Inclusivity in medical education: a step forward and tools that can help

Towards a more inclusive curriculum

Research worldwide also shows that diversity within medicine improves its quality. And when we see that there is still a considerable imbalance between the physician population and society, there is still a lot to be gained.One of the studies recently conducted at the GP training programs has formulated a so-called DEI (Diversity, Equity, and Inclusivity) strategy. This consists of 7 very concrete strategies, of which these are the most important:

• DEI expertise promotion for all those involved in GP training using training programs;
• Appointment of DEI ambassadors in all teams of GP training, who contribute to knowledge transfer, reflection on possible prejudices;
• Participation in DEI networks; Giving an active voice to trainees from ethnic minority groups in developments within GP training.

Despite the fact that there is a lot of attention and a number of initiatives have already been started within medicine, there are still plenty of challenges remaining. To address these challenges, it is essential that medical education actively works towards a more inclusive curriculum. In general, the following aspects are often mentioned as supporting the process towards more ‘DEI’:

• Awareness of implicit biases
• Knowledge about health issues specific to particular groups
• Skills to communicate effectively with a diverse patient population

The role of digital tools in inclusivity

Digital tools, including e-portfolios, can make a modest but potentially valuable contribution to promoting inclusivity in medical education. For example, we see in studies on biasing and the transfer of graduated doctors to the practical work environment as residents (learner handovers), the influence of negative feedback has a major impact on how the learner continues the learning path. A student who carries negative feedback consistently receives lower grades. And often this happens unconsciously or at least out of sight.

A number of very practical tools to promote diversity are:

• Personalized learning: E-portfolios allow students to follow their own learning path and reflect on their experiences. This can help recognize and value the unique perspectives and backgrounds of students.
• Equal opportunities for feedback: Digital platforms can provide a more structured and objective way of giving feedback, reducing the chance of unconscious biases.
• Accessibility: Online tools can increase the accessibility of education for students with physical limitations or other challenges.
• Cultural competence: E-portfolios can contain specific modules aimed at developing cultural competence, better preparing students to work with diverse patient populations.

Conclusion

Although digital tools such as e-portfolios may contribute more positively to more inclusive medical education than we think, they are only part of the solution. Real change requires a holistic approach, where all aspects of the training are critically examined and adjusted. Instruments or concepts such as ‘workplace-based assessment’, programmatic assessment, multi-source feedback, OSCE, where the origin of a decision can always be clear for the learner and the assessor, can be very useful in this regard. That’s why we believe these are also important elements of a good digital portfolio. Especially now that algorithms and AI support are increasingly being applied in such tools.

Creating an inclusive learning environment in medical education is not only a matter of justice for students but also an investment in better healthcare for everyone. By embracing diversity and promoting inclusivity, we train doctors who are better able to provide care to an increasingly diverse society.

Sources

1. https://www.huisartsopleiding.nl/kwaliteit-innovatie/opleidingsinnovatie/bevorderen-van-diversiteit-inclusie-en-gelijke-kansen-tijdens-de-opleiding/
2. https://www.revalidatie.nl/ntr/diversiteit-en-inclusie-in-de-opleiding-tot-revalidatiearts/
3. https://dejongedokter.nl/djd-schrijft/hoe-ver-zijn-we-al-diversiteit-en-inclusie-in-het-medisch-onderwijs/
4. Naar een inclusieve opleiding in de zorg: Diversiteit en inclusie onder artsen (Obihara & Maarse 2024)
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