Category Archives: Uncategorized

Socialization and Implicit Bias

Review the following terms from the EHM WordPress Lexicon. Identity, Implicit Bias, Cultural Competency and Narrative Humility.

Discover the basic tenets of socialization. Watch the following video to develop a basic understanding of socialization.

Socialization: Crash Course Sociology #14

 

Understand how bias is ubiquitous. Watch the following video to understand how bias is an everyday part of our lives.

“Are you biased? I am.” | Kristen Pressner | TEDxBasel

 

Read the systematic review and focus on the sections of “Background” (2-3) and “Existence of Implicit biases/stereotypes…” (13-14).   Gain an appreciation of how implicit bias can lead to direct and indirect consequences in patient care.

FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics. 2017;18:19. doi:10.1186/s12910-017-0179-8. 

 

Supplemental.

  1. Refresh your memory on how narrative humility can improve our experience with patients.  Reread the article from Immersion – The art of medicine – Narrative Humility.
  2. Learn basic first steps for recognizing bias in your communication and interaction with others. Read the last sections on “Checking Perception” and “Getting Competent – Communication in the Real World: An Introduction to Communication Studies. 2.4 Improving Perception: http://open.lib.umn.edu/communication/chapter/2-4-improving-perception/   

Community Visit

Complete the readings

READ: Entering and Exiting Communities

  • Whether you’re working with a partner, conducting a site visit, doing research, or getting to k now folks in a community, it helps to think through the before, during, and after to create a comfortable, safe, and reciprocal experience

READ: Collins, Janet, and Jeffrey P. Koplan. “Health impact assessment: a step toward health in all policies.” Jama 302.3 (2009): 315-317.

  • Instructions: Review social and structural determinants of health and how they apply to communities and health outcomes.

 

Supplemental readings and resources (not required)

Community Engagement in Population Health

Optional reading:

This article presents an overview of the mechanisms by which community-based organizations can contribute to community well-being. Consider the implications for local communities you have worked in, and think about questions you’d like to ask panel members about their work.

Institute for Healthcare Improvement

The Ecology of Health and Medicine course will introduce students to the field of health care improvement.  Students will become acquainted with key concepts of improvement science including quality measurement, improvement methodology, patient safety, population health, and health care leadership throughout the remainder of the course.

The EHM course has been designed to parallel the Institute for Health Care Improvement (IHI) Open School online certification course in quality improvement and patient safety.  This educational resource provides additional depth and detail to augment the EHM course material.  Several individual lessons from the online course will be used as required prework for the EHM course.  This prework will enable us to utilize classroom time for practical application of the material to health care situations and systems.

Interested students are encouraged to take advantage of this opportunity to obtain the IHI Open School Basic Certificate in Quality and Safety.   Modules that relate to the coursework will be identified as required or optional out of class work.   Students who complete the IHI optional modules as listed will successfully complete the online certification by the conclusion of the EHM course.  Certification offers the advantage of acquiring the skills and knowledge required to productively participate in quality improvement work.  Students who are certified are attractive to their clinical faculty not only because certification demonstrates commitment to health care excellence, but also because these students are well prepared to contribute to projects and research.  Residency programs are emphasizing health care quality and patient safety as key domains in providing an ideal learning environment for trainees.  Students who demonstrate understanding and skills in improvement science are well positioned to be leaders in this program process.

This document describes how to register and access IHI modules.

MD-MPH Joint Degree Programs at the University of Washington School of Public Health

UW School of Medicine Students who have a special interest in making social determinants of health and advocacy part of their medical careers are encouraged to explore information on the joint MD-MPH programs offered by the UW School of Public Health. Information on the different programs available can be found at: http://sph.washington.edu/mph/. The programs most relevant to social determinants of health are health services (focused on the US health system), global health (focused on health systems in resource-limited settings), environmental health (focused on climate change, worker health, etc.), and epidemiology (focused on the distribution and determinants of diseases and other health conditions). Interested students are encouraged to reach out to those programs for information on program structure and content and on the application process and deadlines.

Key Ethics Concept: Care Ethics

Care ethics began as a feminist perspective on ethics. Some of its founders (e.g. Carol Gilligan, Nel Noddings and Virginia Held) stressed that traditional ethics neglected roles and values that were stereotypically attributed to women, such as care and empathy.

Care ethics begins from a different metaphysical stance on identity. It conceptualizes humans as fundamentally relational, interdependent, and emotional.

The ethical approach starts from this position of relationality and focuses on the value of creating and sustaining caring relations. Care ethicists sometimes disagree about what this means, but overall the stance is different from other theories insofar as it places our relationships with others as the primary focus of ethical analysis. So, rather than ask ourselves “what are my ethical obligations?” or “what are my ethical duties and rights?”, we instead ask “how can I cultivate caring relationships?”.

In the clinical setting, this approach can change our actions insofar as it asks us to think about our particular relationships first. Think about the case of a “difficult clinician-patient encounter”. Care ethics would ask us to think about how to repair the relationship first and then move towards figuring out the best treatment options. Likewise, in the case of a non-adherent patient, care ethics would ask us to think about what relationships are obstructing adherence and how they might be appropriately changed to best instantiate care.