Title

Medical Student Perceptions, Attitudes, and Beliefs about Diversity, Equity, Inclusion, and Racial Advocacy Education in a Medical School Curriculum

Authors

Oreoluwa E. Olakunle*, Olivia Veira*, Molly Lavaud, Tamia Ross, Jenny Nguyen, Tuzo Mwarumba, Michaela Whitelaw, Grace Nguyen, & Tracey L. Henry

Introduction

Diversity, equity, inclusion, and antiracism pivoted to the forefront of undergraduate and continuing medical education with the murder of George Floyd in 2020. At the same time, racially inequitable morbidity and mortality during the COVID-19 pandemic heightened awareness of structural racism and the role of physicians in addressing and preventing its harmful health impacts. Because of these concomitant racial reckonings and the resultant student advocacy, the Emory University School of Medicine (EUSOM) approved the Diversity, Equity, Inclusion, and Racial Advocacy (DEIRA) thread in 2020. The DEIRA thread team conducted an annual survey of student attitudes, perceptions, and knowledge of the DEIRA thread to gauge program effectiveness proactively. The data obtained from these surveys provide a unique snapshot of medical students’ attitudes about diversity, equity, and inclusion (DEI) in medical education. It also offers key insights into how to continually improve the DEIRA curriculum at EUSOM and similar programs at other medical schools around the country.

Methods

Data was obtained from annual surveys administered to EUSOM classes of 2022, 2023, 2024, and 2025 by the DEIRA team. On the Qualtrics-administered survey, students were asked to respond to statements using a Likert scale and to several open-ended questions. Demographic data were also collected. Survey results were analyzed to obtain quantitative measures of the evolving attitudes and perceptions of the DEIRA curriculum. A thematic analysis was also conducted to explore reoccurring themes from the open-ended responses.

Results

There was a significant response rate for the survey in the classes of 2022, 2023, 2024, and 2025 (n= 77, 55, 130, 112) respectively. Half of the respondents identified as White, 20% as African American, 9% as Asian Indian, 6% as Chinese, and the remainder (15%) identified as not listed, Middle Eastern and/or North African, or Asian- otherwise unspecified. Most respondents (mean = 89%) agreed or strongly agreed that understanding the consequences of racism in the U.S. on health and healthcare is important for medical students. Increasingly, students agreed or strongly agreed that there should be more curricular time devoted to racial issues (mean = 66.25%). Although students consistently recognized the importance of being an upstander (mean = 88.75%), they were less likely to report that they have developed skills to become effective upstanders for patients and other healthcare professional colleagues in the classroom or clinical setting (mean = 58.75%). Accordingly, less than half of respondents indicated that the curriculum has equipped them to address racial inequities through advocacy (mean = 39.25%). In addition, through qualitative responses, students requested further discussions of topics such as ableism, Latinx health inequities, and heterosexism.

Conclusion

Students consistently reported that understanding the social determinants of health, recognizing the consequences of racism in the United States on health and healthcare, and learning how to advocate for racial equity are essential for medical education, but perceptions of the DEIRA initiative varied. Future directions can focus on more structured mechanisms to provide insight into how students perceive the quality and value of DEI programs as more medical institutions begin to adopt similar curricular developments.

References

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