Answer to "How can I overcome faculty challenges to enhance EDI?"
Specific training strategies can be implemented to ensure that EDI initiatives are maximally effective.
Use a positive and open approach
Some EDI training may result in backlash, particularly when they overemphasize a “blame and shame” approach and/or enhance (rather than reduce) stereotypes about cultural groups (e.g., Mobley and Payne, 1992; Chavez and Weisinger, 2008). Accordingly, EDI curricula should avoid creating atmospheres of guilt and negative affect. Trainers should also be careful not to amplify stereotypes about different subgroups. While it can be useful to understand the breadth of cultural practices, trainers should avoid propagating or relying on unfair or harmful generalizations. Instead, programs can underscore “cultural humility” (Kleinman and Benson, 2006; Chang, Simon and Dong, 2012), which emphasizes attitudes of openness, adaptability, and empathy. This perspective can also help overcome EDI-related difficulties outside of programming itself. If individuals approach sensitive situations with humility, they may be better able to avoid escalating conflicts stemming from differences in cultural beliefs and practices.
Be transparent and realistic
Scepticism can also impact the degree to which faculty adopt EDI. Stakeholders often express reservations about the ability of EDI initiatives in eliminating racial and ethnic disparities in health care, particularly given the many contributing causes of these inequities (Betancourt et al., 2005). To this end, training should be transparent and realistic about the objectives and impact. While educators should underscore the greater goals of cultural competency, they should also temper the expectations of the class: cultural competency is a process, not a state of being (Campinha-Bacote, 2002). Medical education is but one part of the multilevel interventions needed to implement EDI change – but it can also be powerful.
Support any claims with evidence
In a qualitative study set in the United States, Betancourt et al. (2005) described multiple levels of resistance to EDI initiatives, including providers’ perceptions of cultural competence as a “soft science” (pg. 500). In order to combat these misperceptions, trainers should ensure that they use evidence-based science whenever possible. For example, educators can provide statistics about health inequities and the effectiveness of interventions in order to underscore objective measures of EDI. They can point to specific case studies, legislation, healthcare organization policy, subject matter expertise, leadership testimony, and other exemplars of EDI as evidence of its importance. It is critical to demonstrate that multiple sources of information converge upon the critical nature of EDI.
Betancourt, J. R., Green, A. R., Carrillo, J. E. and Park, E. R. (2005) ‘Cultural Competence And Health Care Disparities: Key Perspectives And Trends’, Health Affairs, 24(2), pp. 499–505. https://doi.org/10.1377/hlthaff.24.2.499.
Campinha-Bacote, J. (2002) ‘The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care’, Journal of Transcultural Nursing, 13(3), pp. 181–184. https://doi.org/10.1177/10459602013003003.
Chang, E., Simon, M. and Dong, X. (2012) ‘Integrating cultural humility into health care professional education and training’, Advances in Health Sciences Education, 17(2), pp. 269–278. https://doi.org/10.1007/s10459-010-9264-1.
Chavez, C. I. and Weisinger, J. Y. (2008) ‘Beyond diversity training: A social infusion for cultural inclusion’, Human Resource Management, 47(2), pp. 331–350. https://doi.org/10.1002/hrm.20215.
Kleinman, A. and Benson, P. (2006) ‘Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It’, PLOS Medicine, 3(10), p. e294. https://doi.org/10.1371/journal.pmed.0030294.
Mobley, M. and Payne, T. (1992) ‘Backlash! The Challenge to Diversity Training’, Training and Development, 46(12), pp. 45–52.