Teaching Anti-Racism at the Bedside: Perspectives from Patients and Clinician Educators

Background Anti-racism medical education is essential for addressing health disparities and improving patient care. This study explored barriers and facilitators faced by clinician educators when teaching anti-racism concepts to clinical learners and examined patient perspectives on engaging in these discussions at the bedside. Design: This qualitative study utilized semi-structured interviews with clinician educators and focus group discussions with patients from underrepresented communities. Participants: Clinician educators (n = 10) were recruited from two academic medical centers in California and Alabama. Patients (n = 17) were recruited from a Virtual National Community Advisory Board, comprising patients and clinicians caring for Black patients in Leeds, AL; Memphis, TN; Oakland, CA; and Rochester, NY. Approach: 1:1 clinician educator interviews focused on knowledge of structural racism, experiences discussing anti-racism, and perceived barriers and facilitators when teaching these concepts in clinical settings. Patient focus groups introduced participants to teaching scenarios around bias and structural racism in clinical decision making, and invited response and discussion focused on perceived comfort as a patient, provider-patient rapport, and sense of inclusion in the teaching moment. Key Results: Clinician educators identified significant barriers to teaching anti-racism at the bedside: systemic challenges (eg. time constraints), lack of structural support, personal discomfort, and fear of retaliation. Facilitators included supportive learning communities and structured curricula. Patients expressed interest to engage in bedside discussions about their racialized experiences, emphasizing the importance of patient narratives in these conversations. Both clinician educators and patients agreed on the importance of including patient stories and voices in bedside teaching on anti-racism. Conclusions This study highlights the potential to enhance anti-racism education in medical training by incorporating patient voices into bedside teaching. This approach empowers patients and enriches clinician educators' understanding of relevant racialized experiences. Future research should focus on the practical implementation of these discussions in clinical environments and their impact on patient outcomes.