R.E.A.C.T: A framework for role modeling anti-racism in the clinical learning environment

Abstract

Purpose

In 2020, medical schools across the U.S. were called to task by students who demanded a response to structural racism in medicine. Many medical schools made anti-racism declarations and pledged to promote more inclusive learning environments. Much of the focus was on changing the pre-clinical curriculum and less on the everyday interactions that occur in clinical settings. As medical educators, we have an obligation to reinforce statements of solidarity by role modeling behaviors that demonstrate anti-racism in clinical practice.

Methods

This article proposes a framework that provides practical steps for role modeling anti-racism in the clinical learning environment. These steps are drawn from a review of the literature on role modeling, constructs from Social Cognitive Learning Theory, and anti-racism praxis.

Results

The resulting framework uses the acronym R.E.A.C.T to describe practical steps that include Reflecting on implicit biases, Educating ourselves on historical and current forms of structural racism, Assessing the use of race in clinical practice and asking how racism is impacting a clinical interaction, Calling out behaviors that perpetuate racism, and Treating everyone with dignity and respect.

Conclusions

The R.E.A.C.T framework is of value to medical educators because it provides practical steps on role modeling anti-racism in the clinical learning environment. The framework calls medical educators not to merely passively ‘react,’ but to be introspective, proactive, and intentional in their response to racism. Examples are provided on how each step can be actualized and adapted for different learning environments.

Keywords:

• Education environment
• clinical skills
• roles of teacher
• undergraduate medical education

Disclosure statement

The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article.

Glossary

Anti-racism: Describes ongoing efforts toward identifying, describing, and dismantling racist policies and practices.

Anti-racism: Includes naming racism, asking ‘how is racism operating here?,’ and responding with organized and strategic actions.

Additional information

Notes on contributors

Carla Boutin-Foster

Dr Boutin-Foster, MD, MS, is the Associate Dean for Diversity, Education, and Research at SUNY Downstate Health Sciences University. She is a medical educator and health disparities researcher.