I sat down with Jade Johnson, the Coordinator of Diversity and Inclusion at Central Michigan University College of Medicine (CMED), to talk about current initiatives to further promote cultural competence on campus. Through our conversation, I learned more about diversity initiatives on campus that will help frame upcoming conversations with individual students about their personal experiences. __________________________________________________________________
What does it mean to be the coordinator for the Office of Diversity and Inclusion?
Jade Johnson: My main responsibility is to plan events for students, faculty and staff. This includes CARES (Continuous Improvement/Curriculum, Assessment, Reinforcement/Remediation, Evaluation and Skills) weeks and planning events throughout the year. I have a couple of podcasts that I am working on including Women in Science Disciplines and Medicine, Adverse Childhood Experiences and CMU (Central Michigan University) College of Medicine Diversity and Inclusion Podcast. I educate our new employees about our diversity and inclusion initiatives and how these initiatives relate to the jobs that they do. I am also involved with multiple committees, including the Student Diversity Committee, Admissions Committee, and New Student Orientation.
Are there some overarching goals that guide the different projects you engage in?
JJ: Overall, my goal is to help people figure out how diversity and inclusion are inherently part of what they already do and to figure out ways to help them make choices aligned with their goals for diversity.
Can you tell me about the current diversity initiatives at CMED?
JJ: The Chief Diversity Officer at CMU has tasked every department with coming up with three long-term diversity initiatives. For CMED, we ensured that our marketing and communication modalities reflect the reality of what we offer here. This involved updating our website as well as promotional materials for our health services. The other two initiatives were updating our anti-discrimination statements in all our handbooks and developing a program about LGBTQIA healthcare.
When it comes to diversity-related programming, what resources do students need?
JJ: We have a lot of different elements to start with. We have Student Interest Groups (SIGs), the multicultural student coordinators in the medical student council, me and others on campus that are passionate about promoting diversity. It’s a matter of figuring out how to take all of the resources and use them in the most efficient way. So, for me, I like to get the SIGs involved with events that we do with the student diversity committee. Instead of reinventing the wheel, we reach out to a SIGs and say “hey, is there something you want to do that we can collaborate with you on?” This will lead to a stronger effort and will get more people involved.
Are there any specific educational needs or topics that you have identified to work on?
JJ: Most of our students have a basic understanding of diversity and inclusion. When it comes to specific patient populations, there is more they need to know about marginalized groups like the LGBTQIA community, people with disabilities, etc. If they have a patient that fits into a marginalized group, they know how to be respectful, but they may not necessarily know how to acknowledge various identities and how to provide the best care to them. With the diversity CARES week sessions this year, I was intentional with bringing in people from all over the campus and community that do different jobs, so they could give students as much information as possible about these different communities.
Archana Bharadwaj: Students tend to have a very theoretical knowledge of what diversity and inclusion look like and your job is bridging the gap between theory and application.
What are some challenges when teaching diversity and inclusion to students?
JJ: First and foremost, it has to be about healthcare and medicine specifically. You have a lot to learn and not enough time, so I have to be proactive and efficient with how I provide information. I have made sure (activities) are engaging and that the topics are relevant.
How does your involvement with students compare to the programming that you are putting on for faculty?
JJ: Faculty don’t always have time to attend a workshop or lunch lecture. Instead, they prefer listening to podcasts, reading articles or participating as group facilitators.
AB: That’s interesting, because students prefer hands-on activities that give them clear takeaways. However, with the faculty, you have found different strategies.
What have been some of the challenges when promoting diversity and inclusion?
JJ: It starts with recruitment and retention. We have improved the recruitment of underrepresented minorities. From 2014 to 2018, the percentage of women and minorities enrolled in our medical school increased by 16% and 28%, respectively. We are seeing improved recruitment, but retention is still lacking. Another challenge is the quality of education students receive before medical school, because not all students start at the same place. Based on their family’s resources, some students may have access to tutors or AP classes, which build their background knowledge so that they are better able to handle the new information they learn in medical school. For others, their attention is split between family or other commitments, which means that learning happens in addition to other responsibilities. So, when they get to medical school, they have to learn the new content in addition to fixing gaps in previous content. As they progress through their education, these disparities build.
AB: Based on what you are talking about, it sounds like there is a disparity happening where students are either surviving or thriving and disproportionately students of color are the ones trying to survive it. This is a systemic problem where they may not have the resources to wrap them in that academic hug or personal hug to get them where they need to go.
JJ: Right. That’s definitely an issue and some of that we can’t really help. But, once they get here, we are doing what we can to provide the best resources possible.
As you mentioned earlier, students of color are more likely to be coming in at a disadvantage and to be struggling sooner. Knowing that, are you watching out for those students? If so, what does that look like?
JJ: One of the groups I’m involved with is an affinity group called Black Doctors Matter. We advertise supportive resources to our black students and invite them to attend our meetings and seek support.
So, is this a longitudinal experience?
JJ: Yes. We keep it going all four years for students.
What does this support group do for students during the clinical years?
JJ: We don’t have a lot that we do with M3s and M4s. For me, personally, I don’t work with them as much, because they are not physically here. We do invite them to provide feedback to us about their experiences during their rotations.
What trends have you noted in the responses?
JJ: A lot of the feedback that I have gotten has been focused on gender- and LGBTQIA-related discrimination instances. While preceptors listen to students’ experiences, they may not know how to resolve such instances.
As you work to catalyze change with respect to diversity and inclusion on campus, what would you say are some of the strengths of working at CMED?
JJ: One of our biggest strengths is that we are a newer medical school, so we are able to make changes quickly. At some of the other medical schools, they are entrenched in tradition, so it can be hard to change culture. We are very open to making cultural shifts and making an environment that is diversity inclusive, even if we don’t know what the journey looks like.
AB: You are laying the path as you go.
JJ: Yes, it’s a lot of trial and error, but it’s good.
What are you goals for the program moving forward?
JJ: I would love to implement a strategic plan for diversity at the college of medicine, specifically. I feel like we have most of the pieces there. We just have to put it in a plan, come up with specific goals and a timeline, and make those goals happen. Right now, there’s a lot of trial and error. It’s kind of like we know that we have to get to this place, but we don’t know how to get there. I also want to work with people in charge of curriculum and try to get them to incorporate diversity and inclusion in the student learning objectives, so we have diversity and inclusion in as many cases as possible. I would also like to do more projects with M3s and M4s, hopefully starting with providing more education and resources for the preceptors and physicians they work.
AB: Thank you for taking the time to speak with me today.
JJ: You’re welcome!
After this interview, I continued thinking about diversity and the steps it takes to promote inclusion. Specifically, when we talk about talk about diversity, we often think of it as something new that people have to accommodate. Rather, diversity can be framed as augmenting existing projects or goals. In this way, diversity becomes part of the natural fabric of what a person is already doing instead of a completely new endeavor.
In this column, I will explore the unique challenges of training as a provider of color and offer solutions for improving diversity and inclusion in medicine. Through conversations with colleagues of color, including premedical students, medical students in training, and residents, I hope to create a community where we can learn from one another, cultivate allyhood, and find support in our professional journeys.