Caucusing Activity

Activity

• Read “caucusing guidelines” to the group

  • If you have a group that includes multiple levels of medical hierarchy (medical students, residents, attendings, nurses, MAs…) consider explicitly pointing out that expertise in medicine does not equate to expertise on issues of race and equity. One example, “For this exercise, experience and expertise may flip from how they are in clinic or on the wards. The attendings in the room may be the learners today and an MA may be the expert. Let’s recognize that we are all here to learn, share, and challenge each other.”

• Introduction

  • Innumerable studies find racial differences, ranging from the prevalence of diseases to predicting prognoses. In many cases, these findings have been integrated into medical calculators or diagnostic machines such as calculating cardiovascular risk, peak flow, glomerular filtration rate (GFR), predicting successful vaginal birth after cesarean section, and more. When medicine uses race as a scientific variable and finds differences, how do we square that with the argument that race is not biologically based?

• Break into small groups.

  • Group size may depend on the size of your large group. We have found that groups of 3-4 work well. Breaking into small groups allows people to be more vulnerable than they might be in a large group. It also makes it challenging to not participate.

  • Consider the make up of your group and how you might do this. Do you want mixed groups that include all levels (ex. student, intern, attending) or would it be helpful to break into groups that might be more comfortable for challenging discussions (ex. group attendings, students, residents separately)? Are the groups assigned in advance or do you have your group “count off” and then group by number (all the “1s” together, “2s” together, etc.)?

• Discuss

  • Ask groups to discuss their thoughts and reactions to “Defining race/ethnicity and explaining difference in research studies on lung function“

  • Discussion prompts/questions might include:

    • Did anything surprise you?

    • How was race and/or ethnicity defined in the literature?

    • 94% of studies failed to examine socioeconomic status. How might that influence the study findings? Are there other variables than socioeconomic status (local air quality, work exposures…) that might also impact spirometry findings?

    • How “scientific” is racial self-identification? Does it accurately describe ancestry or genetics?

• Report back

  • Ask each group to share some highlights of what they discussed with the large group.