ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Training Program Directors

Anti-Racism Toolkit

For educators, training program directors, program coordinators, fellows, and anyone else.

Introduction

Background
In the United States, kidney failure rates are 3.5 times greater in Black and African Americans, 2.7 times greater in Native Hawaiians and Pacific Islanders, 1.5 times greater in Latinx people, and 1.4 times greater in Native Americans when compared to White Americans (1). These individuals are also less likely than White Americans to receive kidney care before kidney failure, to receive a kidney transplant, and to be treated with home dialysis (1). Black and African Americans in particular are less likely to be placed on the kidney transplant waiting list and have disproportionately high rates of transplant failure, compared to White Americans (1). The populations most at risk for and overburdened with kidney diseases also face inequitable social conditions—they "are less likely to have health insurance, have less access to health care, and experience lower-quality care when they do have access." (1) 

In order to address these comprehensive social determinants of health, systemic racism in medical education and health care must be identified and eliminated. The American Society of Nephrology made a commitment in June 2020 to work towards dismantling systemic racism (2, 3). The society invites all kidney health professionals to join in efforts to reduce the adverse impact of racism in medicine. 

Using This Toolkit
These resources are intended to guide nephrology training programs and other individuals in addressing topics such as better understanding systemic racism, recognizing unconscious bias, eliminating disparities in health care, approaching patient encounters with cultural humility, improving recruitment practices, and more. If you have any suggestions for improvements to this webpage, please email workforce@asn-online.org.

References

1. Gadegbeku, Crystal A., Tod Ibrahim, Anupam Agarwal, and Susan E. Quaggin. " Identifying, Confronting, and Addressing Systemic Racism in US Nephrology", Kidney News 13, 6 (2021): 12-13, accessed Dec 14, 2021, https://www.kidneynews.org/view/journals/kidney-news/13/6/article-p12_5.xml.
2. "ASN Statement Against Racism." ASN Society News. The American Society of Nephrology, 2020.
https://www.asn-online.org/news/item.aspx?ID=173.
3. "Dismantling Systemic Racism in Nephrology". In Dismantling Systemic Racism in Nephrology, (20 Apr. 2021) accessed Dec 14, 2021, https://www.kidneynews.org/view/post/clinical-15/dismantling-systemic-racism-in-nephrology.xml.


Cultural Competency Role-Playing Scenarios and Facilitator Guide
This engaged learning activity involves exploring a series of situations where social and cultural factors have disrupted the health care environment, and encourages trainees and faculty to look deeply into their role in addressing the conditions. It has been designed as one 3-hour session or two 75-minute sessions. It can be delivered in a conference room with 2-10 fellows and faculty members. If time is limited, these scenarios can be discussed in a small group setting instead of role-played. 


Facilitators are strongly encouraged to consume some of the resources below to help prepare for this activity.

Click on this link to access a PDF of the guide. 

Click on this link to access a PowerPoint version of the guide (abridged).

Relevant ASN Initiatives

Resources
This list of resources was last updated on February 6, 2022. If you have any questions or comments, or would like to suggest an addition to this list, please email workforce@asn-online.org.

Downloadable Primers and Toolkits
  • Health Disparities Collaborative, Alliance for Academic Internal Medicine, Subgroup 2: Implicit Bias
    There are many useful resources in this toolkit, but there is an especially good section on implicit bias which includes a downloadable PowerPoint presentation titled, "An Introduction to Implicit Bias" and a toolkit to address methods of combating bias in medicine titled, "Addressing Bias Through Mitigation". This includes the PAUSE framework, ERASE framework, PRISM® Toolkit, and WELL Toolkit. This linked toolkit will provide access to materials to address recruitment and increasing diversity (Subgroup 5: Recruitment). AAIM often hosts relevant webinars, which can be accessed through this same webpage.
  • Anti-Racism and Race Literacy: A Primer and Toolkit for Medical Educators
    A comprehensive source providing background on why this discussion on anti-racism is important, the vocabulary to understand the discussion, and a toolkit to develop anti-racism education at your institution. This provides a detailed "suggested reading" section directing readers to sources (podcasts, websites, videos, books, and academics on Twitter) focusing on health equity and race.
  • Words Matter: An Antibias Workshop for Health Care Professionals to Reduce Stigmatizing Language 
    The site provides materials to hold a 90-minute workshop with the following learning objectives:
    1. Explain the impact of providers' language on creating biases on patient care
    2. Describe strategies that can be used to mitigate providers' language biases
    3. Apply strategies from the Mindful Language Toolkit to address stigmatizing language
    (Cases can be modified to be nephrology-centric.) 
Podcasts

  • Six Words: 'You've Got to Be Taught' Intolerance (8-minute listen)
  • How to Talk About Race and Racism (60-minute listen) 
  • Brené Brown with Ibram X. Kendi on How to Be an Antiracist (60-minute listen) 
  • Be Antiracist Podcast by Ibram X. Kendi in collaboration with Pushkin Industries and iHeartRadio 
  • Antiracism in Medicine Podcast Series from The Clinical Problem Solvers
    A series of monthly podcasts addressing topics regarding racism in medicine. The following episodes may be of interest:
    - Episode 188: Antiracism in Medicine Series – Episode 10 – Counterspaces in Medicine: Creating Safe Spaces and Redefining Value (7/14/2021)
    - Episode 181: Antiracism in Medicine Series – Episode 9 – Moving Towards Antiracism in Medical Education (6/10/2021)
    - Episode 176: Antiracism in Medicine Series – Episode 8 – Towards Justice and Race Conscious Medicine (5/10/2021)
    - Episode 169: Antiracism in Medicine Series – Episode 7 – Antiracism, Global Health Equity, and the COVID-19 Response (4/1/2021)
    - Episode 162: Antiracism in Medicine Series – Episode 6 – Racism, Trustworthiness, and the COVID-19 Vaccine (2/25/2021)
    - Episode 155: Antiracism in Medicine Series – Episode 5 – Racism, Power, and Policy: Building the Antiracist Health Systems of the Future (1/19/2021)
    - Episode 148: Antiracism in Medicine Series Episode 4 – Dismantling Race-Based Medicine Part 2: Clinical Perspectives (12/16/2020)
    - Episode 145: Antiracism in Medicine Series Episode 3 – Structural Inequities and the Pandemic's Winter Surge (12/2/2020)
    - Episode 141: Antiracism in Medicine Series Episode 2 – Dismantling Race-Based Medicine Part 1: Historical and Ethical Perspectives with Edwin Lindo (11/17/2020)
    - Episode 120: Antiracism in Medicine Series Episode 1 – Racism, Police Violence, and Health (8/25/2020)
  • Kirwan Institute for the Study of Race & Ethnicity's Implicit Bias Module Series 
    This course will introduce you to insights about how our minds operate and help you understand the origins of implicit associations. You will also uncover some of your own biases and learn strategies for addressing them. Each module is divided into a short (2-5 minutes) series of lessons.
    - Module 1: Understanding Implicit Bias
    - Module 2: Real Word Implications
    - Module 3: Understanding Your Own Biases
    - Module 4: Mitigating Unwanted Biases

On Recruitment and Interviewing
Activities

Acknowledgments
Special thanks to the following contributors to the content on this webpage:
Abinet Mathias Aklilu, MD
Jason Cobb, MD
Sarah L. Elfering, MD
Scott J. Gilbert, MD, FASN
Rachel Hilburg, MD
Koyal Jain, MD, MPH, FASN
Cynthia Miracle, MD
Ebele M. Umeukeje, MD, MPH, FASN

Also, special thanks to the ASN Diversity, Equity, and Inclusion CommitteeASN Health Care Justice Committee; and ASN Workforce and Training Committee for their support.