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 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

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.

On the Pulse: A Curricular Sphere Update

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.