Moderated by Michael Cossoy
Session Coordinator: Belinda Carrion

AWARD NOMINEE
Presentation 1  - Integrates but Separate: How to Enhance Recognition of Discipline Core Concepts in Horizontally & Vertically Integrated Curricula
Youngjin Cho
Geisinger Commonwealth School of Medicine

Purpose
With increasing utilization of horizontally and vertically integrated curricula, learners have difficulty recognizing and building upon core concepts of immunology, which is presented infrequently throughout the curriculum and in USMLE and often combined with other discipline contents. We designed a strategy that highlights core concepts, pathophysiological contexts, and links to other disciplines in our integrated curriculum. 

Methods
Using backward design (Wiggins & McTighe, 1998), we implemented the four-step strategy. First, we mapped immunology instructions throughout the four-year curriculum, determining applicable core concepts. Second, relevant core concepts were refined through a student focus group and reviews of a free-access curriculum database (Aquifer Sciences TM) and literature. Third, in each immunology instructional module, we placed a linkage table. The linkage table included new and reviewed core concepts, applicable clinical context, and connected material from other disciplines. Additionally, a stop sign was used as a visual cue directing students to important core concepts to review. Lastly, in strategic placement of content, our medical students first learned the basic structure and function of the immune system with 7 short videocasts over two days. The remaining 22 immunology modules containing the linkage table were presented over 12 months within organ system-based courses. 

Results
In our Graduate Questionnaire, students' ratings on preparedness for a clerkship with the study of immunology increased by over 40% over four years. In our block evaluations, student comments that previously expressed difficulty with the conceptual understanding of immunology disappeared, replaced with comments that expressed positive experiences with instruction. Students' performance on immunology assessment items in block exams improved. 

Conclusion
Visual strategies to consistently highlight core concepts strengthened students' recognition of immunology discipline and core concepts. This strategy has been successfully applied to other disciplines, such as microbiology, and has been durable with our recent curriculum renewal process.

AWARD NOMINEE
Presentation 2 - Using a Cultural Competency Inventory to Assess Medical Student and Faculty Cultural Mindsets
Heather Christensen
University of Cincinnati

Purpose
Despite cultural competency requirements for US medical schools, a standardized curriculum to measure these skills does not exist. The purpose of this study was to introduce a validated tool (Intercultural Development Inventory; IDI®) within an undergraduate medical curriculum, to measure intercultural competence and assess whether this tool enhances understanding of cultural competence in medical students and teaching faculty. This tool evaluates movement along an Intercultural Development Continuum (IDC®), using five orientations from monocultural orientation to global mindset.

Methods
First-year medical students (M1s ; n=177) and faculty (n=24) completed the IDI; participants received individual results revealing their perceived and actual cultural humility mindset. Students received individual development plans, and participated in a class-wide review of aggregated (anonymous) M1 cohort results. Faculty had 1:1 coaching on their results, completed an in-house survey, and received a teaching guide. The same cohort of students will complete the IDI again (2023), to assess movement along the IDC.

Results
Ninety-eight percent of students (strongly)-agreed cultural competency is valuable in medical education. Students perceived they held intercultural (87%) vs monocultural (13%) mindsets. Aggregate IDI results revealed the M1 "perceived orientation" on the IDC to be "Acceptance", a more advanced orientation than their actual cultural mindset, which the IDI revealed to be a transitional mindset. This "perceived-vs.-actual" delta shows M1s overestimated their intercultural competence, and they may feel more adaptive than they likely are. Faculty taking the IDI reported increased understanding of students' cultural competency, preparedness to audit course content, and adequacy of faculty and student training. After the intervention, faculty were less likely to agree that they knew ""next steps"" to take with cultural sensitivity. 

Conclusions
Students overestimated their cultural competence, which supports using this tool early in medical education as they form professional identities. This project increased faculty confidence in this arena, and revealed areas for faculty development.

AWARD NOMINEE
Presentation 3 - Antiracism Education in a Diverse Pre-Clinical Setting: What Students Know and What Students Want
Karie Gaska
Ross University School of Medicine

Purpose
The wave of activism across the U.S. in 2020 brought new resolve to address racism in medicine and medical school curricula. Students and faculty brought the Antiracism Reading Program to Ross University School of Medicine (RUSM) in the summer of 2020, currently still being implemented. A challenge in antiracism education is meeting the needs of all students who bring varied experiences to the classroom. The current presentation reports on students' qualitative experiences in a large and diverse population of first semester medical students. 

Methods
Our program, adapted from the University of Washington, includes pre-reading and small group discussions co-facilitated by students and faculty for all incoming first semester students. A total of 1,059 students participated in the program between fall 2020 and Spring 2022 with 803 completing post program surveys. We began preliminary qualitative analysis of the free responses provided regarding student understanding of racism in medicine and what they would like to see in the antiracism curriculum. 

Results
In terms of student awareness of how racism impacts clinical medicine, responses ranged from having no awareness to very specific personal examples. Other responses fell under these categories: 1) physician bias leading to poorer outcomes 2) BIPOC patients receiving worse care 3) awareness of specific historical links, and 4) structural racism impacts. Students wanted to see: 1) logistical changes 2) encouraging more participation 3) enhancement through pre/post activities 4) space to share personal experiences 5) ideas for action steps 6) more opportunities throughout the curriculum, and 7) including the impact of other forms of oppression in the antiracism curriculum. 

Conclusion
Results highlight the need to understand specific learner experiences regarding antiracism. Weighing the importance of personal sharing while ensuring BIPOC students and members of minoritized communities are not coerced into the emotional labor of educating their peers is an area for investigation.