P3.193: Reflecting On Our Biases: A 30-Day Curriculum to Address Pediatric Health Disparities

Background: Equity, Diversity, and Inclusion (EDI) are vital to delivering effective healthcare and reducing disparities affecting marginalized pediatric populations. Yet, medical training often lacks opportunities for trainees to learn about experiences of individuals from different backgrounds and self-reflect on implicit biases that contribute to health disparities. 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.

Project Description: Our objective was to evaluate how reflective learning within a self-guided 30-day EDI curriculum enhances trainees’ self-awareness, EDI competency, and confidence in addressing pediatric health disparities. A mixed-methods prospective cohort study was conducted in April 2024, involving pediatric trainees (medical students, residents, and fellows) and attendings who voluntarily participated. The curriculum covered four weekly themes: (1) Introduction to EDI and Cultural Humility, (2) Social Determinants of Health, (3) Disparities & Inequities in Neonatal, Infant & Child Health, and (4) Community Health of Specific Populations. Participants engaged with content through four domains (Read, Watch, Listen, Engage), designed to accommodate diverse learning styles, and were encouraged to complete two daily tasks and submit weekly reflections. Interactive discussions with national EDI experts occurred in weeks 1 and 4 via webinars. Pre- and post-surveys, linked by unique identifiers, assessed changes in knowledge and comfort addressing pediatric health disparities using a 5-point Likert scale. Descriptive statistics summarized cohort demographics, and paired t-tests analyzed changes.

Discussion: The study cohort included 450 participants. 325 people or 72% completed the pre-survey. Of those who completed the pre-survey, 60% were attendings and 40% were pediatric trainees. Participants described expanding knowledge, improving care, familiarity with best EDI practices, and understanding marginalized patient issues as key motivations for engagement. A statistically significant difference was observed for all survey domains from the pre to post survey (with P< 0.05) with an enhanced understanding of topics including cultural humility, equity, and pediatric health disparities. When results were stratified based on learning group, attendings had a statistically significant difference in comfort and understanding of neonatal child health outcomes, dermatologic conditions, and children with neurodiversity. (p < 0.05) Pediatric trainees had a statistically significant difference with comfort in topics including taking care of marginalized patients, intersectionality, positionality, and privilege (p < 0.05). Participation increased >20-fold after CME credit was added in the 2nd year edition of the curriculum.

Conclusion: 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 medical education.