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.”

• 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 Hidden in Plain Sight.

  • Discussion prompts/questions might include:

    • What came up for you reading this article?

    • Did anything surprise you?

    • Have you ever questioned the use of race in calculators or algorithms before? Were you ever encouraged to question it?

    • If people are struggling with the concepts, consider discussing some mixed race examples: If you saw Lenny Kravitz (who’s father is white/Jewish) in your clinic, would you ask him his race or make an assumption when using a calculator? He, or another similar patient, might even say only “black” if you asked their race. If you were to use a spirometer or ASCVD calculator, should you then choose “black”? Do you average the risk between “white” and “black”? Many African-Americans have mixed-race heritage because of sexual violence that occurred during slavery (and since) - how would you choose their “race”?

    • How does simplifying race to a check box or decision branch functionally perpetuate the idea that race is a valid scientific variable?

• Report back

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