Town Hall: Nine Questions; Nine Answers

Town Hall: Nine Questions; Nine Answers

On Tuesday, March 20, the Department of Medical Education hosted a Town Hall  to announce a clear message about racism and bias: The time to change is now. After the event, we distributed a post-event survey eliciting your feedback. Based on the post-town hall survey results, we identified and answered the top nine questions posed.

How did this initiative start? Are we just appeasing students? What happens to resistant faculty?

As a result of ISMMS medical student activism and advocacy aimed at having our medical school recognize the historical underpinnings of racism and bias in medicine and in our medical trainingwe launched the Racism and Bias Initiative in 2015. Since the initiative’s launch in 2015, we have undertaken several RBI interventions that have primarily addressed events related to racism and bias in curricular and student affairs, admissions, and other functional areas of the School.

 

During this time, medical education leadership also:

 

  1. Envisioned a transformational change vision for the initiative.
  2. Hired a Director of Strategy and Equity Education Programs who will work on all things RBI.
  3. Developed and approved an integrated change management strategy and structure.
  4. Participated in retreats and training opportunities to build internal capacity to lead transformational change.

The students ignited this process, and it is now a paradigm shift for our school.

How does racism and bias manifest itself in the School and hospital? What are the real issues we’re facing?

In our school, we see persistent patterns and behaviors that privilege white students, faculty, and patients. These patterns and behaviors are deeply embedded in our structures. They are written and unwritten “rules of the game” and include policies, practices, distribution of resources, relationships, lack of faculty of color, unequal access to and quality of care, persistent beliefs in the genetic and biological view of race, and unequal outcomes for academic success for students of color.

What are the specific action plans? How can we track progress?

We have developed a new timeline feature on Change Now that allows you to stay informed about where we are at in the process, where we are headed, and where to find additional information (blog posts, references, etc.). The timeline will be updated on a monthly basis.

How do we measure outcomes? How do we know if we are successful?

Starting in June, the Guiding Coalition will define what the change targets will be, how to get there and how to measure success. Prior to the implementation phase in August, we will share a more formal plan and metrics on Change Now.

 How are leaders held accountable? Why should we trust leadership? Why can’t we bring in an anti-racist third party?

One of the mechanisms and structures set in place to hold all of us accountable is the Guiding Coalition, comprised of individuals from across ISMMS (staff, faculty, students, other stakeholders) who contribute unique skills, roles, lived and professional experiences, perspectives and networks in order to enable the most innovative ideas to emerge.

 

The Guiding Coalition is a powerful, enthusiastic group of change leaders who:

 

  • Represent all our constituent groups
  • Develop new strategies
  • Oversee the transformational change targets
  • Identify options for implementation
  • Make decisions about where the energy and resources should be focused in order to transform ISMMS

In order for transformational change to be profound, lasting, foundational, and irreversible we need a long-term commitment that can only be driven from within.

How can people get involved? What are roles for allies and activists?

You can get involved in many different ways.

 

On an individual level, we encourage you to start or continue to adopt anti-racist approaches, a racial justice lens and anti-bias mindsets, behaviors, and practices. This includes focused and sustained actions that reduce power differentials and eliminate racism. It’s an active way of seeing and being in the world in order to transform it.

 

Our individual actions can cumulatively serve to maintain existing forms of inequity or they can serve to dismantle systems of oppression. Because racism is at all levels and spheres of our school and society, anti-racism must permeate everything. It doesn’t just happen in the work force, the classroom or in select aspects of our lives. Throughout the year we will provide tools, training, and other opportunities for all of us to learn more about how to be anti-racist.

 

If you want to play more of an active role in identifying what needs to change in order for us to provide health care and education that is free of racism and bias, and how to get there, you can join the Guiding Coalition in June for a series of interactive sessions. If you would like to sign up, click here [insert link] by 5 pm on May 21.

 

After the change has been identified, we will provide more information about how you can support the change and be an ally.

Why are we worried about changing processes and people if we haven’t yet acted on seemingly minor issues raised by students?

If our vision is for transformational change, we recognize that organizations or institutions don’t change, people do. Therefore, it is critical for our strategy to not only identify what needs to change (content), but how we as individuals and as a community engage, prepare, support embrace and utilize the change (people side). We have been intentional about the process of how we design, develop, and deliver the change so that it isn’t just a top down strategy, and aims to center marginalized voices. All of this is needed in order to transform or shift the culture of the school from the current state to the future vision.

Where will we be in one year from today? What do we know will be different?

This a great question, and we will know more after we identify the change targets, outcomes and outputs, and tactical plan. Stay tuned. We will know more after June.

What are our guiding principles? How do we know how to undertake this process?

In order to transform the School from the current state to one that actively identifies and explicitly addresses all forms of racism and bias, centers racial justice and health equity, and lifts up underrepresented voices and experiences we must recognize the current state, support individuals and ISMMS through the transition state, and envision and actualize the future state. We are relying on a strong foundation of research and the practice of change management to inform and guide our process map.

 

 

While not necessarily comprehensive, the following principles capture many of the qualities of transformational change (Gass, 2014).

Attend to the whole system.

Transformational change is a true systems approach that attends equally to hearts & minds, behavior, structures and the social systems in which they exist.

Be the change.

A fundamental tenet of transformation is that who we are impacts the results we will create. We use practices to “be the change.” We don’t just talk about the change, and we don’t wait for the change to happen.

It’s all about “we.”

Our dominant culture teaches us individualism and competition. Transformational change invites us to recognize that we not only need each other, we are profoundly interconnected. It’s important to appreciate that collaboration is not just about being nice to each other. It’s about learning how to embrace the rich diversity of different interests and perspectives that can help us achieve the critical breakthroughs we need at this time of increasing complexity and political divisiveness.

Practice, practice, practice.

It’s important that we understand the necessity of practice to integrate real change in our lives and in our work, clinical and learning environments.

 What we appreciate, appreciates.

Critical analysis is an important tool that helps us attend to the whole system while we transform our approach to racism. But it also has limitations.  There is a need to balance critique with an appreciation of what’s good. Throughout this process we will learn how to build as well as how to deconstruct, to honor as well as critique.

Go the distance.

We have approached this work from the onset with an eye toward what is required to sustain the transformation. The structured process of RBI is designed to integrate sustainability throughout the process.

The Time to Change is Now: RBI Town Hall

The Time to Change is Now: RBI Town Hall

On March 20, 2018 the Department of Medical Education hosted a town hall meeting in an effort to share our approach to the next phase of the Racism and Bias Initiative—the people and process side of the transformational change. The town hall presented a unique opportunity for students, staff, senior administrators, faculty, and others to come together to learn how we are going to  address racism and bias in curricular and student affairs, admissions, and the clinical learning environment.

Dean Muller presented a change management strategy that will guide our transformational change process  and fielded questions on the next steps. Members of the leadership team responsible for shepherding change in their functional areas spoke of their personal commitment to the initiative.

The town hall included a question and answer portion in which students voiced concerns regarding the current climate of the learning environment, and highlighted the necessity for systemic, transformational change.

Some of those concerns were echoed  in the post-town hall survey:

 

 

These results demonstrate that while there is uncertainty regarding the strategy that informs the Racism and Bias Initiative, there is strong interest and support for the cause. As we proceed with the Racism and Bias Initiative, we hope to provide transparency and authenticity that speaks to this uncertainty. We will work actively and relentlessly to realize our vision: to become a health system and health professionals school with the most diverse workforce, providing health care and education that is free of racism and bias. In doing so we ask for your help.Track our work and get involved by signing up to participate in interactive sessions that will aim to answer the question: “What needs to change in order for us to provide health care and education that is free of racism and bias, and how do we get there? Sign up here.