P3.151: Use Your Words: Building Trust and Equity in Medicine Through Communication Skills, An Application of the AAMC DEI Competencies Framework

Background: A 2017 report by the Accreditation Council for Graduate Medical Education (ACGME) highlighted a deficiency in the preparedness of trainees to identify and address health disparities. In 2022, the Association of American Medical Colleges (AAMC) released its Diversity, Equity, and Inclusion (DEI) Competencies, providing a structured framework to identify and address educational gaps. Our primary objective was to use this framework, in combination with a local needs assessment, to develop a curriculum to empower residents to develop skills to identify, address, and mitigate health inequities. Our secondary objective aimed to use the competencies to evaluate a new curriculum’s impact on residents’ confidence in communicating and caring for diverse patient populations.

Methods: Applying Kern’s methodology, results of an institutional needs assessment were used to identify training gaps in advancing diversity, mitigating stigma, practicing anti-racism, and fostering belongingness. Based on these results, a two-part curriculum was designed. A two-hour classroom session was led by health equity leaders and educators and included a community circle and didactic. During the 60-minute circle, invited community members shared their lived experiences and perspectives on trust and communication in health care. The didactic aimed to improve residents’ baseline knowledge of health equity topics, while emphasizing trust-building and communication skills. In the simulation session a week later, resident teams rotated through cases focused on communicating with patients from diverse marginalized backgrounds. Residents received feedback on communication skills from standardized patients and community members. Evaluation included a retrospective post-then-pre survey administered after the simulation session, and qualitative feedback via survey and post-session debrief.

Results: The curriculum was delivered to a total of 70 residents between January and February 2025. Of participants, 41 residents (59%) completed the post-session survey. The curriculum covered the following AAMC competencies: valuing the impact of identities and experiences, mitigating stigma and biases, practicing anti-racism, fostering belongingness, providing culturally responsive care, and the additional domain of interprofessional communication. Participants rated themselves across these competencies (Table 1). After the curriculum, most surveyed participants (> 50%) felt more confident in the following skills: considering diverse dimensions of a patient in their assessment and plan (58.6%), fostering belongingness (51.3%), demonstrating allyship (58.5%), using language interpretative services (51.2%), and communicating effectively with patients from diverse backgrounds (51.2%) (Table 2). Inclusion of open dialogues with community members was noted to be valuable in helping build empathy and developing improved communication skills.

Conclusion: The AAMC DEI competencies provide a useful framework in both assessing learners’ knowledge and skills in health equity domains at different stages of training, as well as the impact of curricula and experiences designed to address DEI educational gaps. Future directions include longitudinal tracking of residents' competencies using the AAMC framework to identify evolving needs and integrating more direct community engagement opportunities.