Share

PEBT

Reimagining the Curriculum Through the Lens of Anti-Racism

May 16, 2022
Reimagining the curriculum through the lens of anti-racism

By Alyssa Haywoode
Contributing Writer

The MGH Institute has long been committed to inclusion, but in the face of the COVID-19 pandemic, an increase in racial injustices, and the insistence of students, the school has embarked on weaving justice, equity, diversity, and inclusion into the curricula in all its programs.

While some programs are further along than others, all are making impressive strides to incorporate principles that will result in students and graduates who are better prepared to care for an increasingly diverse population.

profile photo of callie
Callie Watkins Liu

“This is transformative work that has to happen through collaboration and partnerships,” says Callie Watkins Liu, the IHP’s first director of curriculum, pedagogy, and faculty support in the Office of Justice, Equality, Diversity, and Inclusion (JEDI). “It’s about supporting everyone so they can step into leadership roles and add their voices to this work.”

Watkins Liu has taken a customized approach to address the needs of every program. She meets with faculty members to review their syllabi and case studies. She joins faculty meetings to discuss issues or develop plans. She helps students, faculty, and staff process emotionally challenging JEDI issues. She designs and runs workshops. She works with student JEDI Fellows, who are embedded in programs to assist efforts. And she fosters conversations so faculty and staff can become resources for each other.

“The goal,” she says, “is to move the whole institution forward so it can become a place of deep, anti-oppression leadership and practice.”

***

In the School of Nursing, students have been vocal advocates for change, which has led to creating a JEDI Curriculum Task Force that includes faculty, students, and JEDI Fellows.

“We started with a needs assessment,” Dr. Patricia Reidy, the associate dean of academic affairs and program innovation, says. “We asked students where they saw gaps in the curriculum. We asked faculty if they were incorporating JEDI concepts into their courses. Based on the feedback, we provided resources and faculty development programs to integrate JEDI content in all our nursing programs.”

Corliss Kanazawa, a JEDI Fellow and a Master of Science in Nursing student, proposed that three workshops—on critical race theory, implicit bias and microaggressions, and intersectionality—be integrated into the curriculum for students in the Bachelor of Science in Nursing program. Kanazawa helped run the intersectionality workshop, which featured a case study about a female, Latina, cisgender patient with COVID-19 who is an immigrant and a member of the LGBTQ community. In the scenario, the patient and her girlfriend face eviction. While at an urgent care facility, she is treated differently than white patients. 

“It was a chance for people to talk about why people with different skin colors aren’t trusted when they describe their complaints,” she says. Integrating nursing and JEDI content can be demanding, Kanazawa explains, but well worth the effort. “This will help students become providers who understand more about their roles and who are better able to help patients,” she says.

Nursing faculty are also actively involved in this work.

“We’ve had a lot of faculty development on JEDI topics. Our faculty and students of color have been brave in sharing their experiences, which helps us all think about our own biases. It’s hard work, but our experts in the JEDI Office are always telling us, ‘You have to be comfortable being uncomfortable,’ and that’s what we’re doing.”

- Dr. Rebecca Hill, program director for the nursing school’s prelicensure program

“We cannot be innocent bystanders,” notes Dr. Margie Sipe, the director of the Doctor of Nursing Practice (DNP) program.

The program asks the working nurses in the program to share the challenges they see at work, providing real-life examples on which they can work together to practice best ways to address them using principles of justice, diversity, equity, and inclusion. DNP students also study population health, so they think about challenges such as people’s access to food, public transportation, and the negative effects of climate change. “Our students are tackling these issues as leaders,” Sipe says, “and what we’re hearing from them is, ‘We never learned about this before. People didn’t talk about it.’”

***

lisa wears a blue top and aqua patterned scarf
Lisa Walker

The Department of Physician Assistant Studies has been incorporating JEDI principles into its curriculum since the first day of classes began in 2015. “We have a course in the first semester that covers implicit bias, racism and health care, health inequities, and social determinants of health,” says Lisa Walker, the department chair. “But when we started, it was a one-and-done class.”

So, the department formed a committee of faculty and students, conducted a survey of students, faculty, staff, and alumni, and rewrote its mission and goals to ensure inclusion principles are incorporated every semester.

Walker also asked faculty members to bring in JEDI content that could be integrated more broadly. The result was change across the curriculum. “Most of the images we were using featured white skin, so our dermatology course coordinator brought in a physician from Mass General whose expertise is dermatology on skin of color, and he did a session for students which was of great value,” she says.

“In our cardiovascular course, we teach students about the health inequities around revascularization versus amputation,” she adds. “If someone has a blocked artery or vein in their leg, revascularization lets you create new blood flow. This procedure is offered more frequently to white patients, while Black patients are more likely to undergo amputation. By raising our students’ awareness of these health inequities, we hope they will become aware of their own biases and advocate for their patients of color.”

When the pandemic prevented students from their fieldwork clinical placements, the department created a virtual clinical rotation on the social determinants of health. Students raved about it. So even after a virtual rotation was no longer required for social distancing, faculty incorporated the content into on-campus seminars. The course has students focus on the impact of social determinants on the patients they see during their clinical placements and strategize approaches to address those social circumstances that impact patients’ health.

“Learning this content has to be ongoing so students understand what it means to be aware of their own biases as they practice, how to practice in an unbiased way, and how to continually assess their interactions with patients,” Walker notes.

The department also prepares students to be leaders and advocates, with many attending national meetings and meeting with members of Congress. “What they’re experiencing,” Walker says, “is that they can take what they’re learning and advocate for real change on the state and federal levels.”

***

keshrie wears a grey blazer and has chin length black hair
Keshrie Naidoo

“Our program has cross-curricular threads, elements that are in every course, like professionalism, evidence-based practice, and clinical decision making,” says Keshrie Naidoo, director of curriculum and coordinator of the Clinical Residency in Orthopaedic Physical Therapy program.

Last summer, the department added a social justice and health equity thread to the Doctor of Physical Therapy curriculum. Faculty use patient case studies that students follow throughout each course. Each case, she says, highlights social determinants of health so students learn about the medical and nonmedical factors that influence patients’ health. Over time, the cases grow more complex and include more information about different aspects of how patients’ identities intersect. 

“Students think about the effects of racism, social capital, and political contexts on health,” Naidoo says. “They think, ‘I’m not a politician. How am I going to make changes in my patient’s life?’ So we introduce structural competencies, asking them to start at the interpersonal level and then think about change at the community level, in research, and in policy.” 

The department also has created professional development content to increase faculty awareness of the inequities in the classroom. While some students live in high-priced housing near campus and can walk to school, others must commute for two hours and/or take public transportation. Another example: Students from minoritized backgrounds have unique needs as they experience bias and discrimination. 

“It’s a way to increase faculty members’ awareness of individual students’ experiences,” Naidoo says. “It isn’t just the responsibility of faculty of color to support students from minoritized backgrounds. It’s the responsibility of all faculty members.” 

***

“Our profession has always included cultural and social contexts,” says Dr. Regina Doherty, chair of the Department of Occupational Therapy. “Even so, we’ve expanded the work we do around integrating anti-racism into our teaching and pedagogy. We’ve done a lot of reflection. And we’re working on a thorough analysis of our content and curriculum.” 

regina wears a royal blue top and speaks at a podium into a microphone
Regina Doherty

The department is threading anti-oppression principles through its foundational courses and thinking more critically about how to assess whether students are learning these concepts. “We are shifting from an implicit curriculum to an explicit one,” she explains. “It’s not just that students should use JEDI concepts, it’s that they must.” 

Annika Chan, an OTD student and a JEDI Fellow in the School of Health and Rehabilitation Sciences, has been working closely with leadership within the SHRS Anti-Oppression task force to design JEDI initiatives. She points to several JEDI-infused classes, including one taught by Dr. Sarah McKinnon, as examples of how this work is making a difference. “The class helped us uncover our own biases,” says Chan. “We also learned about the systemic racism that exists in our professions and in health care. It was a very safe space where we could challenge ourselves.” 

To create more of these opportunities, the department is developing additional content for its upcoming summer and fall classes as well as providing faculty with more resources. “We’re building a bridge that links theories and concepts to what JEDI competencies look like in practice,” Doherty says. “We want students to see how occupational therapists can address social and structural inequities, especially since we work with persons with disabilities, who can be vulnerable to the intersection of racism and ableism. We want our students to understand that to deliver true client-centered care, they must deliver just client-centered care.” 

***

Maureen wears a black dress with puffed sleeves and stands at a podium
Maureen Flynn

The Master of Science in Genetic Counseling program began in Fall 2019 with a focus on JEDI principles. Every semester, students take a seminar course with both cohorts and faculty in attendance; the courses have been designed with JEDI principles as the framework, with modules including LGBTQIA+, disability justice, linguistic equity, accessibility, economic justice, neurodiversity, and the intersection of racial and disability justice. First- and second-year students are paired to present articles and share clinical cases connecting to the module theme of the week. By bringing everyone together, says the program’s chair, Maureen Flynn, the course draws on and shares lived experiences, while taking a deep dive into the dark history of medical injustice and eugenics. 

“A lot of students don’t know the history of medical eugenics, and how it is not just history, but is ongoing today,” she says. “This is the path forward: If you pause, think, and ask the right questions, you will inevitably find systemic racism and oppression. If you don’t ask the right questions, you don’t get answers and you can’t make change.” 

This approach, she notes, inspired one student to ask a sweeping set of questions: When genetic counselors work with nonbinary and transgender patients, how can they address the fact that the name of “maternal fetal medicine” departments overlooks the array of patients’ gender identities? How are inclusive spaces created? What changes need to be made in clinical genetics and medicine overall? 

For Flynn, some answers and signs of success will have to come from measures of patient satisfaction. “Data would need to demonstrate that patients feel included in their care, that services were delivered equitably, and that there were no differences based on socioeconomic status, race, disability, gender, language, ZIP code, or education level,” she says.

***

leslie wears a yellow blazer and speaks at a podium into a microphone
Leslie Maxwell

“The field of speech-language pathology has a problem,” says Lesley Maxwell, associate chair of the Department of Communication Sciences and Disorders. “It is a mostly female, white, historically privileged population, with only about 8% of our practicing clinicians identifying as diverse. That has to change.” 

Over the past 10 years, the CSD department has worked to recruit and support students from diverse backgrounds. Faculty and students have joined to support anti-oppressive practice by making significant changes to the program’s curriculum, teaching, and research practices. Faculty have participated in focused readings and professional development programs on justice, equity, diversity, and inclusion. 

Student-faculty task forces have evaluated and redesigned curriculum, hiring, communication with the speech-language pathology community, and faculty and preceptor education. The work prompted Maxwell to change her approach in a class for early reading specialists she has taught for several years. 

“I’ve reframed conversations, which can be as simple as switching from ‘achievement gaps’ to ‘opportunity gaps’,’ she says. “At the end of the semester, when I ask students what they’ve learned, they now say, ‘I thought I was going to learn how to teach people to read better. Now I know I need to be an advocate and deal with oppressive systems that cause people not to be able to acquire literacy.’” 

Innovative work in anti-oppressive curriculum development has been led by instructor Indigo Young, CSD ’14. Topics include forms of bias, systemic racism, oppression, cultural competence and cultural humility, deficit versus strength-based models, inclusion, and ableism. “We’re coming to this work with an understanding that it’s a lifelong process,” says Dr. Marjorie Nicholas, the department’s chair, describing an attitude that’s prevalent across the IHP, “and we are coming to it with humility.”