On the Pulse: August/September

Admissions Sphere

Committee training is now complete for the 2022 admissions cycle and we are gearing up for the interview season. Our first committee development session proved to be an informative, inspiring and engaging experience for all. Relevant and timely presentations led to robust and thoughtful conversation. With members from both the MD and MD/PhD committees present we are encouraged and plan to harness the momentum to continue these sessions to learn and grow together. Learn more.

Clinical Sphere

In August, the Clinical Sphere reached out to stakeholders in the Department of Pediatrics, including Faculty, Social Workers, House Staff, Patient Representatives, Clinical Admin leaders, Nursing, and Child Life to talk about how we can help these stakeholders achieve their anti-racism goals. We have had several meetings already and will continue this fact-finding/needs assessment in the coming months. Learn more.

Student Affairs Sphere

Faculty Advisors met with incoming students at orientation and began the process of informing students about Appreciative Advising by describing the phases of the AA model to their learning communities. A timeline has been created for the faculty advisors to implement the steps of Appreciative Advising when communicating with students. This month they have focused on getting to know their students through the phases of Disarming (creating a safe, welcoming space for students) and Discovery (identifying strengths and offering affirmation).  Learn more.

Student Resources Sphere

In June, the Student Resources Sphere held a series of three equity lens workshops with staff and faculty from the medical and graduate schools. In July and August, participants will integrate techniques and strategies derived from these workshops in order to critically analyze their functional areas for equity barriers and opportunities and come together to report-out on their progress. The overarching goal of this program is to cultivate a community of practice in which participants plan and implement impactful and practical solutions that lead to lasting, equity-centered change. Learn more.

Student Sphere

We welcomed the Class of 2025 during this week’s Person-Role-System Orientation series. Additionally, we have completed the data analysis from our engagement measures added to the student council comprehensive survey. We are currently planning to disseminate the report to key stakeholders and in key spaces (i.e., Guiding Coalition, incoming and current students, Chats for Change sessions). Feedback from these stakeholders will guide next steps in strategizing interventions to address the outcomes from the report. Learn more.

Medical School-Wide

A working group composed of faculty, staff, and students has been assembled to draft a few versions of a new mission statement. Once composed, these versions will be shared with the Med Ed community for a vote. We hope to reveal a new mission statement during an upcoming town hall. 

In the past month, the Climate Survey team has completed the feedback process across all stakeholders (Medical Education and Graduate School of Biomedical Sscience workgroup), and compiled the survey questions into a master document that was delivered to the intended survey vendor. After several meetings with the external vendor, Viewfinder, it has come to light that this vendor will not meet our needs and we have been exploring other options including new vendors and hosting the survey internally. We have begun the process of pivoting and understanding logistics for all potential options an d are currently still on track to launch the survey in September. Learn more.

For more information about the on-going focused work within the spheres, check out the Change Targets tracker and our latest release of the RBI 2021 Action Update.

On the Pulse: June/July Action Updates

Admissions Sphere

We have had a busy and productive month, with one class about to start and admissions work for the new cycle under way. We have almost all new admissions committee members trained and ready to begin. Our inaugural committee development session is scheduled for August where we will take a deep dive on important admissions topics like Diversity, Equity and Inclusion; Metrics and Letters of Recommendation. We see this as a great step forward in nurturing and further developing our committee culture of thoughtful and holistic evaluation.

We have also gained momentum in the planning of our pathway retreat, where stakeholders will gain awareness of what the various programs we as an institution have to offer. With this growing collaboration we hope to harness valuable expertise and resources to best prepare the future science and medicine workforce. Learn more.

Clinical Sphere

The clinical sphere has continued to work within the pediatrics department to facilitate the Chats for Change series to normalize open dialogue about racism and bias. We have completed the two part series of chats for change and have continued discussions around requests for future sessions. We are taking an intentional pause to reflect and strategize about next steps. We are exploring and implementing a survey around chats for change experiences as well conducting a needs based assessment with our original stakeholders. Learn more.

Student Affairs Sphere

Student Affairs has collected verbal feedback from students about their advising experiences. The feedback has indicated that students are not always aware of how they can utilize their faculty advisor. We are working with Leona to create a one pager that describes Appreciative Advising so that students can learn about the advising model that we have implemented. We will also have a new Appreciative Advising “timeline” that will act as a schedule for when the different steps of Appreciative Advising should be carried out throughout a student’s time in medical school. Students will learn about Appreciative Advising in orientation so that there is more awareness around how advisor’s support students. Learn more.

Student Resources Sphere

In June, the Student Resources Sphere held a series of three equity lens workshops with staff and faculty from the medical and graduate schools. Participants will integrate techniques and strategies derived from these workshops in order to critically analyze their functional areas for equity barriers and opportunities and come together to report-out on their progress. The overarching goal of this program is to cultivate a community of practice in which participants plan and implement impactful and practical solutions that lead to lasting, equity-centered change. Learn more.

Student Sphere

We have been able to analyze the comprehensive student survey data that assessed student engagement in anti-racist efforts. We are finalizing the quantitative analysis and planning to distribute the information to key stakeholders. We are looking forward to potentially conducting qualitative analysis to supplement the quantitative data. Learn more.

Medical School-Wide

The mission statement campaign is pushing forward. The qualitative analysis of the Padlet responses has been completed and will be shared with the medical education community. During this time, we hope to partake in engaging dialogue with faculty, staff, and students. Once completed and a series of new statements are composed, we hope to reveal a new mission statement during the fall’s anti-racist town hall. Regarding the Campus Climate Survey, our team (Med Ed and GSBS workgroup) has focused on building a timeline, gaining and organizing feedback from students, faculty, and staff stakeholders across Medical Education and GSBS.

We have met with the external vendor, Viewfinder, who will conduct the survey to organize logistical details and to set deadlines for survey question delivery, and communicated and tested technological requirements with the appropriate departments. We will continue to integrate and compile outstanding feedback from stakeholders into the finalized questions to be communicated to the vendor, and will then enter the testing phase. Learn more.

For more information about the on-going focused work within the spheres, check out the Change Targets tracker and our latest release of the RBI 2021 Action Update.

The School’s First RBI Quarterly Meeting | June 2021

The Guiding Coalition recently held its first quarterly meeting for 2021, which was open to all medical school employees, faculty and students. A total of 58 attendees joined the Guiding Coalition on zoom. While the Guiding Coalition’s goal for these open meetings is to remain transparent about the progress being made towards our change targets and the challenges we face along the way, we hope that these meetings can provide an opportunity for the medical school community to feel more connected, learn how to become more involved in the Racism and Bias Initiative (RBI), and find new ways to collaborate.

Admissions Sphere

In the Admissions Sphere, steps have been taken to build upon the first change target: to reflect on and broaden the education and training of the admissions committee to continually engage in admissions work from an equity lens. During the most recent application cycle, the MD admissions committee consisted of 50 faculty members and 30 medical students and the MD/PhD admissions committee consisted of 32 faculty members and 4 medical students. All committee members attended an in-person orientation session which included trainings on topics such as unconscious bias and diversity as a driver for excellence. Additionally, the admissions sphere developed an equity handbook which has been in use for the past application cycle along with the “Time-In” to Learning tool for effectively addressing instances of racism and bias as they occur. They’ve begun gathering data surrounding the atmosphere around racism and bias amongst the committee members through the DEI form and committee climate surveys, finding that POC on the admissions committees have started to feel more comfortable talking openly about racism and bias with other committee members. In October, the admissions sphere is holding a retreat with the aim of finding more opportunities for collaboration with several pathway programs.

Clinical Sphere

In the Clinical Sphere, they have updated their change target to focus on the entire Mount Sinai Health System rather than limiting it to the Pediatrics Department. This decision was made to accommodate for increased interest and momentum across the health system after the death of George Floyd last year. Within Pediatrics, they have completed five department-specific Chats for Change including their most recent one on reporting racist events to compliance which took place in June. Their chat in July focused on alternatives to reporting. Across these departmental programs, they’ve had over 200 attendees with numbers steadily decreasing with each event.

Despite this decrease in attendance, they have committed to continuing hosting these sessions. As of February, the reporting system has received 19 compliance reports regarding racism and bias within the past 6 months. Although the cause of this spike is unclear, the number is an increase from the 31 total reports for all of 2020. Ultimately, they can see the perception of the clinical sphere changing as more sub-clinical departments are beginning to show interest in starting their own initiatives and using the sphere as a resource.

Curricular Affairs

In the Curricular Sphere, a new Medical Education Program Objective (MEPO) has been developed to address racism and bias. Set to roll out next month, the MEPO states, “Upon graduating, students should be able to demonstrate approaches to mitigate the manifestations of racism, bias, and social inequities in healthcare.” In order to fulfill this MEPO, Curriculum Affairs will assess the inventory of racism and bias curricular offerings and communicate with stakeholders about the change.

Additionally, the sphere met with ODI, national leaders, and a medical illustrator to develop a specialized patient session on navigating racist patients and/or colleagues during clinical encounters for both UME and GME. They also aim to diversify patient representation across all courses by creating a HIPAA compliant image database in collaboration with dermatology resident Dr. Krystal Mitchell-Gba and clerkship students.

Student Affairs Sphere

In the Students Affairs Sphere, we are working to adopt and support advising practices by Learning Community advisors that actively address racism and promote equity. We are proud to have developed a community of practice amongst our faculty advisors. Additionally, we have collaborated with the student sphere to collect feedback from students about their advising experiences and hope to analyze this data as our next step. We’ve also conducted faculty development training sessions on appreciative advising and crating our advising blueprint for the upcoming year. We look to continue this work by adding a new change target focused on implementing new anti-racism communication strategies for our faculty advisors to utilize with their students.

Student Sphere

In the Student Sphere, they have been focused on understanding the barriers and mediators to student engagement in anti-racist work and developing potential interventions to increase student participation in addressing racism. Thus far, they have hosted monthly racial healing circles since June of 2020, collected engagement data via the student council comprehensive survey, created the Participatory Decision-Making Guide with the MSHS task force to address racism, and facilitated collaborations between groups like Student Council and SNMA. As they begin to analyze the data from the survey, they hope that it will provide more information about student engagement, identify gaps in knowledge in the student body, quantify representation from different student categories, and serve as a baseline to examine longitudinal effects.

While much progress has been made, the students have come across challenges in promoting anti-racism as a value in medicine, increasing the visibility of our work, and maintaining student involvement. They have succeeded, however, in building a community of practice among students and creating space for conversation. They hope to continue this work by implementing healing circles for the clinical years and partnering with other medical schools on the new Anti-Racism in Medical Education program that was recently funded by the Macy Foundation.

Student Resources Sphere

In the Student Resources Sphere, we’ve developed an equity lens decision-making playbook and will be using outcome mapping to monitor the changes that result from its use. There was also work put into developing three one hour equity workshops that will be attended throughout the year by “equity champions” elected from different departments. These identified “equity champions” will attend the workshops, bring the knowledge back to their respective units, and give status update on the changes being seen during several report out sessions. It’s been challenging to implement some of our equity-based strategies as it can be difficult for individuals to pushback against the workplace status quo. Many have also voiced that they believe their individual influence is limited and they cannot directly link changes they see to our ongoing equity lens work. Fortunately, we have started to develop a community of practice and are seeing increased interest and active engagement from a diverse group people.


 

For more information about the on-going focused work within the spheres, check out the Change Targets tracker and our latest release of the RBI Action Updates.

 

This post was written by:

Kiarra Lavache

Strategy and Equity Education Summer Program Intern

On the Pulse: May Action Updates

On the Pulse: May Action Updates

Admissions Sphere

The Admissions sphere has been engaged in analyzing data to inform our work moving forward. With upcoming committee training sessions, we will continue to build upon conversations with veteran members and onboard new members to our culture of self-reflection, learning and holistic review. We continue to gather information about the many different pathway programs in our institution, both known and newly discovered, so we are able to come together and learn together how we can best serve our scholars, students and prospective applicants. Learn more.

Clinical Sphere

The clinical sphere has continued to work within the pediatrics department to facilitate the Chats for Change series and normalize open dialogue about racism and bias. We have completed the first part of the two part series and have the second scheduled for June with additional sessions pending. The second session is in collaboration with the Compliance Office to discuss reporting and options. Based on feedback, we are considering holding a third part to the peds chats for change dedicated to alternative actions/solutions to reporting racism/bias. We are gathering data through surveys and outreach around case examples. We are also starting to explore additional departments that are interested in working with our sphere (ex. Neurology). Learn more.

Student Affairs Sphere

The Student Affairs Sphere conducted a month-long faculty development on appreciative advising. The group explored their own identities and how they impact the advising relationship. The group engaged in breakout work exploring each of the phases of appreciative advising: disarm, discover, dream, design, delivery, don’t settle. For each phase, the groups discussed features, good better, and best practices, reviewed an illustrative case, and described best practice advising questions, how to facilitate student growth, what ways this could be implemented via email, what tools or supports would be needed to achieve the “best” features of this phase, and what considerations might be different for a URM student. The groups debriefed and created an approach to best practices to inform a new model of equitable advising. A writing group is drafting a manuscript on the best practices of appreciate advising for building an anti-racist model in Student Affairs. Learn more.

Student Resources Sphere

The Student Resources Sphere has held two of three equity lens workshops with participants from the medical and graduate schools. Participants will integrate techniques and strategies derived from these workshops in order to critically analyze their functional areas for equity barriers and opportunities. After the third workshop, we will cultivate a community of practice in which they think through impactful and practical solutions that lead to lasting, equity-centered change. Learn more.

Student Sphere

The Student Sphere is awaiting results from the student comprehensive survey to analyze and disseminate the results. We have met to discuss best strategies and practices to disseminate the results, including disseminating quantitative data, planning to clarify the results through qualitative interviewing, and identifying next steps with key stakeholders. We have also begun discussions around orientation programming for the incoming MS1 class to provide a foundation of ways to engage in anti-racist work in their medical education. Learn more.

Medical School-Wide

Our mission statement campaign has entered the next stage. The data collected from the Padlet has been shared with an external expert. Once analyzed, the data will be shared in a community-wide forum to allow for reflection prior to the creation of a revised statement. 

 

The culture survey planning is underway and on schedule! The planning group has identified the core questions that will be included in the staff, student, faculty and postdoc surveys that will be administered in the medical school and the graduate school. Workgroups are starting to review the proposed core questions to provide feedback and identify additional questions of interest. Learn more.

For more information about the on-going focused work within the spheres, check out the Change Targets tracker and our latest release of the RBI April 2021 Action Update.

Comprehensive, Strategic Plan for 2021 | Addressing Racism Across all Functional Areas of the School

Each Guiding Coalition Sphere is in the process of developing a comprehensive, strategic plan for 2021 that incorporates all activities that contribute to the vision of becoming a health system and health professions school free of racism and bias. This year our aim is to integrate all efforts into one comprehensive plan so that we can work more collaboratively and begin to examine our collective impact. 

The 2021 plan will include:

Change Targets

Change Targets will be...

A concise (one sentence) goal, desired outcome, or end result. Each of the spheres will reevaluate their existing change target and add additional change targets based on the new scope of work (e.g., SNMA actions). The proposed change targets will focus on 1 to 2 year time periods. 

SMART Objectives

Smart objectives are...
  • Specific: includes the “who,” “what,” and “where.” 
  • Measurable: focuses on “how much” change is expected
  • Achievable: realistic given resources and planned implementation
  • Relevant: relates directly to change target
  • Time-bound: focuses on “when” the objective will be achieved

Accountability

Accountability means...

Each sphere will utilize a tool to establish a clear accountability structure to: (1) quickly clarify accountability for the 2021 plan; (2) clarify specific roles for everyone involved in working towards change targets; (3) create a shared language for assigning and tracking accountability; (4) enhance Med Ed’s efficiency; and (5) deepen trust by improving follow-through.  

  •   DARCI Accountability Grid:
    • DECIDER/DELEGATOR: Holds the ultimate power re. the 2021 Plan. Power can be retained as the right of final approval/veto, or delegated to the A. The D in this case is the Guiding Coalition.
    • ACCOUNTABLE: The single person fully accountable for the change target. The A must be given sufficient decision-making power and room to learn/adjust commensurate with accountability. 
    • RESPONSIBLE: Those responsible for doing the work on the project. There may be a number of R’s on a project. R’s are responsible for dealing with roadblocks, raising questions, etc. – not just being “good soldiers.”
    • CONSULTED: Those from whom input will be solicited. 
    • INFORMED: Those to be kept apprised of relevant developments. This is an FYI role.

Success Measures

Success measures means...

For each of the Change Targets there will be metrics that will measure the success of our efforts towards our vision. To identify these metrics, we are examining the characteristics of “significant” system change that provide powerful signals that the system has changed. Here are a few key features that will inform our success measures:

  • The depth of the change in terms of:
    • Disruption of existing system patterns
    • Networks of connections within the system that shape how we interact 
    • Norms influencing the behavior of those who are in the system 
  • The strength of the change in terms of:
    • The scale at which the change has taken place 
    • The level of “buy-in” to the change 
    • The relevance of the change in how strongly it influences the way the system achieves (or not) the change target outcome

Timeline for the 2021 Comprehensive Plan

February 12

Sphere comprehensive 2021 plans are due.

February 22

Spheres present plan to the guiding coalition and obtain feedback.

February 24

 Incorporate feedback and finalize 2021 plan.

March 1

Share the final plan in the RBI’s monthly action updates newsletter and post on Change Now.

June 14

The first quarterly review will happen in June where the guiding coalition will review its work towards the 2021 plans and assess progress. A participatory decision-making structure will be implemented during this meeting to address differences in positional power,  better integrate our efforts, and promote collective impact.