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

Feb 1, 2021 | Racism and Bias

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.

On the Pulse: February’s Action Updates

Feb 1, 2021 | Racism and Bias

Every month, we are providing action updates across the Racism and Bias Initiative’s spheres. This month’s action updates bring us closer to collaborating on our efforts, strategically building on existing actions, and developing new actions to address racism and bias across all areas of the medical school.
Admissions Sphere

The Medical School Admissions team has developed and implemented a “Diversity, Equity, and Inclusion Form” to document important discussions about bias or equity that occur at any point during the admissions process. The Admissions Committee has created a procedure called “time-in” in which committee members can state “time-in to learning and discussing” to address potential occurrences of bias, facilitate discussion, and enhance the educational experience. This process is now embedded in the MD and MSTP Admissions Committee meetings. A Committee Learning Climate Pre-Survey was distributed to all Committee members on the MD and MSTP Admissions Committees. This survey will gather a baseline of committee perception of bias in the admissions space. The post cycle survey is poised to go out to committee members. Importantly the Admissions Sphere is actively partnering with the SNMA Leadership to align priorities and develop strategic initiatives for admissions.

Clinical Sphere

The Clinical Sphere is embracing the SNMA action items across many areas. We’ve reinforced communication around the importance of our zero-tolerance policy related to retaliation towards students who take a stand against racism. The Committee on the Student/Trainee Learning Environment will be including students in the process of adjudicating mistreatment reports. The mission statements for Medical Education and for ISMMS are being revised, denouncing racism and incorporating our commitment to racial justice.  SNMA and ISMMS leadership meet regularly to review and update progress on addressing the SNMA action items. A dedicated Chats for Change is ongoing with co-facilitation between Clinical Sphere members and the Department of Pediatrics; this includes workshops for strategies to interrupt instances of bias in the workplace. Med Ed is working with the Faculty Council on targeted URiM faculty recruitment to key committees.

Curricular Affairs Sphere

The Curricular Affairs Sphere is undertaking a comprehensive inventory of all current curricula on race and racism, with the intent of identifying thematic threads and ensuring they all have theoretically sound educational frameworks. In addition, the CA Sphere is also seeking to identify all current faculty development offerings on anti-racism and anti-oppressive facilitation techniques. Building on the success in InFocus Weeks, ASM, and Brain and Behavior, we are working closely with course leadership and faculty to enhance anti-racist content and educational practices within the Year 2 Musculoskeletal Pathophysiology Course and the Year 3 Internal Medicine Clerkship. Recognizing the critical role of both content and pedagogy in anti-racist medical education, we are creating a comprehensive plan for our efforts in 2021. In early February we are scheduled to meet with SNMA leadership to share our current progress and discuss next steps, and aim to share details about our 2021 comprehensive plan next month.

Student Affairs Sphere

The Student Affairs team is continuing to develop the “Appreciative Advising” model to provide a framework for increasing advisor and student success. The Student Affairs sphere is partnering with students on evaluation and feedback to inform future planning. We are brainstorming to determine other means of effectively evaluating the success of our advising techniques.  We are also looking ahead to the month of May when each of our weekly faculty advising meetings will be dedicated to Appreciative Advising training. We look forward to collaborating more closely with the Student Sphere of the Guiding Coalition in the coming months.

Student Resources Sphere

The Student Resources sphere has completed a first draft of an equity lens playbook for use by stakeholders throughout the Department of Medical Education. Student Resources is moving forward with plans to fund student research related to anti-racism with the goal of compensating students for taking action to combat racism and bias.

Student Sphere

The Student Sphere is finalizing the last steps of their engagement surveys to be shared with the study body. We are continuing to hold monthly racial healing circles and work on the Participatory Decision-Making strategies for the implementation of the MSHS Task Force interventions or action to address racism.

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 February 2021 Action Update.

Change Targets
RBI Action Update

On the Pulse: A Curricular Sphere Update

Jan 4, 2021 | Racism and Bias

The Curricular Affairs Sphere aims to promote personal growth in antiracist knowledge and skills among course and clerkship directors. We developed this change target in partnership with students and faculty. 

The first steps included conducting focus groups and structured surveys of course and clerkship directors. This process helped us identify existing strengths and areas for growth as well as opportunities for and barriers to growth in antiracist knowledge and skills.

We then began to work systematically with course and clerkship directors to help meet immediate needs while also gathering data on barriers to growth. So far, efforts have included:

The Art and Science of Medicine (ASM)

  • Extensive anti-racist curricula exist, and will be expanded and used as a framework for approach to racism as the driver of racial inequities explored in other courses.
  • Anti-racist and anti-oppressive small group facilitation faculty developments

Brain and Behavior

  • Additional content: history of racism in psychiatry, racism as driver of racial inequities in serious mental illness, cerebrovascular accidents (incidence and outcomes) and dementia
  • Additional didactic and small group discussion on racism in psychiatry
  • Inclusion of content on summative exam
  • Faculty developments on anti-racism content
  • Faculty developments on anti-oppressive facilitation techniques

Muscoskeletal (MSK)

  • Meetings with course director and faculty underway, with additional content and faculty developments being planned

Internal Medicine Clerkship

  • Divisional grand rounds being developed
  • Meetings with clerkship director under way

Pediatric Clerkship

  • Anti-racist trainings initiated with all Pediatric Hospital Medicine faculty and fellows and Adolescent Medicine faculty and fellows including introduction to White Supremacy Culture and antiracist bedside skills.

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 January 2021 Action Update.

Change Targets
RBI Action Update

An Open Letter Response: SNMA x ISMMS Collaboration

Nov 25, 2020 | Racism and Bias

In response to the SNMA’s open letter, the Dean’s Office and the Department of Medical Education launched and continue to work on the following actions. Expand the sections below to view the actions that have been launched, initiated, and more. Beginning in January, we will provide new action updates on the Change Tracker.

Launched
Initiated
  • Mission Statement Revision Committee
  • Establishing academic and recruitment ties with HBCU’s
Upcoming
  • Incorporating Diversity and Inclusion into the annual performance reviews for Chairs
  • Incorporating required Diversity and Inclusion criteria into Appointments and Promotions
  • Incorporating required Diversity and Inclusion section to institutional CV format

“For me working towards the goal of being an anti-racist school has been the most challenging and most rewarding work I have done over more than 30 years in academic medicine. I am inspired by the courage and perseverance of our colleagues, students and staff of color. Their willingness to sacrifice so much, and place their faith in others, like me, who have historically let them down, is an incredible demonstration of their humanity, integrity, and dignity.”

David Muller, MD

Dean for Medical Education, Icahn School of Medicine at Mount Sinai

Mistreatment
  • Individuals reporting mistreatment receive updates on outcomes of reports; there is an explicit zero tolerance policy for retaliation/retribution
  • Subcommittees formed to address
    • Incorporating students into adjudication of mistreatment reports
    • Enhancing messaging and outreach on mistreatment policy and processes
Ongoing
  • Revising the Med Ed Mission Statement

  • Recruitment of BIPOC faculty to leadership positions in Med Ed (ongoing)

  • Work with Faculty Council to recruit BIPOC faculty to major Med Ed committees (ongoing)

  • Strategic Leadership Collaborative (SLC) July retreat focused on training Med Ed leadership to be anti-racist. This work is ongoing and is addressed at every weekly SLC meeting.

  • SLC October retreat brought together SLC, RBI-GC, and SNMA leadership to work on SNMA action items

“The demands of working towards equity within Mount Sinai have been both extremely taxing yet overwhelmingly inspiring. Although I had not imagined being a part of implementing anti-racism initiatives as a facet of my medical school trajectory, it has significantly enhanced my experience by enriching my ability to think critically about tough issues, reinforcing my sense of purpose, and strengthening my capacity for problem solving. Some days are heavy, but I am sustained by the resilience of those who came before us, the fortitude of my colleagues, and the support that has been given to SNMA. While the road to truly achieving equity is long and sometimes tortuous, I am most proud of the collaborative spirit between leadership, faculty, staff, and students that have allowed the voices of Black students to be amplified and for our perspectives to be validated. It is SNMA’s hope that this continues to be the narrative, that we never allow this fire to be extinguished, and that Mount Sinai can position itself as a beacon of transformational change in addressing the systemic oppressions that exist within academic medicine.”

Taylor Harell

President, ISMMS Chapter, Student National Medial Association (SNMA)

For more SNMA Executive Board updates, check out this blog post.

Reflections from the SNMA Executive Board

Nov 25, 2020 | Racism and Bias, Uncategorized

This is what the SNMA Executive Board had to say after reflecting on the past few months following the open letter addressing anti-Blackness and racism at Mount Sinai and the broader medical community.

Jennifer Dias

This year we’ve been confronted by two pandemics that have warranted a hard pause and deep introspection. Personally, it’s made me reflect on my faith, failures, value to self and others, particularly as a Black body, and the power of community. While I struggle with my faith in the supernatural at times, this process has reaffirmed my faith in people. I recognize the work and voices of our ancestors, mentors and fellow classmates which have allowed us to harness our vulnerability and share our vision. This process has shone light on the values we must be willing to defend together: humanity, connection, truth and healing- which gives me hope.

Beselot Birhanu

SNMA was inspired by the events of this summer to reflect more on our own experiences and Mount Sinai’s institutional history. Coming to Sinai with a love of anthropology and history, I felt it was important to centralize and capture the long legacy of leadership and activism by Black students, staff, and faculty. This is not only to see how far we have come, but to also see how much farther we can go. As a result, we have partnered with the Arthur H. Aufses Archives to create a digital archive documenting the history of the Black community at the Icahn School of Medicine. Through a series of interviews with alumni, staff, and faculty, we are hoping to reconstruct the evolution of the community through pivotal moments, like the founding of our chapter and the creation of the Center for Multicultural and Community Affairs (CMCA), and all of the allies that made these milestones possible. We hope that this archive will be a living, breathing document that continues to evolve alongside the institution. I am also proud of our partnership with the Apothecary, Sinai’s student-run creative arts magazine, on a special issue dedicated to uplifting Black creative expression and providing a space for healing through art. In spite of all of the really important conversations I have had since the events of this past summer, I sometimes feel like words fail me, and I hope that this issue serves as a means of expression and community. Above all, I am really thankful for the dedication and friendship of our Board and of the student and faculty allies who made this time a little less lonely.

Taylor Harrell

The demands of working towards equity within Mount Sinai have been both extremely taxing yet overwhelmingly inspiring. Although I had not imagined being a part of implementing anti-racism initiatives as a facet of my medical school trajectory, it has significantly enhanced my experience by enriching my ability to think critically about tough issues, reinforcing my sense of purpose, and strengthening my capacity for problem solving. Some days are heavy, but I am sustained by the resilience of those who came before us, the fortitude of my colleagues, and the support that has been given to SNMA. While the road to truly achieving equity is long and sometimes tortuous, I am most proud of the collaborative spirit between leadership, faculty, staff, and students that have allowed the voices of Black students to be amplified and for our perspectives to be validated. It is SNMA’s hope that this continues to be the narrative, that we never allow this fire to be extinguished, and that Mount Sinai can position itself as a beacon of transformational change in addressing the systemic oppressions that exist within academic medicine.

Sewit Bereket, Jeffrey Okewunmi, and Makda Getachew Zewde

Overall, we have been heartened to see such an enthusiastic and supportive response from leadership throughout the hospital system on ways to bolster an anti-racist community at Mount Sinai. Regarding efforts to improve the medical student curriculum, we’ve begun to make progress on actualizing initiatives related to increasing diversity throughout our learning spheres. Specifically in the areas of student clinical encounters, basic science lectures, and research experiences, we look forward to seeing these efforts move forward. As trainees, it has been both rewarding and empowering to be able to contribute to the design of a curriculum that is inclusive, diverse, and representative of the community in which we live and learn. While we feel that it is our obligation to continue to push for these improvements, we acknowledge the disproportionate burden that we as Black students bear and we eagerly look forward to the day where future underrepresented students are relieved of this kind of work. Although the work at times was painful, the experience on this board has produced strong bonds of friendship, invigorated a drive for equity, and helped develop leadership and communication skills that will undoubtedly serve us, and our patients, in the future.

Last thought from Jeffrey Okewunmi:

Black women have been stunting on all the Black men who consistently fail to show up.

If you are interested in learning about the actions that the Dean’s Office and Medical Education have taken since the SNMA open letter addressing anti-blackness and racism at Mount Sinai and the broader medical community, check out this blog post.

On the Pulse: Racism, Assimilation, and Professionalism—Student Council Collaboration

Nov 15, 2020 | Racism and Bias

During a recent Chats for Change on Monday, October 19, close to 40 students, staff, and faculty gathered from across the health system and the Icahn School of Medicine at Mount Sinai to discuss how racism, assimilation, and professionalism operate in medicine and science. This was the first Chats for Change co-hosted by Student Council and the Racism and Bias Initiative.

 

To provide a common framework for discussion, the following definitions were provided to participants. While there aren’t “right” definitions, we hoped to at least provide a starting point for further conversations. After presenting each definition, the participants were encouraged to use slido to answer questions on how racism influences science and medicine and define for themselves what professionalism and assimilation means. 

Racism

(1) “A belief that race is a fundamental determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race. (2) The systemic oppression of a racial group to the social, economic, and political advantage of another.” —Merriam Webster.

Professionalism

(1) “The conduct, aims, or qualities that characterize or mark a profession.” – Merriam Webster; (2) “…the set of standards concerning appearance, character, values, and behavior that mark employees as competent, appropriate, effective, ethical, and respected/respectful.” – Mark D. Davis, Master’s Thesis; (3) “A belief system about how best to organize and deliver health care, which calls on group members to jointly declare (“profess”) what the public and individual patients can expect regarding shared competency standards and ethical values, and to implement trustworthy means to ensure that all medical professionals live up to these promises.” —American Board of Medical Specialities.

 

 

Assimilation

(1) “to absorb into the cultural tradition of a population or group.” – Merriam Webster; (2) “…to accept the new culture wholeheartedly, even to the extent of minimizing or rejecting their culture of origin; this is termed an assimilation strategy” – Knapp et al., “The Dark Side of Professional Ethics”; (3) “Assimilationist: one who is expressing the racist idea that a racial group is culturally or behaviorally inferior and is supporting cultural or behavioral enrichment programs to develop that racial group.”—Ibram X. Kendi, How to Be an Antiracist.  

 

 

 

After providing these common definitions, participants then broke out into small group rooms where they discussed the following questions:

 

  • What are the attributes of professionalism in academic medicine and science?
  • What skills are valued in professionalism, and who decides this?
  • Is the concept of professionalism exclusionary?
  • Are there short or long-term consequences to assimilation? 

 

After coming back to the larger group, participants were able to share out some of their conversations during the small group sessions. Some people shared how they’ve seen professionalism benefit white men and hold back women and BIPOC; from elitist language to physical appearance being qualifiers. There was also a fruitful conversation about whether the concept of professionalism would always be inherently biased and how we could reframe the definition to be more inclusive. Others reflected on the culture at Mount Sinai and ways in which they’ve found it to be more welcoming than other institutions. 

As with every Chats for Change, the session ended with an opportunity for folks to share what they needed to learn and unlearn. While the responses to this prompt varied, it was clear that giving folks the space to reflect on these aspects of academic medicine and science that are rarely discussed helped spur reflection.

Student Council was grateful to have the opportunity to partner with RBI on this Chats for Change and looks forward to hosting another one soon. You can read more about Student Council’s work on racial equity here.