Kate T Chazin, Jennifer R Ledford, Jane M Wilson-Moses, Adithyan Rajaraman, A Pablo Juárez
Centering Autistic Perspectives: Social Acceptability of Goals, Learning Contexts, and Procedures for Young Autistic Children
Journal of autism and developmental disorders
health disparities military health system mhs consistently documented despite system ensuring equal access care beneficiaries research shown social economic political factors ie social determinants health health carespecific factors like provider bias systemic discrimination key drivers health disparities general population medical education focused introducing concepts using casebased learning led effective learning health equity terminology however significant gap exists identifying optimal teaching approaches develop skills recognize factors actual clinical cases begs milliondollar question casebased learning help trainees acquire skills needed identify main factors contributing health disparities mhs longitudinal casebased curriculum developed clinical cases internal medicine wards medical intensive care unit general internal medicine clinic national capital consortium solicited trainees analyzed evidence health care provider bias systemic forms discrimination using small groups national capital consortium internal medicine residency program implemented pilot study november 2021 retrospective pretestposttest survey assessing trainee reactions curriculum changes selfreported confidence skills used curriculum assessment survey data analyzed using paired samples ttest survey administered last session 20222023 academic year 14 23 available trainees completing 608 response rate overall 93 reported cases selected academic year engaging skills taught practicechanging educational value curriculum good good excellent confidence ratings assessed via 5point likert scale demonstrated statistically significant increase selfreported confidence following skill domains large effect sizes identification bias systemic discrimination clinical caseschange mean 107 pre 329 post 436 p 001 g 138 recognizing mitigating personal biaseschange mean 071 pre 350 post 421 p 001 g 110 participating discussion health care provider bias systemic discriminationchange mean 079 pre 357 post 436 p 001 g 106 leading discussion bias systemic discriminationchange mean 100 pre 293 post 393 p 002 g 098 need address health disparities united states becomes pressing need military physicians recognize drivers disparities within mhs results pilot study health equity rounds suggest casebased learning may optimal teaching approach improve skills military internal medicine trainees identifying recognizing impact health care provider bias systemic discrimination clinical cases mhs