P3C113: Enhancing Diversity, Equity, and Inclusion Training in Pediatric Residency Program Through Narrative Stories

Background: United States is becomingly increasingly racially and ethnically diverse, with children at the forefront of this change. Awareness and education on diversity, equity, and inclusion (DEI) are important aspects of pediatric training. The role of storytelling in DEI training has not been clearly reported before. Narrative monologues can provide perspectives that otherwise could be difficult to relate to. This program evaluation provides insight into the impact of narrative stories in DEI training for pediatric residents.

Methods: We invited 2 facilitators from a community theater group to provide narrative monologues related to how race affects individuals and their interactions with others. This program was 2 hours long, divided into two sessions. The first session included video monologues based on true stories told by actors, and the second session involved small groups with facilitators where residents shared stories with each other. We performed descriptive statistics, paired t-test, sample t-test and effect sizes using Cohen’s d on the pre- and post-program surveys with anonymous participant IDs.

Results: A total of 60 residents in a single pediatric residency program participated in the DEI program. 54 (90%) participants completed both the pre- and post-program surveys. 5 (8%) participants only completed the pre-program survey and were excluded from analysis. All answers were placed on a five-point scale. Participants on average had 0.15 +/- 0.13 point increase in their understanding of inclusiveness of other identities and cultures (t-value = 2.214, p = 0.03), and 0.37 +/- 0.20 point increase in how frequently they consider the impact of their race and other identities shaping their perceptions (t-value = 3.5823, p = < 0.01). Participants’ comfort level in interacting with unfamiliar identities and culture did not have a statistically significant change with an increase of 0.18 +/- 0.22 (t-value 1.65, p=0.10). Of note, 7 (13%) participants had a decrease in comfort level, and 13 (24%) participants had an increase in comfort level. Both the narrative monologue and small group sessions were felt to be effective in understanding how identities affect their lives, but monologues were marked to be more effective (monologue rating 4.41, small group rating 4.13, p = 0.03). Residents expressed their surprise in the power of stories in free-text answers.

Conclusion: Stories, especially narrative monologues, proved to be an effective method in enhancing residents’ understanding of inclusiveness of other cultures and also in increasing the frequency of how often they will consider the impact of race and other identities in shaping perceptions. Some showed a decrease in comfort level in interacting with unfamiliar identities or cultures, and this could be due to exposure to ideas or perceptions they were not aware of before. This program showed that stories can be an impactful tool in enhancing DEI training for pediatric residents.