Education

Healthcare Disparities & Cultural Competencies

APDR Healthcare Disparities Curriculum

This curriculum was developed through the 2020 Jerome Arndt Grant, awarded to Carolyn M. DeBenedectis, MD, Nolan J. Kagetsu, MD, and Priscilla J. Slanetz, MD, MPH.

Introduction:

The goal of this sustainable, accessible curriculum is to provide radiologists and trainees with educational tools so that they can better understand and address health care disparities.  In addition, the curriculum provides information on cultural competency with the goal of making radiology a more welcoming place for all patients and healthcare team members.  The curriculum is designed to be presented to trainees over the course of 1 year.  The minimum curriculum requirements are necessary to satisfy curriculum completion.  Reach activities are also included for programs or individuals who would like to pursue more in-depth knowledge of certain topics.   Programs enrolled in this study are required to complete the “minimum” requirements. 

Curriculum Instructions:

Four in person sessions are required over 1 year to complete the minimum curriculum. The educational modules should be presented in the order below.

Click here to download the curriculum instructions.
Introduction to Health Care Disparities
  1. Minimum requirements (session time approx. 1 hour)
    1. Conduct this session like a journal club
    2. Have residents review prior to the session
      1. The health care disparities glossary
      2. Read “An Introduction to Health Care Disparities for the Practicing Radiologist” by NM Safdar
      3. Read "Racial and Ethnic Disparities in Radiology: A Call to Action” by JR Betancourt et al.
      4. The facilitator (only) of the session should review “Health Care Disparities in Radiology: A Primer for Resident Education” by L Americo et al.
      5. During the session the articles and glossary should be discussed in journal club fashion
  2. Reach activity
    1. Exploring Their Community
      1. Follow instruction for exposing resident to the community they serve through a scavenger hunt
Types of Health Care Disparities in Radiology
  1. Minimum Requirements (session time approx. 1 hour)
    1. Facilitator should give the teaching presentations on “Health Care Disparities in Radiology” and “Equity and Access”
  2. Reach Activities – read any of the following articles for more in depth information
    1. Black Lives Matter: Racism in Research Needs to be Acknowledged in U.S. Preventive Services Task Force Guidelines (Harvey JA, JBI 2020)
    2. Breast Cancer Screening Recommendations: African American Women Are at a Disadvantage (Rebner M et al, JBI 2020)
    3. Evaluation of USPSTF Lung Cancer Screening Guidelines Among African American Adult Smokers (Aldrich MC et al, JAMA Onc 2019)
    4. Racial Disparities in Screening Mammography in the United States: A Systematic Review and Meta-analysis (Ahmed AT et al, JACR 2017)
    5. Relationships Between Health Care Disparities and Coverage Policies for Breast, Colon, and Lung Cancer Screening (Berland LL et al, JACR 2019)
    6. Improving Lung Cancer Screening Access for Individuals With Serious Mental Illness (Flores EJ et al, JACR 2019)
    7. Racial and Ethnic Differences in Diagnostic Imaging Utilization During Adult Emergency Department Visits in the United States, 2005 to 2014 (Schranger JD et al, JACR 2019)
    8. Ethnic differences in pain and pain management (Campbell CM et al, Pain Manag 2012)
Action to Address Disparities in Radiology
  1. Minimum requirements (session time approx. 1 hour)
    1. Facilitator should present the teaching presentation on “Action to Address Health Care Disparities in Radiology”
    2. Small group discussion cases
  2. Reach Activities – read any of the following articles for more in depth information
    1. “The Role of the ACR Data Science Institute in Advancing Health Equity in Radiology” by B Allen et al
    2. “Quality Improvement and Reimbursements: An Opportunity to Address Health Disparities in Radiology” by SG Harrington et al.
    3. “U.S Health Disparities – Opportunities for Radiologists” by N Kadom
    4. “Community Breast Health Education for Immigrants and Refugees: Lessons Learned in Outreach Efforts to Reduce Cancer Disparities” by S Kamraju et al
    5. “Radiology Support, Communication, and Alignment Network and Its Role to Promote Health Equity in the Delivery of Radiology Care” by KY Wang et al.
Cultural Competency
  1. Minimum Requirement (session time approx. 1 hour)
    1. Pre-lecture required reading
      1. “Microaggression in Radiology” by CM DeBenedectis et al
      2. “Unconscious Bias” by N Kagetsu et al
      3. “Cultural competency in diagnostic imaging” by FH Lee et al
    2. Facilitator to give lecture “Creating a Cultural Competency Curriculum” and “How cultural competency can help reduce health disparities”
  2. Reach Activities - read any of the following articles for more in depth information
    1. Small group discussion cases on cultural competency
    2. Mitigating Asian American Bias and Xenophobia in Response to the Coronavirus Pandemic: How You Can Be an Upstander- by Christopher P. Ho et al
    3. Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education – by Melanie Tervalon et al
    4. Radiologykey.com/diversity/
    5. How diverse is your universe? An activity for students to reflect on ethnoracial diversity during orientation- by Tahira J. West et al