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Introduction

At UNC SOM we recognize the importance of integrating social justice into the curriculum to prepare our students and trainees to improve health equity and reduce health disparities. In addition, a just learning environment where faculty are well prepared to support a diverse learner group is essential for our success.

These have been priorities of our institution for the long term, and we are proud of our diverse student body and alumni cohorts, our innovative curriculum in social and health systems science, and many markers that demonstrate our commitment to the reduction of health disparities.


To that end, Dr. Julie Byerley, former Vice Dean for Academic Affairs, convened the Task Force for Integrating Social Justice into the Curriculum and gave it four charges:

  1. Report recommendations on the learning environment, faculty development, and curricular innovation regarding social justice topics to the Education Leadership Committee.
  2. Establish clear goals, strategies, action steps, metrics, and outcomes for enhancement of integration of social justice into the medical school curriculum and create recommendations to submit to the Education Committee for consideration.
  3. Specify the anti-racism components to the curricular pieces proposed.
  4. Identify other key partners within UNC SOM, expand the task force, and work collaboratively with those partners to make recommendations on best approaches to integrating social justice into the curricula for graduate medical education, allied health, and biological and biomedical graduate programs.

Process

Infographic radial design representation of the Social Justice Task Force. The first ring (center) is the Core Team. The second ring is the Task Force Leadership Committee. The third ring is the Task Force which is composed of administrators, faculty, staff, and students. The last ring is the School of Medicine student community.
Task Force to Integrate Social Justice

The Task Force used a multifaceted approach to achieve its goal and recruited a diverse group of individuals for the sake of equity and inclusion. By recruiting a diverse group and using a concentric ring structure of leadership, we aimed to distribute power to all participants and allow thoughts to flow in all directions among members.

The first ring of participants was a core team made up of four individuals who were well connected to theory and practice of their respective areas, and who understood the administrative processes necessary to integrate social justice into the curriculum. The second ring was the leadership team, which included content-experts in the areas of the learning environment, curriculum, and faculty development. The third ring included the entire task force, which was composed of administrators, faculty, staff, and students who were involved in this work and could move it forward within the school. The last ring was the School of Medicine student community, in which task force members hosted town halls to keep individuals apprised of what we were doing and to receive their feedback.

The leadership team identified three key areas that would require systemic change in order to effectively integrate social justice into the medical curriculum:

  • the learning environment,
  • curricular innovation, and
  • faculty development

The task force was divided into three workgroups, each of which focused on developing recommendations in one of these three areas.

Task Force Members

Leadership team

Chair
E. Nathan Thomas III, PhD
Social Justice Strategist
Stephanie Brown, PhD, MA

Lead experts

Co-chair for Medical Curriculum
Alexa Mieses Malchuk, MD, MPH
Co-chair for Medical Curriculum
Emily Vander Schaaf, MD, MPH

Learning Environment

Lead
Georgette Dent, MD
Task Force
  • Claudis Polk, MA
  • O’Rese Knight, MD
  • Alexis Flen
  • Casey Olm Shipman, MD, MS

Curricular Innovation

Lead
Neva Howard, MD, MS
Task Force
  • Johanna Foster, MPA
  • Raul Necochea, PhD
  • Quinta Fernandes

Faculty Development

Lead
Beat Steiner, MD, MPH
Task Force
  • Giselle Corbie-Smith, MD
  • Brenda Mitchell, PhD
  • Raj Telhan, MD, MFA
  • Rasheeda Monroe, MD
  • Julia Draper, MPH

View Report

Social Justice Task Force Report and Recommendations

Recommendations

Status Key: On time Completed Timeline shifted Project restructuredVice Dean of Academic Affairs

Recommendation 1.7: Improve accountability measures for students, faculty, staff, and residents who either fail to promote a positive learning environment, contribute to a hidden curriculum that does not support SOM values, or is involved in the mistreatment of medical students.
Status: On time

Recommendation 1.9: Secure formal sponsorship from the SOM and ACGME and designate executive sponsors. They will be responsible for reviewing and advising upon deliverables, supporting alignment of initiatives and goals between SOM, UME and ACGME as they pertain to this initiative, and help facilitate progress and remove barriers.
Status: On time

Recommendation 2.14: Teachers who already have a history of discrimination (two or more actions) will be excused from teaching in the school of medicine.
Status: On time

Recommendation 3.8: Ensure that the selection process for leaders at the UNC SOM includes assessing an applicant’s growth mindset as it relates to social justice.
Status: On time

Education Committee

Recommendation 1.5: Review the composition, training, and processes associated with the Student Progress Committee, Admissions Committee, Student Support Committee, and other committees that impact student success.
Status: On time

Recommendation 1.8: Recruit working group/task force of content experts from SOM and other UNC Schools, including resident, fellow, and medical student representatives, to develop core competencies, content, and case studies for an online curriculum as it pertains to social justice, DEI, and healthcare disparities. From November to end of January, establish core competencies, outline content, and identify case studies that can be used to teach key concepts.
Status: On time

Recommendation 2.1: Provide/develop workshops by content experts for phase leadership and departments on how to incorporate outlined core concepts of anti-racism, with a plan for ongoing use.
Status: On time

Recommendation 2.2: Directors of all phases will begin to examine and change content as needed to include anti-racist concepts as defined in the objectives.
Status: On time

Recommendation 2.3: School of Medicine and directors of all phases will examine and develop assessment procedures (including post-foundation, post-application, and finish-line questionnaires, AMA grading tool, and focus groups) that are ongoing to measure student and faculty impressions.
Status: On time

Recommendation 2.5: Phase leaders will ensure that instructors in all phases coordinate to make explicit connections between the topics/concepts addressed in the curriculum.
Status: On time

Recommendation 2.6: Continue TEC Leadership work group to develop case bank for Foundation Phase
Status: On time

Recommendation 2.7: Develop and start relationship-based training for faculty and students on team-work, conflict resolution and inclusivity including evidence-based concepts of the relationship between belonging, trust, wellness and anti-racist curricula.
Status: On time

Recommendation 2.8: Appoint inclusive work-group for long-term transformation of curriculum.
Status: On time

Recommendation 2.9: Full implementation of new curriculum 2023-2024
Status: On time

Recommendation 2.10: Form a work-group to:

  • Determine the breakdown of assessments in all phases by 2021
  • Identify best practices for use of a wide variety of assessments for a student portfolio by 2022 with phased implementation
  • Identify the necessary resources required for portfolios and determine if institutionally feasible (software, coaches, admin support).

Status: On time

Recommendation 2.11: Appoint group (including colleagues from the Gilling’s School of Public Health) to:

  • Revise advocacy competencies for medical students to reflect above objectives
  • Develop group project assignment, assessment method(s), and implementation plan. Should include longitudinal, robust community partnership projects, that involve needs assessments, evidence-based interventions, assessment, and sustainability plans made effective by Individualization phase at the latest (Refer to work done by Dr. Pedro Greer at Florida International University SOM)
  • Determine best placement in curriculum for this project

Status: On time

Recommendation 2.13: Appoint a diverse advisory group to develop expectations/milestones and review teachers every three years with a decision for renewal or not. Portfolio for review will include:

  • DEI Certificate
  • Demonstration of growth mindset with application of learning theory to program/teaching
  • Student and peer evaluations (including anonymous evaluations)

Status: On time

Associate Dean of Admissions

Recommendation 1.10: Analyze outcomes of UNC SOM matriculants including academic and professionalism performance, transition to GME, and retention to the North Carolina physician workforce, to instruct a modification of the admissions committee processes by April 2021
Status: On time

Recommendation 1.11: Modify existing screening processes to identify applicants with an increased likelihood of success at the UNC School of Medicine and service to the North Carolina community more effectively for implementation by the 2021-2022 Admissions Cycle.
Periodically review matriculant outcomes to continue to fine tune recruitment and selection algorithms
Status: On time

Recommendation 1.13: Require that all members of the admissions committee complete trainings related to the principles of holistic review, selection bias, and the patient care and education goals of the UNC School of Medicine for implementation by the 2021-2022 Admissions Cycle.
Status: On time

Recommendation 1.14: Modify the applicant selection algorithm to prioritize applicant factors consistent with success with the UNC School of Medicine curriculum and retention to the North Carolina physician workforce.
Status: On time

Recommendation 1.15: Examine barriers to recruiting and maintaining an admissions committee that mirrors North Carolina’s demographics by 2021. Develop a plan to sustainably minimize those barriers by 2022.
Status: On time

Office of Faculty Affairs and Leadership Development

Recommendation 3.2: Allocate the resources and support needed to develop the capacity to train all UNC SOM faculty
Status: On time

Recommendation 3.4: Develop a communication strategy system where reflection prompts are widely disseminated to SOM and UNC Health Employees and where high-quality reflections are shared and celebrated.
Status: On time

Recommendation 3.6: Revise Promotion and Tenure Guidelines to include a social justice domain required for promotion
Status: On time

Recommendation 3.7: Develop mechanisms for rewarding faculty members who demonstrate excellence in their teaching in the domain of social justice above and beyond the typical incentive plans (e.g. rotating endowed chairs).
Status: On time

Recommendation 3.9: Increase financial investment to recruit, support, mentor, and retain URM faculty.
Status: On time

Recommendation 3.11: Develop more rigorous pathways and outreach programs to recruit, mentor, support, and retain URM faculty, trainees, and students.
Office of Inclusive Excellence
Status: On time

Recommendation 1.12: Develop specific initiatives to recruit applicants from UNC System institutions (both majority and minority) inclusive of potentially developing new/supporting existing healthcare sciences pipeline programs at each institution
Status: On time

Recommendation 2.4: OIE will secure formal relationships with REI, UNC LGBTQ+ Center, and other leading expert organizations or individuals for use in the curriculum as needed.
Status: On time

Recommendation 2.12: OIE to Secure relationships with NCMS (North Carolina Medical Society), NC School of Public Health, and NC Law School for partnerships available for student projects/collaboration.
Status: On time

Recommendation 3.1: Develop curriculum for core education training sessions which includes but is not limited to training on implicit bias, the history of discrimination and racism in the US and their relationship to health and health care, and skills to effectively incorporate issues of discrimination based on race/ethnicity, gender, sex, sexuality, nationality, religion, and socioeconomic status into teaching.
Status: On time

Recommendation 3.10: More visibly display our commitment to social justice and the concrete action steps we’re taking to move toward that goal to learners, faculty, staff, and the wider community. Examples might include but are not limited to multimedia public relations campaigns, inclusive signage, and architectural and design changes in the physical space.
Status: On time

Office of Medical Education

Recommendation 1.1: Perform a qualitative/quantitative analysis of the personal and professional needs of students to get a better idea of the resources it will take to promote their success.
Status: On time

Recommendation 1.2: Perform a qualitative/quantitative analysis of the UNC SOM hidden curriculum and its impact on the learning environment.
Status: On time

Recommendation 1.3: Hire an embedded SOM counselor with expertise and interests in diversity and inclusion.
Status: On time

Recommendation 1.4: Perform a qualitative/quantitative analysis of the causes of the opportunity gap in UNC SOM students so that programs to reduce the opportunity gap can be implemented.
Status: On time

Recommendation 3.12: Develop an active URM faculty network that can raise awareness about open positions and encourage applications.
Status: On time

Recommendation 3.13: Increase the diversity of educational leaders and faculty serving on key committees to reflect the diversity of the communities of North Carolina.
Status: On time

Clinical and Basic Science Chairs

Recommendation 1.6: Create systems that ensure that faculty involved in career advising are effective and accountable including providing them with salary support and protected time.
Status: On time

Recommendation 3.3: Develop a system to help faculty develop and use Individualized Education Plans.
Status: On time

Recommendation 3.5: Develop uniform policies and procedures on how social justice contribution is integrated into the annual reviews and tied to incentives.
Status: On time

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Resources

View DEI Resources