Original Publication
Open Access

Stopping Discrimination Before It Starts: The Impact of Civil Rights Laws on Healthcare Disparities - A Medical School Curriculum

Published: December 7, 2009 | 10.15766/mep_2374-8265.7740

Included in this publication:

  • Facilitator's Guide.pdf
  • Workshop.ppt

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Abstract

This resource is a curriculum that introduces medical students to Title VI of the Civil Rights Act of 1964, the law that prohibits recipients of federal funds, including hospitals that participate in the Medicare program, from discriminating on the basis of race, color, or national origin. Through role-playing and discussion during an extensive hypothetical exercise, students not only learn about possible discriminatory actions under Title VI but also gain new appreciation for the role that physicians can play as leaders in the broader public policy arena regarding health care disparities and discrimination. Students typically are exposed to the existence of health care disparities but are rarely made aware of federal civil rights laws that impact the institutions where they practice. Through this curriculum, participants learn that health care providers have a role in identifying, preventing, and addressing Title VI violations. The content is presented in a 2- or 3-hour workshop aided by a detailed slide-by-slide facilitator guide followed by a postworkshop assessment tool. This curriculum has a significant legal component, so medical schools may wish to consider partnering with their law school counterparts to copresent the material. Workshop participants self-assessed their knowledge, skill, and attitude changes postworkshop and showed significant increases in knowledge in all domains. Participants also felt that the workshop improved their abilities to identify, prevent, and address Title VI violations, and noted moderate change in attitude about physicians’ roles. In addition, participants rated the impact of the workshop highly on both their likelihood of considering potential Title VI issues in their practice, educational setting, and home institution and of teaching others about Title VI.

Educational Objectives

By the end of this workshop, participants will be able to:

  1. Discuss the relevance of civil rights law to health care practice.
  2. Describe the current extent of health disparities.
  3. Identify and address potential discrimination under Title VI of the Civil Rights Act of 1964.
  4. Apply the law to hypothetical health care scenarios.
  5. Understand how the Department of Health and Human Services Office for Civil Rights enforces Title VI through investigations and technical assistance to health care providers and entities.

Author Information

  • Sylvia Bereknyei, MS: Stanford University School of Medicine
  • Sheila M. Foran, JD: US Department of Health and Human Services: Office for Civil Rights
  • Kenneth D. Johnson, JD: US Department of Health and Human Services: Office for Civil Rights
  • Angela J. Scott, JD: US Department of Health and Human Services Office of the General Counsel
  • Tamara L. Miller, JD: US Department of Health and Human Services Office for Civil Rights
  • Clarence H. Braddock III, MD, MPH: Stanford University School of Medicine

Disclosures
None to report. 

Funding/Support
This research was supported in part by the National Institutes of Health, National Heart, Lung and Blood Institute, award # K07 HL079330-03, RFA-HL-04-012, “Integrated Immersive Approaches to Cultural Competence” (2004-9).

Prior Presentations
Bereknyei S, Braddock CH, Johnson K, Foran S. Fostering compliance of Title VI of the Civil Rights Act: an educational program. Workshop presented at: Association of American Medical Colleges Annual Meeting; November 2007; Washington, DC.



Citation

Bereknyei S, Foran S, Johnson K, Scott A, Miller T, Braddock III C. Stopping discrimination before it starts: the impact of civil rights laws on healthcare disparities - a medical school curriculum. MedEdPORTAL. 2009;5:7740. https://doi.org/10.15766/mep_2374-8265.7740