WMJ Vol 123 Issue 2: Critical Reflection to Investigate Medical Student Attitudes Toward Skin Tone in Their Preclinical Years

ABSTRACT

Introduction: Implicit racial bias, defined as unreasoned judgement based solely on an individual’s skin color, is a persistent barrier to quality medical care for people of color in the United States. Early, learner-centered intervention is crucial to establish cultural competence within health professional training programs.

Methods: Over 3 academic years, preclinical, second-year medical students were asked to submit an anonymous critical reflection regarding skin tone in medicine (n=794). Critical reflection is an instructional approach that encourages students to investigate their own thoughts and actions. Course credit was given based on the honor system. Reflection submission content and student feedback were analyzed quantitatively and qualitatively using constructivist thematic analysis.

Results: Most students completed the assignment (93.0%) and reported feeling comfortable expressing themselves honestly in the anonymous format (84.6%). Students’ comfort level with honesty declined if they would have had to identify themselves (50.8%). Student comments indicated relief to have a place to process experiences and emphasized the importance of anonymity for value of this assignment. Thematic analysis identified 2 themes and 13 subthemes among student submissions. Submissions varied in format and typically contained multiple codes (4.08 ± 1.77 subthemes), indicating that students participated meaningfully in the assignment.

Conclusions: Although some educators may hesitate to address these topics, students at our institution appreciated having a space to process their thoughts. This assignment structure is an effective way for educators to address a difficult, sensitive, and important topic in a meaningful way with students.

Intended Audience

The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.

Learning Objectives

As a result of this journal-based activity, learners as members of the healthcare team will be able to:

  1. Describe a critical reflection assignment in a dermatology course designed for medical students to express their attitudes toward skin tone in relation to the care they provide as future physicians.
  2. Summarize the results of constructivist thematic analysis of students’ critical reflection submissions.
  3. Elaborate on applicability of a critical reflection approach as a learner-centered intervention in addressing implicit racial bias during undergraduate training of healthcare professionals.
Course summary
Available credit: 
  • 1.00 AAPA Category 1 CME
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™
Registration opens: 
08/15/2024
Course expires: 
08/14/2025
Cost:
$0.00
Part of: 
Wisconsin Medical Journal Volume 123
Rating: 
0

FACULTY DISCLOSURE

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE).  In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Name of IndividualIndividual's Role in Activity

Financial Relationship Disclosure

Discussion of
Unlabeled/Unapproved
Uses of Drugs/Devices
in Presentation?

Marianna Shershneva, MD, PhDAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Molly Thapar, BSAuthorNo relevant relationships with ineligible companies to discloseNo
Elizabeth Dominguez, BSAuthorNo relevant relationships with ineligible companies to discloseNo
Katarina Stark, MDAuthorNo relevant relationships with ineligible companies to discloseNo
Johnathon Neist, MLISAuthorNo relevant relationships with ineligible companies to discloseNo
Kerrie Quirk, MEdAuthorNo relevant relationships with ineligible companies to discloseNo
Malika Siker, MDAuthorNo relevant relationships with ineligible companies to discloseNo
Jeffery D. Fritz, PhDAuthorNo relevant relationships with ineligible companies to discloseNo
Gretchen M. Roth, MDAuthorNo relevant relationships with ineligible companies to discloseNo
Teresa Patitucci, PhDAuthorNo relevant relationships with ineligible companies to discloseNo
Brenda Rooney, PhDReviewerNo relevant relationships with ineligible companies to discloseNo
Thalia Williams, MSPH, PhDReviewerNo relevant relationships with ineligible companies to discloseNo
Fahad Aziz, MDEditorNo relevant relationships with ineligible companies to discloseNo
Jennifer Esch, PharmD, MBA, BCPSReviewerNo relevant relationships with ineligible companies to discloseNo
Laura Ozkan, PAReviewerNo relevant relationships with ineligible companies to discloseNo
Caitlin Weitzel, APNP, ACNP, MSNReviewerNo relevant relationships with ineligible companies to discloseNo

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.

Discloser List CME Internal Report

Accreditation

Accreditation Statement

Jointly Accredited Provider LogoIn support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Credit Designation Statements

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.  

AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)

The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs  (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until 08//27/2025. PAs should only claim credit commensurate with the extent of their participation.

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.

Available Credit

  • 1.00 AAPA Category 1 CME
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™

Cost:
$0.00
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