What’s New with Chats for Change?

by | Sep 30, 2022 | Racism and Bias, Uncategorized

 

 At the Icahn School of Medicine at Mount Sinai, Chats for Change was built on the notion that in order to respond to racism and to be anti-racist we must engage in dialogue, learning and action.

 

Beginning in the fall of 2018, the Department of Medical Education launched Chats for Change—a series of sessions that spark dialogue centered on racism and bias in medicine. The idea of Chats for Change was developed in response to medical education staff and medical students who wanted dedicated time to engage in a dialogue as a community to deepen our understanding and ability to address racism.

 All faculty, staff, trainees, students and others within the health system are invited to engage in dialogue and work towards common understanding by contributing their best thinking, knowing that other peoples’ reflections help to improve their thinking rather than destroy it. We are committed to engaging in dialogue in order to help us reveal our assumptions and biases for self-revaluation.

 By participating in Chats for Change, we offer an opportunity for attendees to explore key concepts related to racism and bias and uncover who they are in relation to others. Even though the dialogue is structured, the expectation is for attendees to express themselves from their own lived perspectives and listen for deeper understanding and insight.

 In August 2020, we launched the national edition of Chats for Change, a series of monthly dialogues focused on topics related to racism and bias in medicine. All medical schools from across the country and Canada are welcome—staff, faculty, trainees, leadership and students.

 

The Process

Each Chats for Change follows the same format:

  1. We open each session with a check in and a review of the grounding assumptions.
  2. The facilitators then introduce a concept or topic related to racism and bias.
  3. To level set knowledge we provide a frame and definition.
  4. The group then goes into breakout rooms to discuss the guiding questions related to the concept or topic.
  5. We then return to the larger group for debrief and close the session with a reflection about what we need to learn or unlearn.

Feedback

Out of 311 respondents:

  • 92% of respondents reported that Chats for Change simulates their interest in the topic.
  • 85% reported Chats for Change dialogue will help them take sound action in the future.
  • 95% would recommend Chats for Change to a colleague or peer.

To the right is what a few attendees had to say about their experience with Chats for Change:

“I find Chats for Change amongst the most valuable learning sessions that I have ever had at Mount Sinai. I have grown through them. Thank you.”

“This venue allows for respectful open and honest conversations with colleagues and allows me to think of different ways to do my work and hear specific examples of things that have worked in other universities.” 

“What I really appreciated about this was the small bite sized ways that we could engage with the content”

“I’m just fatigued. It helps and feels validating to hear other people experiencing similar experiences and feelings as me.”

Here’s how you can get involved with Chats for Change.

 
Attend Chats for Change

Join the National Chats for Change to conclude the three-part series called In the News. The media is a powerful socialization tool that creates unspoken attitudes, beliefs, and narratives through messages and images. We often do not stop, reflect, and analyze how this tool impacts us as individuals and the environments in which we work and learn. 

Join Us on Zoom.
Become a Facilitator

If you are interested in learning more about how to facilitate Chats for Change, please sign up to attend one of our upcoming trainings. Space is limited.

  • 10/19 11:00-12:00p EST 
  • 10/20 3:00-4:00p EST 
  • 10/24 1:00-2:00p EST 
  • 10/26 1:00-2:00p EST 
Tell Me More.
Download New Content

We are making the Chats for Change slide decks available. Please fill out this brief form to gain access to the shared folder. We are launching the Say what you mean, mean what you say series first.

Decks on Demand.

Shout Outs

Last but not least, we would like to recognize the Chats for Change core group facilitator group for their dedication and commitment to this work. We have facilitated over a hundred and twenty topics with over 3,000 attendees. Congrats!

 

Special thanks to:
Alia Barnes, MPH   |  Ashley Michelle Fowler, MEd  |  Leona Hess, PhD, MSW  |  Jay Johnson, CHES  |  Jenn Meyer, MPH, MSW  |  David Muller, MD  |  Ann-Gel Palermo, DrPH  |  Pete Zweig, MPA 
Racism and Bias Initiative (RBI) x Center for Anti-Racism in Practice (CAP) Fellowship for Icahn School of Medicine Students

Racism and Bias Initiative (RBI) x Center for Anti-Racism in Practice (CAP) Fellowship for Icahn School of Medicine Students

by | Aug 21, 2022 | Racism and Bias

Our mission is to support and advance the lifelong pursuit of anti-racism, equity, and racial justice as the organizing principles of medical education at the Icahn School of Medicine at Mount Sinai (ISMMS).

RBI x CAP Fellows will work closely with ISMMS leaders across all functional areas of the school of medicine and report directly to the co-Directors of the Center for Anti-Racism in Practice. Fellows will serve as an invaluable capacity-building resource for school and institution-wide anti-racism initiatives.

 

Applications Open: Monday, August 22

Applications Close: Monday, September 5

As a fellow, here’s what you’ll do:

While any of these activities may result in a scholarly product,

the primary purpose of RBI x CAP Fellows is to expand the workforce

focused on anti-racism work for the Icahn School of Medicine

at Mount Sinai. 

 

Fellow projects for the 2022-2023 cycle are:

Situational Judgment Tests

  • Name of project: Investigating the use of situational judgment tests (SJT) and their use in ISMMS MD and MD/PhD admissions
  • Project supervisor(s): Carrie Ernst, MD, Valerie Parkas, MD, Talia Swartz, MD, PhD
  • Why is this project important?: AAMC is piloting a new SJT (PREview) which will be broadly available in the upcoming academic year. We aim to evaluate how this can be used equitably in assessing our applicants and mapping these assessments to our attributes.
  • Brief description: Situational judgment tests are designed to evaluate applicants based on how they would respond to specific situations as a measure of pre-professional competencies. In this project, we are seeking to Aim 1) review the literature on situational judgment tests with a lens toward equity to understand how racism and bias may manifest or be mitigated by this assessment and Aim 2) map how the ISMMS attributes in successful candidates are measured using SJT.
  • Outcomes/deliverables: Aim 1) to generate a literature review manuscript on racism and bias in SJTs in medical school admissions and Aim 2) to create a scheme understanding how use of the PREview results could inform admissions at the ISMMS. 
  • Responsibilities: Conduct literature review, develop a scheme, draft a manuscript, present work to the admissions team and Selections Subcommittee, and attend meetings.  

Equity Audit

  • Name of project: Conducting an equity audit of student policies 
  • Project supervisors: Leona Hess, PhD
  • Why is this project important? It is critical to identify institutional practices that produce discriminatory trends in data that affect students. 
  • Brief Description: As part of the change target of the school-wide sphere of the RBI’s Guiding Coalition, a protocol was developed to provide a structure for examining existing written policies and institutionalizing a process of developing, implementing, and assessing the impact and outcomes of policies over time. The next phase is to conduct an equity audit with a focus on 15 student facing policies. 
  • Outcomes/deliverables: Aim 1) Equity audit of 15 current student facing policies and Aim 2) a planning document outlining how we will develop, implement/enforce and assess the impact/outcomes of policies to eliminate potential barriers. 
  • Responsibilities: Partner with the Director of Quality, Compliance, & Accreditation and various functional areas of the Dept. of Med Ed.; use the protocol to facilitate one-on-one interviews and small group meetings with students to examine current written policies; contribute to the planning document; and attend planning group meetings and present audit findings.
    •  

Anti-Racist Transformation in Medical Education (ART in Med Ed)

  • Name of project: Developing the capacity of eleven medical schools across the country and Canada to dismantle systemic racism and bias. 
  • Project supervisors: Leona Hess, PhD and Chloe Martin, MSW, David Muller, MD
  • Brief Description: Anti-Racist Transformation in Medical Education (ART in Med Ed) is a three-year Josiah Macy, Jr. Foundation grant-funded project aimed at implementing and adapting Icahn School of Medicine and Mount Sinai’s (ISMMS) change-management strategy with 11 partner medical schools in the United States and Canada (more info here). The ART in Med Ed team/program has always prioritized elevating the student perspective as a critical aspect of co-creating how we work, learn, grow and change together. This is a great opportunity if you are interested in medical education, administrative leadership, teaching, and/or gaining skills related to organizational change management. It’s also a great way to get exposure and network with health professionals across the country.
  • Outcomes/deliverables: Aim 1) sustain the community of practice among students; and Aim 2) assist in developing the capacity of medical schools to dismantle systemic racism and bias in their work and learning environments.
  • Responsibilities: Participate in regular team meetings with the ART in Med Ed team (can be flexible based on student schedule); facilitate monthly coaching sessions for students; analyze project data and report findings in collaboration with the ART in Med Ed team; work independently to develop change management content, session materials, and other program-related tasks (with support available); and identify projects of interest. 

Anti-Oppressive Curriculum Revamp

  • Name of project: Scaffolding curriculum content to achieve anti-oppressive Medical Education Program Objective (MEPO) 
  • Project supervisors: Leona Hess, Phd, Ann-Gel Palermo, DrPH MPH, Rainier Soriano, MD and Joe Truglio, MD 
  • Why is this project important? We are currently undertaking a curriculum revamp and this is the time to ensure our existing course content is aligned and scaffolded to achieve the new anti-oppressive MEPO. 
  • Brief Description: Over the years there has been an intentional effort to map existing course content across four-years of the curriculum that focuses on health disparities, social determinants of health, race, diversity, equity, inclusion, anti-racism, structural competency, race-based and race-conscious medicine, etc. The next step is to take the map and identify any gaps, remove redundancies, and ensure the content is aligned and scaffolded to achieve the new anti-oppressive MEPO. The goal is to inform the new curriculum that will roll out in the academic year 2024-2025.
  • Outcomes/deliverables: Aim 1) updated curriculum map with scaffolded content, including learning objectives and measurements/assessments. 
  • Responsibilities: Collaborate with project supervisors to develop scaffolding framework, collect and assess existing course content, identify content gaps, meet with students/student groups to gather feedback and content requests, attend curriculum revamp meetings, attend meeting with pedagogy expert, present work to curricular affairs and CAP, etc.

Student Sphere

  • Name of project: Leading the student sphere of the RBI’s Guiding Coalition 
  • Project supervisors: Alia Barnes, MPH and Leona Hess, PhD 
  • Brief Description: As part of the Racism and Bias Initiative’s (RBI) change management plan, our commitment is to establish a diverse guiding coalition of faculty, staff, leadership, and students to determine the change targets, identify options for implementation, make decisions about where energy and resources should be focused, determine how to hold people accountable, and manage resistance in the medical school and beyond. The guiding coalition is made up of seven spheres or functional areas: Admissions, Curricular Affairs, Student Affairs, Clinical, Resources, Medical School-Wide, and Student.  
  • Outcomes/deliverables: Aim) Oversee and monitor the change targets in the student sphere; Aim 2) Oversee student involvement in Chats for Change, Orientation, and other RBI Sphere work. 
  • Responsibilities: Attend two 1-hour Guiding Coalition meetings a month; participate in the guiding coalition planning process for 2023; recruit and convene students and student groups in the change target development and implementation; track and monitor change over the year; and meet with guiding coalition leadership.

Propose Your Own Project

  • This year we are offering an opportunity for a fellow to propose and execute an innovative project of their own. In the application you will have the opportunity to submit a potential project name, supervisors, description, outcomes/deliverables, and responsibilities. We are looking for a project that is:

    • Aligned with our mission to nurture a visionary community of students, staff, faculty and leaders who are committed to advancing exceptional clinical care and science that is free of racism and oppression in all its forms;
    • Designed to address a gap or concern related to our learning environment;
    • Achievable in 8 months; and 
    • Innovative and doesn’t duplicate or complete with the current twenty-four change targets 

Fellows will:

  • be closely mentored by Med Ed leadership and CAP
  • work with or be a liaison to other relevant medical school administrators, students, and partners including but not limited to the Office for Diversity & Inclusion and the Graduate School of Biomedical Sciences
  • be part of a Fellows community of practice and mutual support
  • learn anti-racist and anti-oppressive teaching, facilitation, and reflection practices
  • learn leadership, communication, and conflict resolution skills
  • have opportunities to develop projects into scholarly products
  • develop the capacity to design and facilitate equity programming beyond medical school, in residency training and their professional careers
  • when applicable, manage a modest programming budget and submit required documentation to Med Ed administration
  • receive a stipend of $5,000 for every year that they serve as a fellow

Fellow Requirements:

  • Approximately 20 hours/month for the eight-month commitment.
  • Fellows may apply to renew their commitment in subsequent years, up to their full tenure at ISMMS.
  • Student on Scholarly Year may not apply for a RBI x CAP Fellowship
  • Participate in two training/program planning lunches each semester that will bring together all Fellows.
  • Complete one scheduled check-in per semester with the Dean for Medical Education.
  • Fellows will present their work to the RBI Guiding Coalition, Senior Leadership Committee, and other key stakeholders in a “re-CAP” presentation at the close of the Fellowship
  • Up to six fellows will be selected to participate.

Application Process

Candidates will be required to submit their CV and answer the following questions in a total of 500 words or less.

Submitted applications will be reviewed and scored by a selection committee comprising of members of the Racism and Bias Initiative Guiding Coalition (Medical Education faculty, staff, leaders, and students). The committee will also conduct one round of interviews with all eligible applicants. Each reviewer will consider your alignment with the School’s vision and values, and your track record of contributions/leadership in addressing racism and bias.

Ready to apply?

Submit all applications by Monday, September 5.

Apply Now

What’s Chats for Change?

by | Apr 2, 2021 | Racism and Bias

Beginning in the fall of 2018, the Department of Medical Education at the Icahn School of Medicine at Mount Sinai launched “Chats for Change”—a series of interactive sessions that spark dialogue centered on racism and bias in medicine.

 

 

Chats for Change is built on the notion that in order to respond to racism and to be anti-racist we must engage in dialogue, learning and action. The idea of Chats for Change was developed in response to medical education staff, students, and faculty who wanted dedicated time to engage in a dialogue as a community and deepen our collective understanding and ability to address racism.

By participating in Chats for Change, we offer an opportunity for attendees to explore key concepts related to racism and bias and uncover who they are in relation to others. Even though the dialogue is structured, the expectation is for attendees to express themselves from their own lived experiences and listen for deeper understanding and insights that will promote learning and unlearning.

We invite all faculty, staff, trainees, leaders, students and others within the health system to join us and engage in dialogue as we work towards a common understanding and contribute our best thinking, knowing that other peoples’ reflections help to improve our thinking. We are committed to helping each other reveal our assumptions and biases for self-revaluation.

Did You Know?

The Department of Medical Education launched two versions of Chats for Change: One that’s offered to all faculty, staff, and students within the Mount Sinai Health System, and another that’s offered nationally—to all within the medical education and healthcare communities.

Join the Next Mount Sinai Chats for Change
Subscribe to the National Chats for Change Newsletter

Inside the Student Healing Circle: A Lesson in Dignity

by | Mar 12, 2021 | Racism and Bias

After many months of online lectures, tele-health physical exams, and learning how to cope with the responsibilities of becoming a health professional during a pandemic, I ventured out back onto the hospital wards for the first time this week. I went to a cardiothoracic unit where most patients had recently undergone an invasive procedure and were being closely monitored during their recovery.

When I first introduced myself to my assigned patient, I explained that I was a second-year medical school student there to practice my history-taking and physical exam skills, and that I hoped to spend the next hour with him getting to know him better. He interrupted me before I could finish, “Excuse me, miss, let me find you a chair to sit in. I don’t know where they all went,” and proceeded to press his “call” button to alert the floor staff that he needed assistance. 

He inquired about the chairs to the nursing staff on the floor with no resolve, and so I took a comfortable stance and began my interview. In common practice, I began by inquiring what had brought the patient in initially. I learned about his medical history, which was largely uncomplicated until the summer of 2020, and we shared about how God grants us the gift of forgetfulness to allow us to endure pain. Time after time in our conversation, he would express his frustration with his missing chairs. In the end, this elderly Black man sat in front of me with an assistance device working to keep him and his heart alive, and an infection that had kept him in and out of the hospital for 3 months now – and still, he was the most upset about the chairs that were missing from his room. He was most concerned about his dignity as a patient. 

Donna Hicks, a renowned expert on the role of dignity in conflict, defines dignity as the internal state of peace that comes with the recognition and acceptance of the value and vulnerability of all living things. As social beings, our survival is linked to the quality of our relationships, and honoring dignity in ourselves and others is the foundation of any functional, healthy relationship – whether it be with our patients, our peers, family, friends, etc. However, our evolutionary legacy of self-preservation and systemic oppression often puts us at risk of violating our own and others’ dignity.

My patient, Mr. L spent most of his days in the hospital bed longing for a genuine conversation, and in many ways, the chairs represented connection for him – one that we all crave and are deserving of. Not surprisingly, no one bothered to get a chair and the moment stuck with me. In the Hippocratic oath, we, as health professionals, vow to “remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” As a physician-in-training, medical school has often made me question my own dignity and reckon with how I/we see and acknowledge the dignity of those we interact with every day. We assume the responsibility for managing patients’ care while frequently serving as leaders to apply our unique knowledge-base, skills and training, and to do no harm. Yet our biggest challenge seems to be the most simple one— treating one another with dignity. 

The power of dignity gives us the awareness and skills to avoid unknowingly harming others, while allowing us to recognize the fullness within ourselves and our relationships. Racial healing, which is grounded in indigenous circle and community-sustaining practices, recognizes the need to speak truths about past wrongs, including those created by individual and systemic racism, and to address the present consequences. It is an experience and a tool that can facilitate trust and build authentic relationships as we draw on our stories to learn from and with one another about how we can heal, rather than cause harm to ourselves and others.

Every month in our circle, we cultivate and harvest wisdom about what is on our hearts and what dignity feels like. Even if we feel a lack of dignity, in our healing circle we can garner the capacity to imagine what it might feel like together and continue to share that practice in our profession. Join us for our next racial healing circle on Friday, March 19 as we stitch together moments of vulnerability to remind each other of our own value and dignity in a safe space.

A community poem, generated from the collective wisdom in our circle and prompts from our Healing Circle session held on February 19.

Dignity feels like

Groundedness

Anchoring

Sureness of self

Curiosity, 

Respect from others,

Feeling physically full,

Nakedness

Authenticity

The power of imagining what it could feel like.

 

My relationship and sense of belonging is grounded in dignity when

It has a name

We are dignified over the conflict over it and the need for it

When it’s chosen and unchosen;

Like the dignity of a child or newborn.

May You Be Happy.

May You Be Safe.

May You Be Well.

 

I will recognize the fullness in myself and others by

Appreciating that there is no right answer and we are figuring it out;

Holding fullness with mystery,

Feeling expansive

Even in our own family, with strangers and those we can count with our fingers,

Expressing gratitude.

This post was written by Jennifer Dias, a second-year medical student at the Icahn School of Medicine at Mount Sinai. 

On the Pulse: Desegregating Healthcare Systems

by | Mar 8, 2021 | Racism and Bias

What does a desegregated health care system look like and how can we get there? This was the theme for the Chats for Change on March 2, 2021.

We gathered.

Nearly 100 students, faculty, care providers, hospital leadership, and administrators gathered to share their perspectives and knowledge on the issue. We had representation from across Mount Sinai’s campuses as well as folks from other institutions in NYC!

We framed the conversation.

We began our conversation by setting a common framework for the dialogue by defining segregated care: the separation of patients based on insurance status. This exists when patients who have public insurance are seen by different physicians, in a different location, or at different times than patients with private insurance. This segregation by insurance negatively impacts patient experience and how students learn about medicine. This separation occurs both within institutions and between the public and private hospital systems. 

The systemic effects of racism, white supremacy culture, and capitalism are embedded into differences in insurance status. As a result, by segregating by insurance, we are segregating patients by race. One-in-four non-elderly New Yorkers have medicaid, and among those Medicaid enrollees, white people are under-represented and people of color or over-represented. Segregated care perpetuates racism and inequity.

As the theme suggests, our goal was to imagine a desegregated, equitable system, which requires us to move beyond the way the system is currently set up. So we moved on to brainstorming the different avenues of care in New York City to acknowledge what is currently in place. Responses ranged from the community health centers, urgent care, private practice, to the internet, with hospitals making up the overwhelming majority. 

We dialogued: 

In small groups, we discussed the following questions:

  1. What would a desegregated system look like across NYC, assuming there are truly no boundaries? 
  2. Who might benefit from a desegregated health care system?   
  3. What is an immediate actionable change that can be made to bring us closer to a desegregated system? 

The point wasn’t to be bogged down in the barriers. The point was to envision a better future. As such, we framed the conversation as aspirational. Our dialogue didn’t need to be feasible or realistic. We focused the purpose on envisioning who and how people would benefit from a desegregated system and what that would look like, rather than how we would get there. Then, we spoke about changes that could be made to get us closer to what we envisioned. 

We aspired: 

Individuals brainstormed and logged in their responses. Here are some of the themes that arose:  

Desegregated care would mean:

  • Equity in access to resources and longitudinal care 
  • Educating physicians to treat a diverse patient population
  • A renewed focus on preventative care
  • All people, regardless of insurance or immigration status, would be able to access care

We brainstormed ways to get there together: 

  • Mount Sinai should/will publicly denounce Segregated Care both institutionally and across NY.
  • Full price transparency mandated to all hospitals/clinics/healthcare systems to promote using money in a more equitable manner. 
  • Lower the debt burden for medical students to prevent the physician financial stress that contributes to segregated care and diversify our physician network.
  • Move towards a single payer model for healthcare. 

We will take action: 

  • Acknowledge and actively address biases. 
  • We will continue the conversation and note differences in our training, work, and community that are grounded in structural racism and segregated care
  • Talk to peers working at different institutions to see how we can work together towards a desegregated, more equitable system
  • Instead of focusing on barriers, we will focus on the immediate actionable changes that can be made. 

We will continue the conversation: 

If you are working on desegregation and integration at Mount Sinai or any other institution, the Segregated Care Work Group would love to hear from you – please email Emily Xu (emily.xu@icahn.mssm.edu) and Paige Cloonan (paige.cloonan@icahn.mssm.edu) to set up a time to meet with us! Please also reach out if you’re interested in working on a project with us! We welcome everyone – regardless of role or institution. 

Do you have any experiences with segregated care as a provider, patient, or trainee (student, resident, fellow) that you would like to share? Feel free to contact us directly, or submit your story anonymously here. 

This post was written by Emily Xu and Paige Cloonan, medical students and co-facilitators of the Chats for Change session, “Desegregating Care: Imagining an Equitable NYC Healthcare System.”

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