, NC, United States; Erika C. Cravanas, Duke University School of Medicine, Raleigh, NC, United States; Christine C. Cheston, Boston University School of Medicine, Boston, MA, United States; Carmel Bogle, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Brittany K. Nagy, American Academy of Pediatrics, New Lenox, IL, United States

Background: Equity, Diversity, and Inclusion (EDI) are vital to delivering effective healthcare and reducing disparities affecting marginalized pediatric populations. Medical training lacks opportunities for trainees to learn about experiences of individuals from different backgrounds. Integrating reflective learning into structured EDI education may enhance self-awareness and build comfort in addressing disparities. This study examines how reflective learning within an EDI curriculum influences trainees' knowledge and comfort in addressing pediatric health disparities.

Objective: To evaluate how reflective learning exercises within a self-guided 30-day EDI curriculum enhances trainees’ self-awareness, EDI competency, and comfort in addressing pediatric health disparities.

Design/Methods: We conducted a mixed-methods prospective cohort study in April 2024. Pediatric trainees and attendings opted-in to the curriculum. 4 weekly themes included 1) Introduction to EDI & Cultural Humility, 2) Social Determinants of Health, 3) Disparities in Neonatal, Infant & Child Health, 4) Community Health of Specific Populations. The curriculum, designed with 4 engagement domains (Read, Watch, Listen, Engage), encouraged participants to complete at least 2 daily tasks and submit weekly reflections. Interactive discussions with national EDI experts were held in weeks 1 and 4. Participants completed pre and post-surveys linked by unique identifiers to measure changes in knowledge and comfort in addressing pediatric health disparities using a 5-point Likert scale. Descriptive statistics were used to describe cohort demographics; t-tests were used to analyze changes.

Results: The cohort included 450 participants. 87% completed all curriculum activities and 90% completed both pre and post-surveys. Participants described expanding knowledge, improving care, familiarity with best EDI practices, and understanding marginalized patient issues as key motivations for engagement. A significant increase in self-reported comfort with EDI topics and addressing health disparities was observed (CI 1.7-2.4; p = .03) from pre to post-survey. Participation increased >20-fold after CME credit was added in the 2nd year edition of the curriculum.

Conclusion(s): The integration of reflective learning in an EDI curriculum was associated with increased comfort and competency in addressing health disparities. Reflective exercises deepened participants’ understanding of biases and empowered them to apply EDI principles in care. These findings suggest reflective learning could be a valuable tool to enhance the effectiveness of EDI training in future studies.