Exploring how physician educators approach politically charged topics with learners

Med Educ. 2021 May 20. doi: 10.1111/medu.14570. Online ahead of print.

Abstract

Context: Medical educators hold and encounter different beliefs and values on politically charged health-related topics such as reproductive rights and immigration. Their views on these topics have implications for how they approach them with learners, yet little work has explored medical educators' views and pedagogical approaches. In this study, we used Hess's approaches to controversial topics (avoidance, denial, privilege, balance) as a guiding conceptual framework to explore physician educators' views on and approaches to politically charged topics. We used this understanding to provide guidance on how best to address politically charged issues within medical education.

Method: We used a constructivist qualitative approach to explore medical educators' approaches to politically charged topics. We interviewed 37 physician educators from two medical schools in different regions of the United States. In these semi-structured interviews, we presented participants with vignettes depicting politically charged topics arising in an educational setting. Participants described and explained their response to each vignette. Interviews were recorded, transcribed and analysed using constructivist-oriented thematic analysis.

Results: Participants were thoughtful about preparing learners for participation in a professional community that holds certain responsibilities to a politically and culturally diverse society. Although some adopted clear approaches on politically charged topics and declared their stance on the topic to learners, others took a balanced approach, focused only on the medical aspects and withheld their views. The context and location of practice played a role in the approaches participants adopted. Additionally, they had varied views on which topics had a place in medical education.

Conclusion: Our findings provide insights that can help guide medical educators and training programmes in decisions about their role in facilitating conversations about politically charged, health-related topics and helping learners form their own perspectives and approaches to such topics.