500 - Development and Implementation of a Hawaiʻi-Specific Anti-Racism Curriculum for Pediatric Hospitalists, Residents, and Wards Nurses

Racism and discrimination manifest differently in Hawai’i, one of only six majority minority states, than on the US Continent. However, according to available data, Micronesians, Native Hawaiians, and other Pasifika Peoples suffer disproportionate and under-recognized discrimination and health inequities. Hawai’i’s unique circumstances demand unique, context-appropriate anti-racism education for healthcare workers. Prior to this project, no anti-racism educational materials tailored specifically for pediatric physicians and nurses were available.


Objective: To develop, implement, and evaluate a practical, learner-focused, inclusive, and culturally relevant anti-racism curriculum for pediatric residents, hospitalists, and nurses caring for pediatric patients on the wards of the only Children’s Hospital in Hawai’i.

Design/Methods: The curriculum was designed with input from national and local experts and community members, as well as extensive literature review. Residents participated in four sessions, scheduled during protected educational time, over one year. Hospitalists participated in two, and nurses participated in one session each. All participants were given time to complete pre- and post-participation surveys about what they had learned and whether / how their attitudes and opinions had changed. Surveys also included space for free text comments, which were used to improve educational offerings.

Results: 20 residents, 15 hospitalists and 65 nurses participated in the curriculum. Participants who completed surveys reported improved understanding of key concepts, such as implicit bias (p< 0.0001) and systemic racism (p=0.0015, physicians only). They also reported increased understanding that racism is a problem in the US (p=0.022) and in Hawai’i (p< 0.0001), while physician participants also reported increased confidence identifying and responding to instances of interpersonal racism (p=0.0007), as well as identifying (p=0.013) and responding (p=0.004) to instances of systemic racism in the clinical setting.

Conclusion(s): Residents, hospitalists, and nurses reported increased understanding of key concepts, as well as feeling more confident identifying and responding appropriately to instances of discriminatory behavior. This curriculum should be expanded to more healthcare workers in Hawai’i, many of whom have limited understanding of the ways racism harms patients and contributes to health inequities, and could be used as a model for others seeking to educate healthcare workers to provide equitable care in other settings where demographics and culture differ from the Continental US.
C71539C0-D7C9-4F1F-88FA-789910CAFC87_4_5005_c.jpeg

16511321-47BC-4452-A5F9-E4C8DBC5B8FB_4_5005_c.jpeg

45CC8C3F-5FE8-49FF-AE68-33CB16874D35_4_5005_c.jpeg