# “I didn’t mean it that way…”: Design and evaluation of an elective course on dealing with discrimination in medical communication

## TL;DR

This paper introduces and evaluates a new elective course for medical students to improve communication with marginalized patients and address discrimination in healthcare.

## Contribution

The paper presents a novel elective course designed to enhance medical students' skills in discrimination-sensitive communication and evaluates its effectiveness.

## Key findings

- The course significantly increased students' self-assessed knowledge across all topics.
- Students reported improved competence in dealing with blind/visually impaired patients and traumatized individuals.
- The course enhanced students' awareness of discrimination and self-reflection abilities.

## Abstract

Experiences of discrimination in the context of medical care are not uncommon and have a significant impact on the health of those affected. For this reason, an elective course (28 units) on “dealing with discrimination in medical communication” was introduced at University Hospital Jena for medical students in the clinical section, which aims to improve the communicative skills of future doctors with marginalized patients. The course was tested for the first time in the winter semester 2023/24. The evaluation was used to check whether the course is suitable for expanding knowledge and skills in dealing with discrimination, as assessed by the students themselves.

The course includes discrimination-sensitive treatment of blind/visually impaired patients, trans*/non-binary patients, patients with right-wing extremist attitudes and/or conspiracy beliefs, people without health insurance, as well as racism- and trauma-sensitive treatment and the use of language mediation. The course also contained numerous elements for self-reflection and reflection on one’s own professional attitude as a doctor. The self-assessment of knowledge and competence gains is based on an online survey at the beginning of the first course and at the end of the last session.

The participating students (N=13) had hardly had any contact with the content of the seminar series through their medical studies, although they rated the relevance for their own practical work as high. The evaluation of the pre- and post-survey showed that completing the course led to significant increases in self-assessed knowledge for all course topics. There was an increase in self-assessed competence, particularly in relation to dealing with blind/visually impaired people, traumatized people and the use of interpreters. The ability to self-reflect and deal with one’s own weaknesses, as well as the awareness of recognizing discrimination, was rated significantly higher also.

The newly designed elective subject could help to subjectively improve medical students’ knowledge and skills in dealing with discrimination in medical communication. The findings thus provide a good basis for the development of further teaching concepts.