Centering Justice in Health Professions Education by Owning Limitations of Anti-Bias Checklists

Introduction

In this article, researchers Wyatt and Randall argue that anti-bias checklists (checklists for assessing bias in educational content) can identify biased, harmful aspects of educational curricula. However, despite providing these identifications, these assessments fail to create systemic change or improve the experience of Black, Indigenous and students of color inside and outside of the classroom.

The authors propose ‘justice-oriented approaches’ as an alternative to anti-bias checklists in order to  “center the needs of marginalized populations in all educational decision-making.” The article outlines how educators can implement antiracist strategies in their curriculum assessments, through this tool, in order to create a more just and inclusive educational experience for all students. Their study relates specifically to curricula in healthcare education with direct implications for other related fields.

Tasha R. Wyatt is an Associate Professor of Medicine at the Uniformed Services University (USU)’s Center for Health Professions Education (CHPE). Wyatt’s research focuses on how larger systems of power and oppression shape the identities of medical professionals. Jennifer Randall is a Professor of Psychometrics and Test Development at the University of Michigan’s Marsal Family School of Education. Her work seeks to interrupt racist logic in assessment through justice-oriented practices that are antiracist.

Methods and Findings

Wyatt and Randall introduce and expound upon an alternative to anti-bias checklists for curriculum assessment—a justice-oriented approach.. The table below summarizes their comparison of the two mechanisms, as interpreted by an educator, and how they differ in their evaluation of a given curriculum:

The authors also discuss how a justice-oriented approach incorporates two critical gaps in traditional healthcare education:

Critical consciousness: This skill Wyatt and Randall argue, “equips individuals to question how power and privilege are maintained in society with the end goal of achieving liberation.” They emphasize that educators must have frequent and challenging conversations about their own biases, and also underscore through their findings how integral this type of discussion is in achieving a justice-oriented approach.

Addressing whiteness: As the authors indicate, “given that, historically, medicine has been largely a white profession, witness is embedded throughout all aspects of medical training and practice, even though it goes unrecognized.” Justice-oriented approaches to healthcare curricula encourage educators to reflect on this power dynamic and seek to incorporate an antiracist lens to discussions of race and privilege.

Conclusions

The authors argue that meaningful change in the healthcare profession will not occur until the focus moves beyond surface-level issues, like simply ensuring the inclusion of diverse representation (such as Black men or elderly women in illustrations and questions). Instead, they emphasize the need for a deeper, more contextual approach to topics like race, disability, and gender. This research emphasizes the pivotal role that healthcare educators can play in addressing systemic biases in the healthcare field as a whole. Ultimately, healthcare educators are essential in advancing equity in their field by applying a justice-oriented approach to their teaching content, educational materials, classroom discussions, and student evaluations.