Developing an interactive reproductive health equity session for pre-clerkship medical students

ABSTRACT In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many axes, including but not limited to race, ethnicity, gender, socioeconomic position, sexual orientation, and disability. Medical schools are responsible for educating students on systems of oppression and their impact on health. Reproductive justice advocates, including lay persons, medical students, and teaching faculty, have urged for integrating the reproductive justice framework into medical education and clinical practice. In response to medical student advocacy, we developed introductory didactic sessions on social and reproductive justice for preclinical medical students. These were created in a team-based learning format and include pre-course primer materials on reproductive justice. During the sessions, students engaged with hypothetical clinical vignettes in small groups to identify oppressive structures that may have contributed to the health outcomes described and potential avenues for contextually relevant and level-appropriate advocacy. The sessions took place in November 2019 (in-person) and 2020 (virtually) and were well attended by students. We highlight our experience, student feedback, and next steps, including further integration of reproductive health equity into medical school curricula in concert with department-wide education for faculty, residents, nursing, and allied health professionals. This introduction to social and reproductive justice can be adapted and scaled across different medical school curricula, enhancing the training of a new generation of physicians to become critically aware of how oppressive structures create health inequities and able to mitigate their impact through their roles as clinicians, researchers, and advocates.

摘要：在美国，性健康、生殖健康和围产期健康方面的不平等有充分的文献记载，并且已知是由多种层面的系统性压迫历史所导致的，包括但不限于种族、族裔、性别、社会经济地位、性取向和残疾。医学院有责任教导学生了解压迫制度及其对健康的影响。生殖正义倡导者，包括非专业人士、医学生和教学人员，一直敦促将生殖正义框架纳入医学教育和临床实践。作为对医学生倡导的回应，我们为临床前医学生开发了关于社会和生殖正义的入门教学课程。这些课程是以团队学习的形式创建的，并包括关于生殖正义的课前入门材料。在课程期间，学生以小组形式参与假设的临床案例分析，以识别可能导致所描述的健康结果的压迫性结构，以及与情境相关且适合其水平的倡导途径。这些课程于2019年11月（线下）和2020年（线上）开展，学生参与度很高。我们强调我们的经验、学生反馈以及后续步骤，包括将生殖健康公平进一步纳入医学院课程，同时在全院范围内对教职员工、住院医师、护士和相关卫生专业人员进行教育。这种对社会和生殖正义的介绍可以在不同的医学院课程中进行调整和推广，加强对新一代医生的培训，使其能够敏锐地认识到压迫性结构如何造成健康不平等，并能够通过其作为临床医生、研究人员和倡导者的角色减轻这种影响。