title: Toward diversity-responsive medical education: taking an intersectionality-based approach to a curriculum evaluation.
abstract: Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a 'narrow' or a 'broad' definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at using an intersectionality-based approach to define diversity-related learning objectives and to evaluate how biomedical and sociocultural aspects of diversity were integrated into a medical curriculum in the Netherlands. We took a three-phase mixed methods approach. In phase one and two, we defined essential learning objectives based on qualitative interviews with school stakeholders and diversity literature. In phase three, we screened the written curriculum for diversity content (culture, sex/gender and class) and related the results to learning objectives defined in phase two. We identified learning objectives in three areas of education (medical knowledge and skills, patient-physician communication, and reflexivity). Most diversity content pertained to biomedical knowledge and skills. Limited attention was paid to sociocultural issues as determinants of health and healthcare use. Intersections of culture, sex/gender and class remained mostly unaddressed. The curriculum's diversity-responsiveness could be improved by an operationalization of diversity that goes beyond biomedical traits of assumed homogeneous social groups. Future efforts to take an intersectionality-based approach to curriculum evaluations should include categories of difference other than culture, sex/gender and class as separate, equally important patient identities or groups.
authors.affiliation: Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. m.muntinga@vumc.nl.
authors.forename: M E
authors.identifier: http://orcid.org/0000-0002-3014-5716
authors.initials: ME
authors.lastname: Muntinga
authors.affiliation: VU University Medical Center School of Medical Sciences, Amsterdam, The Netherlands.
authors.forename: V Q E
authors.initials: VQ
authors.lastname: Krajenbrink
authors.affiliation: VU University Medical Center School of Medical Sciences, Amsterdam, The Netherlands.|Department of Neurosurgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Peerdeman
authors.affiliation: VU University Medical Center School of Medical Sciences, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Croiset
authors.affiliation: Department of Medical Humanities, EMGO Institute for Health and Care Research, School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Verdonk
mesh_terms: D054521:Cultural Competency / Q000193:education; D018864:Cultural Diversity; D003479:Curriculum / Q000592:standards*; D004501:Education, Medical / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D009426:Netherlands
keywords: Class; Culture; Curriculum evaluation; Diversity; Diversity-responsiveness; Gender; Intersectionality; Medical education