Evaluation of a Longitudinal Health Equity Curriculum: A Pilot Initiative for Advancing Inclusive Medical Education
TL;DR
A longitudinal health equity curriculum was piloted within a PHM fellowship and then replicated in a larger cohort, with measurable improvements in understanding of health equity concepts.
Abstract
Background Despite the Accreditation Council for Graduate Medical Education (ACGME) requirements for education on health equity, many graduate medical education (GME) programs lack structured learning in this area. Health inequities persist in clinical practice, emphasizing the importance of incorporating training in health equity concepts. Objective This study aimed to design and pilot a longitudinal health equity curriculum for pediatric fellows to improve their knowledge, beliefs, and comfort with equity-related concepts. Methods A two-phase pilot study was conducted. Phase I was from October 2024–March 2025 within a two-year pediatric hospital medicine (PHM) fellowship. Of six total PHM fellows, five were eligible and participated. Curriculum development followed Kern’s six-step model. A needs assessment informed session topics. Four, sixty-minute interactive, in-person sessions were held. Phase II curriculum sessions were delivered to a separate replication cohort of pediatric fellows in November and December 2025. Anonymous pre-post-session surveys were administered to assess changes in knowledge, beliefs, and comfort. Demographic data was not collected during phase I to maintain anonymity but was collected from the larger phase II cohort. Results were compared using pre-post-session data, using descriptive statistics. Survey tools were internally developed and not externally validated. Results During phase I, five fellows were eligible to participate, with 4-5 fellows per session (80-100% participation). All phase I participants (100%) completed both pre- and post-surveys. Self-reported knowledge, beliefs, and comfort improved across all sessions. In phase II, similar patterns of improvement were observed and participants shifted away from neutral or disagree responses, with marked improvements in knowledge, belief, and comfort domains. Conclusion A longitudinal health equity curriculum was piloted within a PHM fellowship and then replicated in a larger cohort, with measurable improvements in understanding of health equity concepts. These findings support the integration of longitudinal health equity education into GME programs to better equip physicians to advance health equity in clinical practice.