Aug 2026· Journal of general internal medicine· 0 citations· 14 references
Medicine
TL;DR
Examination of how Internal Medicine residents, fellows, and faculty trained in health equity navigate applying health equity principles in practice and what internal and external factors facilitate or hinder implementation found ability to apply health equity skills developed through iterative cycles of awareness, reflection, and deliberate practice.
Abstract
Background
Despite growing emphasis on health equity education in graduate medical education, little is known about how classroom learning translates into clinical practice.
Objective
To examine how Internal Medicine residents, fellows, and faculty trained in health equity navigate applying health equity principles in practice and what internal and external factors facilitate or hinder implementation.
Design
Constructivist study using semi-structured interviews and grounded theory to examine individual developmental processes within multilevel contextual influences.
Participants
Eleven Internal Medicine physicians (seven residents/fellows, four faculty) at a military academic medical center who participated in a case-based health equity curriculum.
APPROACH
Interviews explored experiences applying health equity principles. Two researchers independently coded transcripts using constant comparative method. Thematic analysis examined patterns across career stages within three domains: individual awareness and identity development, interpersonal dynamics in clinical encounters, and institutional and structural contexts.
KEY
Results
Participants' ability to apply health equity skills developed through iterative cycles of awareness, reflection, and deliberate practice, but this growth was continually shaped by external constraints. Clinical encounters served as learning opportunities only when attending physicians created space for reflection and dialogue. Infrastructure gaps, policy limitations, and organizational culture frequently restricted what physicians could enact, contributing to moral distress, particularly among trainees who felt unable to apply what they had learned. Developmental patterns showed movement from reactive navigation of barriers to more proactive efforts to influence team processes and environments.
Conclusions
Health equity in clinical settings emerges through negotiation between individual transformation and environment. Without attention to power dynamics, resource allocation, and institutional culture, health equity educational interventions risk developing demoralized physicians who recognize inequity but lack support to address it. Programs require aligned curriculum, faculty development, and institutional infrastructure to enable equity-oriented action.
Background Despite the Accreditation Council for Graduate Medical Education (ACGME) requirements for education on health equity, many graduate medical education (GME) programs lack structured learning in this area. Health inequities persist in clinical practice, emphasizing the importance of incorporating training in health equity concepts. Objective This study aimed to design and pilot a longitudinal health equity curriculum for pediatric fellows to improve their knowledge, beliefs, and comfort with equity-related concepts. Methods A two-phase pilot study was conducted. Phase I was from October 2024–March 2025 within a two-year pediatric hospital medicine (PHM) fellowship. Of six total PHM fellows, five were eligible and participated. Curriculum development followed Kern’s six-step model. A needs assessment informed session topics. Four, sixty-minute interactive, in-person sessions were held. Phase II curriculum sessions were delivered to a separate replication cohort of pediatric fellows in November and December 2025. Anonymous pre-post-session surveys were administered to assess changes in knowledge, beliefs, and comfort. Demographic data was not collected during phase I to maintain anonymity but was collected from the larger phase II cohort. Results were compared using pre-post-session data, using descriptive statistics. Survey tools were internally developed and not externally validated. Results During phase I, five fellows were eligible to participate, with 4-5 fellows per session (80-100% participation). All phase I participants (100%) completed both pre- and post-surveys. Self-reported knowledge, beliefs, and comfort improved across all sessions. In phase II, similar patterns of improvement were observed and participants shifted away from neutral or disagree responses, with marked improvements in knowledge, belief, and comfort domains. Conclusion A longitudinal health equity curriculum was piloted within a PHM fellowship and then replicated in a larger cohort, with measurable improvements in understanding of health equity concepts. These findings support the integration of longitudinal health equity education into GME programs to better equip physicians to advance health equity in clinical practice.
Naseem Alammar, Y. Rivera-Sánchez, K. Martinez et al.· Journal of Medical Education...· 0 citations
BACKGROUND
Nursing education emphasizes social determinants of health (SDOH) to promote health equity and care, but evidence of students' application in practice remains limited.
PURPOSE
This program evaluation examined the extent to which Bachelor of Science in Nursing students addressed SDOH, and the domains most and least addressed.
METHODS
Senior bachelor of science in nursing students (N = 137) completed a survey covering 999 encounters in Spring 2025. The survey assessed engagement with 23 SDOH domains using 4 response options: not addressed, observed, collaboratively addressed, and independently addressed.
RESULTS
Students addressed at least one SDOH in 91% of encounters. Commonly addressed domains were social support, primary care access, health literacy, housing, and employment. Least addressed were immigration status, discrimination, climate change, civic participation, and neighborhood safety. Students addressed SDOH collaboratively or independently in 59% of encounters.
CONCLUSION
Students engaged with common SDOH, but gaps in structural determinants suggest the need for targeted curricular, clinical, and preceptor-focused training and assessment strategies.
Lalita Kaligotla, Shankar Bhat, Jessica M. Potts et al.· Nurse Educator· 0 citations
ABSTRACT
Physician assistant (PA) education focuses heavily on developing the medical knowledge and clinical skills necessary for competent practice. However, qualities such as empathy, leadership, teamwork, and patient-centered care are often cultivated through experiences beyond the formal curriculum. This reflective article describes the development of advanced professional exploration (APEX), a student-led initiative created to complement traditional PA education through experiential learning, professional exploration, and meaningful engagement with patients and health care topics. Developed with faculty mentorship, APEX provides opportunities for students to broaden their understanding of health care through patient and family storytelling sessions, discussions on health equity and disparities, hands-on clinical skills workshops, and simulation-based teamwork exercises. These experiences encourage reflection, curiosity, and a deeper appreciation of the human dimensions of medicine. Drawing from personal experiences as an immigrant, military veteran, and parent, the author reflects on how service, communication, and cultural awareness shape professional identity and patient care.
Riya Chaudhari, Brian Terzian· The journal of physician ass...· 0 citations
Peer learning is a collaborative approach grounded in social constructivist theory, emphasizing that knowledge is co-created through interaction. In medical education, it promotes active engagement, critical thinking, and professional identity formation. Within the author’s research group, PhD students in the field of neurosurgery and medical students working on their undergraduate medical research projects, benefit from structured peer learning by sharing expertise, discussing challenges, and providing feedback. This aligns with communities of practice theory, where learning occurs through participation in a shared domain, and with Topping’s framework highlighting peer tutoring as a reciprocal process that enhances cognitive and social development. Recent studies demonstrate that peer assisted learning improves clinical knowledge, practical skills acquisition, and learner engagement compared with traditional teaching approaches. These effects appear particularly strong in clinical and applied contexts, with evidence suggesting retention beyond the immediate learning period and improved transfer to performance. Integrating peer learning as a deliberate strategy strengthens academic outcomes and fosters lifelong learning skills. The Kirkpatrick framework can be used to evaluate the design, implementation, and outcomes of peer learning (PL) interventions. In line with these traditions, recent work in Academic Medicine has clarified mechanisms through which longitudinal near-peer learning operates—structured preparation, dynamic role-shifting during joint encounters, and post-encounter debriefing within trusted relationships—offering concrete practices that can be translated into the proposed setting.
A. Elmi-Terander· Journal of Medical Education...· 0 citations
The CoLearn Framework offers an explanatory model for designing reflective, relational, and situated faculty development and was associated with participants' self-perceived gains in selected dimensions of cultural competence, particularly cultural understanding and communication strategy adjustment.
Sisi Li, Xunchen Liao, Xi Chen et al.· BMC Medical Education· 0 citations
Experiences of pre-health and health professions students, health promotion students, and practitioners in an independent online language interpretation training are examined.
Leslie E. Cofie, Joseph G. L. Lee, Emery L. Harwell et al.· Pedagogy in health promotion· 0 citations
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