In July 2021, and in support of its commitment to diversity, equity, and inclusion, the ACGME proudly and formally announced ACGME Equity MattersTM, a new initiative that introduces a framework for continuous learning and process improvement in the areas of diversity, equity, and inclusion (DEI) and anti-racism practices. The initiative aims to drive change within graduate medical education (GME) by increasing physician workforce diversity and building safe and inclusive learning environments, while promoting health equity by addressing racial inequities in health care and overall population health. ACGME Equity Matters launched in July 2021 with the convening of the first of four initial Learning Communities to embark on an 18-month engagement cycle.
ACGME Equity Matters, led by the ACGME’s Department of Diversity, Equity, and Inclusion, will result in a comprehensive set of ideas, models, practices, and data to support interventions that address structural barriers to developing a diverse physician workforce that will improve care for diverse patient populations. Moreover, ACGME Equity Matters provides a safe space for additional discussion and growth through monthly Learning Community meetings. In these meetings participants explore their new knowledge and experience with the initiative’s Fundamentals of DEI and Antiracism modules with physician subject matter experts, peer support, and advising. The individual, institutional, and association participants of these Learning Communities will ultimately develop Capstone Projects reflecting innovative equity practices they have integrated into their respective clinical learning environments.
We asked Vice President, Diversity, Equity, and Inclusion Bonnie Simpson Mason, MD, FAAOS to share background on ACGME Equity Matters and explain the framework in which the Learning Communities will engage over the 18 months of their participation.
Question: What brought you to the ACGME?
Dr. Simpson Mason: Every once in a while, you get a chance to innovate and contribute to something really important. And that’s what ACGME Equity Matters is giving us, our department, and the organization an opportunity to do.
I consider ACGME Equity Matters to be the ultimate exercise in convening and collaborating around problem solving in these most intense and highly critical issues of DEI, antiracism, and implementing equity practices—not just in GME, but for the country.”
Question: Where did ACGME Equity Matters come from?
Dr. Simpson Mason: In spring 2020, in response to the reality of black and brown Americans being disproportionately impacted by COVID-19 in terms of morbidity and mortality, along with the murder of George Floyd, the ACGME Board of Directors charged the Department of DEI to “do something.” ACGME Equity Matters was formed. We thought at the time that this would be a smaller initiative, but as we’ve seen, it’s evolved into a larger and more comprehensive approach engaging national leaders. We expect now that this will be a 10-year initiative, because this work is meant to be transformative and not performative, and transformation takes time. So, with that expectation, we are building out this comprehensive set of fundamental resources and equity practices along with creating the vehicles for our institutions and programs to facilitate change.
Question: What is the ACGME Equity Matters initiative?
Dr. Simpson Mason: ACGME Equity Matters is a continuous learning and process initiative with the goal of instituting and implementing equity practices at the institutional and program levels. We’re pursuing this through our four phases of Acknowledgement, Acceptance, Action, and Assessment/Adaptation.
Two of the most frequently asked questions we receive at all levels of GME include ‘what do we do first?’ and ‘how do we implement equity practice?’
This program will provide the ‘what’ by building a conglomeration of over 35 DEI and antiracism educational and skills building online modules from over 70 subject matter experts in the field from across the country. In addition, we are creating a comprehensive resource bank of equity practices we’ve been able to collect through ACGME Annual Updates and surveys, and now two rounds of the ACGME’s DEI Award applications. That’s the ‘what.’
Historically, we know that just giving people DEI and antiracism information or the access to this information doesn’t teach the practical implications of how to engage in this challenging work. So, we’re also providing the vehicle for ‘how,’ in the form of Learning Communities, based on a peer advisory model, and through which institutions, programs, and individuals come together regularly and consider the specific challenges they face in their own learning environments. Using an implementation science approach, these communities innovate, and will ultimately develop an intervention to test and assess—the capstone project—and share their findings. This is the ‘how.’
Question: How is the format of ACGME Equity Matters different from other educational opportunities?
Dr. Simpson Mason: Key pillars of ACGME Equity Matters includes a reverse ideation approach, starting with holding leadership accountable for meaningful investment and integration of their position of power into this work because it is with meaningful leadership investment that we can on a larger scale work to increase diversity of the health care workforce. But this diverse health care workforce needs a safe, inclusive learning environment – and that is the rising tide that lifts all boats. A safe, equitable, and inclusive learning environment benefits everyone in it, and ultimately it benefits the patients.
Having the information and the knowledge necessary to begin making changes is critical. If we don’t fully understand something and begin attempting to implement changes, we can inadvertently cause harm. This happens not because someone intended it to, but because people don’t know what they don’t know, especially in a context like DEI, anti-racism, anti-oppression work, where it’s critically important to understand being trauma aware and trauma responsive in our efforts.
Question: Who is involved?
Dr. Simpson Mason: Four Learning Communities of Impact are participants in the first cohort of the ACGME Equity Matters framework. They are: program directors and coordinators from [the Organization of Program Directors Associations] OPDA; DEI Officers; [the Council of Medical Specialty Societies] CMSS; and members from seven member organizations of Blue Cross and Blue Shield of Illinois [BCBSIL].
Question: How were the four Learning Community groups identified/recruited?
Dr. Simpson Mason: Since August 2020, our office began convening a regular DEI Officers Forum, providing a shared space for DEI officers looking for a community to network and share advice and experiences. This grew from 30 to more than 800, who now meet monthly in a virtual setting. From there, approximately 90 were identified and enrolled for the first Equity Matters DEI Leadership Certificate Program.
Another opportunity emerged from existing professional relationships. Dr. Derek Robinson of the Institute for Physician Diversity at BCBSIL has been working in this space for a very long time and was able to orchestrate a unique opportunity for his member organizations to invest their time and energy in diversity work and building equity practices – this was a natural fit to help his institutions move their equity practices along. And Dr. Helen Burstin at CMSS wanted to make sure the leadership from the medical specialty societies and from OPDA also had the knowledge and tools to help facilitate change at the association level that will trickle down to our program directors and faculty members.
Question: How is the content and program being developed?
Dr. Simpson Mason: Five groups of individuals – experts in the field from across the nation –are our content partners.
We have subject matter experts who are authoring the Fundamentals of DEI content modules—this is approximately 70 individuals.
Fifteen faculty facilitators, individuals who are DEI experts, executive coaches, and consultants in systems change, will be leading and facilitating the Learning Communities.
Additional contributions are coming from project coordinators from each of the four pilot Learning Community groups.
We also have a Residents Advisory Group, who will advise and contribute to development of tools.
And finally, interdepartmental teams within the ACGME and additional external contributors are helping to create the processes, content, assessment and evaluation modules, and more.
Question: What’s available now and to whom? At what point will content and resources be available publicly?
Dr. Simpson Mason: The “beta” version launched this summer for participants of the first cohort of Learning Communities. The Fundamentals of DEI courses are anticipated to be CME accredited and available publicly through the ACGME’s online learning portal, Learn at ACGME, hopefully by early 2022.