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Starting With Lucy: Focusing on Human Similarities Rather Than Differences to Address Health Care Disparities

Clementz, Laura MA, MS; McNamara, Megan MD, MSc; Burt, Nicole M. PhD; Sparks, Matthew MSN, NP-C; Singh, Mamta K. MD, MS

doi: 10.1097/ACM.0000000000001631
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Problem Multicultural or cultural competence education to address health care disparities using the traditional categorical approach can lead to inadvertent adverse consequences. Nontraditional approaches that address these drawbacks while promoting humanistic care are needed.

Approach In September 2014, the Cleveland VA Medical Center’s Center of Excellence in Primary Care Education Transforming Outpatient Care (CoEPCE-TOPC) collaborated with the Cleveland Museum of Natural History (CMNH) to develop the Original Identity program, which uses a biocultural anthropologic framework to help learners recognize and address unconscious bias and starts with a discussion of humans’ shared origins. The program comprises a two-hour initial learning session at the CMNH (consisting of an educational tour in a museum exhibit, a didactic and discussion section, and patient case studies) and a one-hour wrap-up session at the Louis Stokes Cleveland VA Medical Center.

Outcomes The authors delivered the complete Original Identity program four times between March and November 2015, with 30 CoEPCE-TOPC learners participating. Learners’ mean ratings (n = 29; response rate: 97%) for the three initial learning session questions were consistently high (4.2–4.6) using a five-point scale. Comments to an open-ended question and during the audio-recorded wrap-up sessions also addressed the program objectives and key elements (e.g., bias, assumptions, stereotyping).

Next Steps The authors are completing additional qualitative analysis on the wrap-up session transcriptions to clarify factors that make the program successful, details of learners’ experience, and any interprofessional differences in interpreting content. The authors believe this innovative addition to health care education warrants further research.

L. Clementz is training administrator, Center of Excellence in Primary Care Education, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.

M. McNamara is associate professor of medicine, Case Western Reserve University School of Medicine, physician associate director, Center of Excellence in Primary Care Education, and medicine associate director, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.

N.M. Burt is curator and head, Human Health and Evolutionary Medicine, Cleveland Museum of Natural History, Cleveland, Ohio.

M. Sparks is assistant nursing director, Center of Excellence in Primary Care Education, and nurse practitioner, Primary Care Clinic, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.

M.K. Singh is associate professor of medicine and assistant dean of health systems science education, Case Western Reserve University School of Medicine, and physician director, Center of Excellence in Primary Care Education, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.

Funding/Support: This project has been funded in whole or in part by the Centers of Excellence in Primary Care Education of the Office of Academic Affiliations, U.S. Department of Veterans Affairs.

Other disclosures: None reported.

Ethical approval: The Louis Stokes Cleveland VA Medical Center Institutional Review Board determined this work to be exempt on September 12, 2011, with final R&D committee approval on October 6, 2011. The most recent annual review granted ongoing approval on December 5, 2016.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs or the U.S. Government.

Previous presentations: This program was awarded a Scholarship and Teaching Award at the Case Western Reserve University and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Annual Education Retreat, Cleveland, Ohio, March 2016.

Correspondence should be addressed to Laura Clementz, Louis Stokes Cleveland VA Medical Center, 10701 East Blvd., EUL 2M-680, Cleveland, OH 44106; telephone: (216) 791-2300, ext. 2337; e-mail: laura.clementz@va.gov.

© 2017 by the Association of American Medical Colleges