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InclusiveVTCSOM Community Forum

July 28, 2020

Video Transcript

00:00:18: [Dean Learman] Oh, yeah, we apologize for the for the muting phenomenon. We wanted everyone to start off as muted in case they had any ambient noise around them that they weren't aware of. But you know, later on if people want to speak up, I will have a way to do that. And of course, the chat stream is a good place to send messages as well as we move along.

00:00:40 We’ll give folks another minute or so to join us.

00:01:10 The participant list, sorted becomes like a tote board as you watch the numbers go up. So I may have to choose an arbitrary number two to reach before we get started. 

00:02:10 All right. All right, well, let's get started, everyone. It's wonderful to see all of your unmasked faces. Those of you who have treated us to the vision of your visage. And for others, don't be shy if your bandwidth permits. It's great for us all to see each other tonight on this very special evening for our inclusive VTC School of Medicine community forum. I'm gonna be switching over to some slides just so we can organize our thoughts. And let's get that started.

00:02:47 Alright. And doesn't seem to be projecting. All right, let me move this over. Here. We're gonna go ahead and share screen. 

00:03:05 Alright, so we now are on the slides. Hopefully everyone can see those and we'll be moving on. So after a few words of welcome, this will be our agenda for this evening.

00:03:12 My oh, my. It's been a very busy couple of months since our last community forum and we're going to be reliving and recapping some of that over time. For those of you who were here with us on June the third, this'll, some of this'll be a little bit of a summary. And for those that couldn't join us back then, including some of our incoming medical students, this will  hope you give you, hopefully give you a framework around where we started.

00:03:35 We'll spend some time talking about our student concerns that came forward. And then as a real centerpiece of the presentation tonight we'll be talking about our new inclusive VTC, School of Medicine Task Force. And we'll go over that in some detail so that everyone understands the direction will be heading in for the next several months through the end of the calendar year, by which time, we hope to have a report and recommendations from our taskforce. 


00:04:00 So first, I just want to welcome everyone. And I I guess, you know we are expecting a pretty large turnout tonight because we have our four classes of medical students. We have our faculty members and staff who are employed by Virginia Tech or Carilion. We have other partners and stakeholders from our community that are present. And I really hope that we have a good attendance tonight.

00:04:30 As it ends up, the task force will be composed of over a 100 participants. And this is intentional. It's a way to be here we use as it had been [inaudible] possible. And hopefully a lot of our task force members are here this evening.

00:04:47 When we get through the taskforce list. It's not any of the slides as we go through participation. Feel free to use your Zoom your zoom tricks to indicate either Was is it, a thumbs up or clap sign, whatever those are called emotional, whatever it is. But what did they call? Everyone's mouthing it to me and I can’t hear them. Okay. You know what they're called, those of you who are Zoom experts will, will, will allow the others to do that. So if you see, oh, there we go. It's not here. Okay. Anyway, you can express yourselves if you see yourself as we go forward. And then we're going to open up for questions and comments after that. 

First Community Forum on June 3rd

00:05:27 So back on June the first, I sent out a pretty lengthy and deep message. This is just some excerpts of it out to our community to, to take a moment, to pause and to really reflect upon the killings of Briana Taylor, Ahmed Arbery, and George Floyd, to reflect on what that tells us about our community. And then at the end of that correspondence, to invite our community to our first forum, which occurred on Wednesday, June third.

00:06:00 We had several panelists, including a guest who used to be one of our faculty members, a psychiatrist at Carilion, who is part of our dean's council on Advancement, Dr. Frank Clark. And I'm happy to hear, at least from the RSVPs that Frank is joining us tonight as well to check in with us from Greenville on how we're doing at this particular point in time. So welcome Frank.

00:06:27 So this is how we got started. And on the third, at that particular forum, we decided to keep it within the VTC School of Medicine community to invited individuals. We decided not to record it. We wanted to promote as much candor as we possibly could in, in the format of Zoom, so that we could really hear from our community. And the tonight, just to offer a contrast as I come back to report to you on progress, this is being recorded for those who can't join us. So they can, if they wish to kind of go through our community forum at their leisure. And hear what we've had to talk about tonight so that we are memorializing this for them in case they're unable to join us.

00:07:15 As with last time, as you put your questions in the chat stream, hopefully, someone else will be looking that over and letting me know if there's an item that I need to respond to as I move through this, I may try to open it up as well on my screen so I can see it. 

Students shared observations and concerns

00:07:30 So we start off on the third, and we had a very good discussion. One of the most moving parts of our discussion that evening was to hear from several of our student representatives who are now in the second year of medical school - at that time beyond the first year -who very, in a very organized and systematic way, shared with us some observations and concerns. They did that in rotation amongst the three of them. And then about a week later, a few days later, we received a thoughtful written document which outline those same concerns with further information, suggestions, references, a beautifully constructed document for us to work with. And so we had been working on that ever since. And tonight I will be telling you about our progress on all of the 17 items that were mentioned in that particular document.

00:08:23 We had heard soon thereafter that there was another document coming forward from the current class, current fourth-year class, who have completed their third year in clinical training and had some observations on the clinical curriculum. And so we received their thoughtful document on July 17th with six very well constructed suggestions with observations, details, and references, and we'll also be discussing those items tonight as well. 

Collage showing an image of Frank Clark along with titles of three of his published works: A Black Man's Lament, A Hope and a Prayer for All Humanity, and a video for Psychiatric Times
Dr. Clark is Clinical Assistant Professor, University of South Carolina School of Medicine, Greenville, SC, and Medical Director & Division Chief for Adult Inpatient and Consult-Liaison Services for the Department of Psychiatry and Behavioral Medicine at Prisma Health.

Frank Clark 

00:08:55 Well, it has been a busy couple of months, including for our colleague Frank Clark and I didn't want to miss this opportunity to to reflect on what he's been doing. So Frank, I don't wanna embarrass you if you're with us, but he's been very, very busy, both providing support through events sponsored by the AMA as well as other organizations to understand the trauma, the suffering, and how communities can support each other through that suffering. But also to show the power of creativity in how to manage some of those feelings and through, through some of these creative works, he's published this, “a black man's lament”, which is a very thoughtful piece in the recent issue of the phychiatry “Psychiatric Times” I think they published it once and perhaps republished it. And in addition, “a hope and a prayer for all humanity”, a video to explain the underpinnings of several of the other pieces of poetry and work that he's done. So he's been busy both in terms of being out in front of these issues in multiple forums, but also in showing how creativity can be used in this unique and stressful time. So I wanted to reflect that for a minute. I don't know how you get it all done, Frank, you've been very prolific over these last couple of months. 

A map showing 6 locations in the United States where the statues were removed by protesters; 13 locations where the statues were legally removed by the government; and 9 locations where the statues are scheduled to be removed.
A map of the United States showing where Confederate Statues have been removed or are scheduled to be removed.
Two headlines. First one states: "We're retiring our old name and building a new kind of team. For the upcoming season, we're calling ourselves the Washington Football Team." Second one: Yale changes Calhoun College's name to honor Grace Murray Hopper.
Renaming Washington Football Team and renaming Yale's Calhoun College to honor Rear Admiral Grace Murray Hopper

Changes at the National Level

00:10:24 Well, we've also seen some very important milestones. Things that had been talked about, debated, um attempted in the past. But in this context and in this time, signs of momentum that hadn't been seen before. A map published recently regarding the removal of Confederate statues, either scheduled or already had been removed. And this may not even be as up to date as it should be at this point. And then a whole series of other milestone events that signify that the unfortunate and horrible violence that we've seen has, has triggered a movement of greater attention across the full spectrum of our society; two very important and chronic issues that have resulted in breathtaking changes. Although overdo that have happened very rapidly in the last few months, including Washington Football team, which is now called Washington football team. As it awaits a real name to come soon, I hope. 

screenshots of three articles surrounding protesters and job losses. Two headlines read Job losses slam Black Virginians, and According to statistics, Black workers are overrepresented in industries hit hardest by the pandemic, such as restaurants, retail, and health care.

Changes at the Local Level

00:11:29 Locally, we just see a reflection of all the things we've seen nationally as well. There are some coverage of police and protestors clashing in multiple cities, including in Richmond, thought to be reactions to the events in Portland, perhaps not part of the or peaceful protest movements that we've seen in the past, but sort of a turn toward more violence as a result of the protests in Portland. And then of course, job losses slamming black Virginians, which we're seeing not only in Roanoke, but throughout the state. According to statistics, black workers are over-represented in industries hit hardest by the pandemic. This looks very familiar, very similar to the Great Recession in terms of the most vulnerable workers, which creates an accelerant behind this the health disparities and chronic social disparities that set the stage for everything. Plus now you have the additional burden of being the most vulnerable in terms of the economic impact and layoffs. So this continues, and this continues in our public discourse over the weeks since June first. 

Scholarship on structural racism

00:12:36 There's been some scholarship developed around this. This is a nice piece from a recent issue of the New England Journal of Medicine, bringing together hanging discussing the interweavings of structural racism, social risks, risk factors and the pandemic. And speaking about how they all intersect to cause particular harm to black Americans. With a number of recommended action items here that you can see and read for yourselves are a mixture of issues related to structure and policy as well as specific programs and health systems issues. Truly things that are interacting together in very complex ways and finally, getting some good attention from the scholarly community in a more public way. 

Slide shown on screen provides the following text

Text from slide: Recommended Action Items for Mitigating Structural Racism

  • Change policies that keep structural racism in place.
  • Break down silos and create cross-sector partnerships.
  • Institute policies to increase economic empowerment.
  • Fund community programs that enhance neighborhood stability.
  • Be consistent in efforts by health systems to build trust in vulnerable communities.
  • Test and deploy targeted interventions that address social risk factors. 

end slide


00:13:23 We've seen other important milestone events across the spectrum of diversity, including a landmark Supreme Court ruling, which is a major victory to LGBTQ employees. A six to three ruling, with justice Neil Gorsuch writing for the majority, regarding protections for gay, lesbian, and transgender employees based on sex, that was on June 15th. 


00:13:45 We’ve seen as somewhat less satisfying Supreme Court ruling on DACA, in which the Supreme Court decision found that the administration's termination of DACA was done in an arbitrary and capricious way that violated federal law. So reversing that termination. However, um not ruling out some administrative maneuvers that could still be used to not restore DACA. So although symbolically successful in terms of the Supreme Court's position on this, it ultimately may not have a long-term impact to DACA recipients, as might have been hoped for. 

ADA 30 (1990-2020). Americans with Disabilities Act. Two images of Judith Heumann are shown, from 1990 and 2020.
Judith Heumann: We need to be able to make sure that no person with a disability from any background is denied those opportunities because of their race or their language or their religion or their disability.

Americans for Disabilities Act turns 30

00:14:26 The Americans with Disabilities Act actually has just had a landmark 30th anniversary. And here's a picture of one of the disability rights advocates, Judy Heumann, back 30 years ago in arguing for the ADA and here she is more recently in a quote that puts us at the intersection of disability rights with race and language, reflecting the important inner intersections that we see in diverse communities. And not to think of people as monoliths who have just one self-identity, but several that can, in an accumulative way cause more challenge for them. 

John Lewis
Left: John Lewis marching with Dr. King on the Edmund Pettus Bridge. Right: Horse drawn carriage with the casket of John Lewis crossing the same bridge.

John Lewis

00:15:01 Well then of course the most recently, we all grieve the death of John Lewis, who's arc of life really extended over a very remarkable period of time. I can't, I wouldn't even try to pretend to do justice in just a few minutes. But just imagining these two images over the fifty-five-year timespan of his march with Dr. King across the Edmund Pettus Bridge, meeting with violent outcome on Bloody Sunday. Then reflecting more recently on the movement of his casket across that bridge, on its way to the capitol through multiple other stops. And in the meantime, in the interim, the life that he led and its meaning across that arc of time and never losing his optimism that through persistent and peaceful efforts that change could occur. He brought, as I was reading, he brought many political, I won't say enemies, but folks, he brought folks over to the bridge on various opportunities and anniversaries so that they could have a frank conversation with him and hopefully change their hearts and minds to move forward with legislation such as voting rights, funding of the US History of, of African-American, Museum of African-American History, and other initiatives that he cared about. I'm just imagining all that he experienced over the course of his life. And, and even up to the point is the last stages of his illness with pancreatic cancer, staying very involved in black lives as well. So remarkable leader.

There are just so many quotes that he's offered us to think about. All of them focusing on not just seeing something and not just saying something, but doing something. Treating freedom as an act and something that needs to motivate action, not only as a state that can sit statically without stewardship of freedoms. And a more famous quote, If you're going to get into trouble, get into good trouble, necessary trouble. And he would probably say nonviolent trouble. And finally, that the vote is the most powerful nonviolent tool that we have. And so many other lessons that are so relevant in our time. 

00:17:26 So it's been a very eventful couple of months, a lot more has happened and what I've been able to summarize. But I wanted to kind of set a tone for the rest of our time together this evening with some reflections here. 

InclusiveVTCSOM Initiative

00:17:42 Well now I'm going to talk about what this Inclusive VTC, School of Medicine initiative is. And we're going to move to some of the specific content that's really important for us to understand moving forward. The first thing it is,

  • It's really the leading edge of our strategic planning process. Now we had planned for and budgeted for strategic planning to occur in this, my second year as Dean. And with that structure being formed for strategic planning, we're applying it first to diversity, equity and inclusion in a very robust way. So much so that a lot of the other components of our strategic plan will by necessity need to wait until the first part of, of calendar year 21. So that we can really do this in a fulsome and robust way. So it's the leading edge of a strategic planning process for the medical school.
  • It's an opportunity to affirm the value of human diversity in, in all of its different nuances for our lives, our communities, and for the medical school.
  • It's a very broad initiative. It's going to address diversity is defined in its multiple ways.
  • It's an affirmation of our Virginia Tech principles of community and Carilion Clinic’s diversity and inclusion statement, as well as very specific leadership directions we've received from the AAMC, which is the American Association of Medical Colleges. This is the umbrella organization that all medical schools belong to. And where we coordinate efforts on a whole variety of issues regarding medical education. We've seen the AAMC step up in a very purposeful way in leadership around the issues that we've just discussed. And we're so happy to see their bully pulpit being used in this particular way with us.
  • Most importantly, this Inclusive VTC School of Medicine Initiative is a forum for listening, understanding, and learning from the observations and concerns of our students, faculty, staff, and community. A lot of what we will be doing within the spaces of our working groups and the task force as a whole is to listen and to understand. That will be a major agenda for the initiative. 

00:20:05 It's also, as I stated on June the third at the initial community forum. It's also a follow through, a next step, in the commitment statements that I made at the end of our June third community forum listed here that are in some ways reflections of what the house of medicine is doing with the AAMC is encouraging all medical schools to do. And that we are going to be showing accountability and intentionality about. You'll see a lot of these themes reflected in some of our student comments, of course. And we expect that the strategic planning process will generate a lot of really great ideas and actionable ideas of how we fulfill these commitments statements, and turn those into actions. 

Slide shown on screen provides the following text

Text from slide: “InclusiveVTCSOM” is also:

  • A way to lead by example and take bold action in partnership with the communities we serve:
  • Acknowledge and speak out against all forms of racism, discrimination, and bias in our environments in our institutions, communities, and society.
  • Stand in solidarity with the black community and speak out against unjust and inhumane incidents of violence.
  • Demonstrate empathy and compassion and acknowledge the pain and grief that the families and the communities of these victims are experiencing.
  • Take the lead in educating ourselves and others to address these issues head-on.
  • Be deliberate and partner with local communities, public health agencies, and municipal governments to dismantle structural racism and end police brutality.
  • Employ anti-racist and unconscious bias training and engage in interracial dialogues that will dispel the misrepresentations that dehumanize our black community members and other marginalized groups.
  • Move from rhetoric to action to eliminate the inequities in our care, research, and education of tomorrow’s doctors.
  • Show accountability and intentionality. 

end slide

Implementing the 17 student suggestions 

00:20:56 Well, let's turn now to the wonderful input we received in two different waves by our students. The first was the 17 suggestions that we received from the students who were then in the first year class now in the second year class, they had circulated these to other students and that got a lot of buy-in from the other students as well. And there were 17 in total. We've been able to complete six entirely or nearly, and I'll be showing you those in detail. And then we'll move on to several others that we are planning to address very soon and then others that will end up in the hands of the taskforce because they require further discussion and clarity.

00:21:40 These are things that we felt we could do quickly without the additional complexity and delay of the task force so that we could show momentum moving forward as soon as possible.

00:21:50 The first two of these had to do with communications about our diversity and inclusion personnel and our programs and access to our diversity and inclusion personnel as well. So we recognized that this really has been an issue with respect to our website as not being an effective clearinghouse for all such information. And so with the help of our diversity and inclusion team and our wonderful web manager Vianne Greek, we've been able to update this website in ways that are, are really amazing in terms of putting all this information in one place. Easy to access through this menu and with a lot of clear information around who is doing what on our team. 

headshots of diversity team as described in captions
Diversity Equity and Inclusion Team. From left: Dr. N.L. Bishop, Carrie Knopf, Karyna Nevarez, Dr. Karen Eley Sanders, Jellie Witcher

Diversity, Equity, and Inclusion Team

00:22:39 So our Diversity Equity and Inclusion Team is listed here with their names, their titles, their phone numbers, their email addresses, most importantly, their office hours, and then a short bio on what their responsibilities are and their background. This occurs for Dr. N.L. Bishop, for Carrie Knopf in student affairs, who works with us as well. For Karyna Nevarez and Karyna has the additional honor of having in bold that she is the point person, the first point of contact because if I were a student looking over these, I'd say, “Isn't that nice? I still don't know who to contact.” So we've answered this in bold with Karyna being that first of contact and she will then triage whatever questions that she either can answer or to other folks who can answer them as well. Karen Sanders, chief diversity officer, and then Jellie Witcher here. So all listed with a lot of good information and with clarity about how to reach them and what their functions are, and you can see a whole bunch of other different tabs here to understand our different programs.

00:23:45 We have the blessing of a fantastic Web Manager and web designer so that if we encounter any additional needs that come out of the taskforce’s recommendations for our website or from students ad hoc, we can easily implement them. 

00:24:04 The next…

[Karen Burns] Dean, if you’ll switch the screen. We weren't able to see the web, the web page

[Dean Learman] You were not before we're able to see the webpage

[Karen Burns] No.

[Dean Learman] Oh, my apologies. Yeah, it was on the screen I was sharing, but obviously…

[David Musick] actually I can see it. So maybe some could see it, some couldn’t, I don’t know.

[Dean Learman] Okay. Well, we can try again. Okay.

00:24:44 I'm now seeing a web page in front of me. I'm now sharing my screen onto said webpage. Can we see it?

[David Musick] Yes.

[Dean Learman] Can those who cannot see before see it now? Is that a yes?

[Jellie Witcher] Yes.

00:25:12 [Dean Learman] Okay. Well, the summary will be that is it has a lot. It's chock full of information. The menu tabs are all here easy to access. The team tab takes us to not only the more simple descriptions and contact information that we've had in the past, but also to Office Hours, detailed information about each person. And then in the case of Karyna, in bold, that she's the first point of contact because it may not be clear who one might go to between Dr. Bishop and Carrie and Karyna and Dr. Sanders and and Jellie. So the first of contact is Karyna and then others can be engaged as needed after that point. There's a whole lot of other information here that people can look at their leisure regarding programs and resources as well with links to Virginia Tech and other helpful resources.

00:26:09 So hopefully everyone saw that. And we can go back to the presentation. Okay. All right, we're back. I think I hope.

Chapter of the Student National Medical Association

00:26:30 The next student's recommendation had to do with creating a chapter of the Student National Medical Association. And indeed, we had a chapter since 2017. And we, because of student participation in the chapter, they may not have been Sign out between classes about it. We were also we had one adviser in Jellie Witcher, we did not have another co adviser. We're very happy to report that Dr. Michael Bergen is our co advisor and we have great expectations for the chapter as it moves forward. The lesson we've learned is to make sure that our non-student chapter co-advisors, are can continue to, to lead through those transitions and to make sure that each incoming class of students is aware of SNMA,, so they can jump aboard as other students become busier later in their curriculum and may not have as much time. So we understand now how to keep that thread moving forward for this if very important association.

Measuring Climate and Culture

00:27:31 Our students asked some really good questions about “how are we measuring the climate and culture?” And I'm gonna dig in a little bit deep here because these same measures are some of the measures that we might use on our taskforce to gauge our success. And so choosing the right measures is an important question for our taskforce anyway. And it's a question the students posed to us as well. We will post summaries of these assessments on the webpage with a secure location. I'll show you where that is on the Task Force webpage a little bit later. But people will be able to access the summary data from these various assessments over time.

00:28:15 What I'd like to do now is just take a brief very briefly through. I don't want to bore you with a whole lot of variables and data, but just so you can get a sense for the differences between these and which ones that we are recommending that we use moving forward. 

2015 Climate and Culture Assessment: Admissions Committee

00:28:28 In 2015, there was a climate and culture assessment that was directed our admissions committee. We had 20 out of 28 responding, only one of which self-identified as an under-represented minority. As you can see on the right, in a five level scale, with 4 and 5 being agree and strongly agree. Everyone, nearly everyone, agreed with all of the positive statements about diversity that are listed here. And the report report concluded that the data were very positive, although there were comments that led to some action items for improvement. So this is from 2015 with only one respondent identified as URM and only related to the admissions committee. I think we have better assessments than this kind of an assessment to use. 

2018 Virginia Tech Climate Survey

00:29:14 In 2018, there was a climate survey which was something done campus wide by Virginia Tech. You got we got these sorts of scores for the School of Medicine as a unit, it was focused more on employees than on others. Familiarity with principles of community, which is where a lot of the diversity statements exist for Virginia Tech, that they have a positive impact, that they're familiar with InclusiveVT. So nothing really detailed and actionable here. Very high level metrics. This one important, of course, that a third of at that time, a third of our employees who answered did not know how to file a complaint or seek assistance and that's been remedied since that time. So that climate survey probably not going to give us the granularity we need to answer some of our important diversity, inclusion, equity questions. 

VTCSOM Learning Environment Survey

00:30:04 Well, the learning environment survey as something developed in School of Medicine, reviewed by our LEAC committee on the learning environment, and it's been revised several times. This goes out to students, faculty, residence fellows, administrative staff, and nursing. It's been done nearly every year, not exactly every year, since 2013-14. And the latest administration of this survey included 805 responses. That was 58% response rate of all these individuals. The, it included these DEI related items, which I think are giving us some useful information about:  witnessing a patient being treated disrespectfully; a patient being discriminated against by a team member; witnessing or receiving mistreatment based on one's own gender; witnessing mistreatment occurring on by other students, faculty or staff; response to complaints in an appropriate fashion; and learning about cultural biases. So these seem like valuable things for us to follow over time. So this is one of the surveys we've been doing that I would expect we would continue to do. 

AAMC Graduation Questionnaire (GQ)

00:31:16 Perhaps the gold standard here of all of these is the AAMCs graduation questionnaire called the GQ, administered to every medical school, where you receive feedback with your relative performance, relative to other medical schools. And within the graduation questionnaire, there are a number of different questions and domains that relate to diversity and inclusion.

00:31:40 The reason this is considered to be such a good measure is that it is in all respects the safest place to be candid in that these graduates receive this in time to complete it before graduation from medical school, knowing that the results will not be released until after they graduate. In fact, for the class of 2020, we are due to receive our GQ, results on July 31st. So it and it's set up to be the safest opportunity to provide the most candid feedback possible without even a hypothetical risk of being identified or of having any potential negative consequence of that survey entry that you've made.

00:32:28 There are questions about the educational environment listed here. How often are the following professional behaviors demonstrated by our medical school faculty? from never to always. You can see there's about 14 questions listed here, many of them general about respectful behavior. There's one called respecting diversity. So in general, it's a, it's a helpful measure, but doesn't dig in on diversity as much as some of the other items do.

00:32:54 Now in our 2019 graduation survey. I'm going to share with you some of the actual data from that survey. First, there were a couple of questions on awareness of mistreatment policy. It's percent answering yes. And procedures for reporting mistreatment of medical students? Percent answering yes. These are the national percentiles in terms of the percent answering yes, you can see that even the tenth percentile, 93% answered yes up to a 100 and then 76%, up to 98%. All of our students who answered the GQ responded yes, which puts us in the 90th percentile or so for each of these Awareness items.

00:33:37 Well, how did we do on some of the other ones? The GQ also measures each student's personal experience with negative behaviors. This table shows the performance across the medical schools. This is the percent who said that they never experienced one of these behaviors. The other options for once, occasionally or frequently. But this is the percent who say never.

00:33:59 So for example, publicly humiliated. If you're in the tenth percentile, as a medical school, 70, only 70% of your students said never. If you’re in the 90th percentile of a medical school, 87% of your students said, graduate said Never. And as you can see, we did really well in our graduating class of 2019 with 94% saying there, Well, we all like it to be a 100%, so there's definitely room for improvement. So this gives us some benchmarking, of course, with other schools. But it also shows us how different from a 100% are we on some of these items.

00:34:33Threatened with physical harm is next; physically harmed is next; required to perform personal services such as shopping or babysitting is next; subject to unwanted sexual advances, is next; asked to exchange sexual favors for grades or other rewards; denied opportunities for training or rewards based on gender; and then we fall out of the nineties here. Less than 90% answered no answer to this one: subjected to offensive sexist remarks and names. So about 11% said that that had happened to them;  felt did they receive lower evaluations or grade solely because of gender? About 9% reported feeling that that was the case.

00:35:21 Lots of questions on the GQ, so denied opportunities for training or rewards based on race and ethnicity. So we're getting to other questions that are helpful here. Fortunately 100 percent said never in the graduates of last year, subject to racially or ethnically offensive remarks and names, looks like about 11% said that it had happened to them at least once. Received lower evaluations or grades solely because of race or ethnicity. Good opportunities for training our workspace on sexual orientation. A 100% said never to those two. Subject to offensive remarks and names related to sexual orientation, about 3% answered that that had happened at least once. Same for lower evaluations or grades solely because of sexual orientation. And same for on the basis of other beliefs and characteristics.

00:06:04 So it appears that these items might be very useful to add to the list of things that we continue to monitor annually. It's done annually anyway, it's part of our benchmarking process with our AAMC. So we have that as another data source. 

Diversity, Equity, Inclusion Maturity Index

00:36:21 There's a new one that we're going to try to add to the list. We have this diversity equity and inclusion maturity index. This is all about diversity equity and inclusion. So it's not just a question here and there out of some other large instrument. It’s the entire purpose of this instrument. And you can see it looks that communication, education assessment, culture, investment in infrastructure, compensation, recruitment and retention. It spits out an index score in all of these domains. And then the only issue with this one is that you've got to figure out how to accumulate it into a summary because it spits out an individual index for each person who answers it separately, but it looks useful. 

Summary: Diversity, Equity, Inclusion Metrics

00:37:00 So our plan moving forward is to focus on the items related to diversity, equity inclusion that come out of our learning environment survey. As well as our AAMC graduation questionnaire. This questionnaire is only to our students who are graduating, but the learning environment survey and this new diversity equity, inclusion, maturity index can go to a broad range of people in our community: students, faculty, staff, nursing, etc. So we think that through these three measures, this will give us the part of the quantitative side of what we're looking for for metrics, there will also be comments that will help us work with more qualitative feedback. 

More reflection time for Problem Based Learning (PBL) cases

00:37:40 Our students also asked that more time be given in their schedules to reflect on their problem-based learning cases. So in our case based medical education format, each week there is a very carefully prepared problem-based learning case that is addressed in small groups, where small groups solve the case over time, receiving additional information at various points. And then on Friday there's actually a wrap up in which all the students come together from all the small groups with a patient who has experienced that same illness, and they have a facilitated question and answer period with that patient.

00:38:19 A lot of issues can come up in that discussion that are ripe for reflection and discussion. But there isn't always time to do that reflection and discussion because the very next Monday is the next case and onward from there. So the students raise some concerns that some cases that might be fruitful for reflection, there wasn't time or it wasn't being observed consistently. So we have a plan in place now to flag those cases where it's likely to occur and make sure that we have adequate blocked time. Making sure that blocked time is implemented correctly so that we have opportunities for reflection.

00:38:55 There are cases in which the reflections may have to do with ethical questions. There are other cases in which the wellness of the healthcare provider who's taking care of a patient may also come into play. So it's not always clear that these are all sort of, I don't know, medical knowledge, sorts of things. A lot of these are around some of the most important intangible aspects of medical practice. So we do want to create an opportunity to talk about these issues with our students. 

End Racism Now
End Racism Now Street Mural: Each of the 12 letters is a separate art piece created by a different artist. Photo courtesy of Roanoke Arts Commission

Donation to community initiative to combat racism

00:39:27 And then finally, on this particular list, our students asked us to make a donation to a community activity or initiative which was anti-racist in nature. And we were looking for a good one to to choose in Roanoke. And we ran into a wonderful initiative called the “urban arts projects end racism now mural”, which as you see from this aerial view, is a beautiful collection of painted components, painted letters on a street. Which took a lot of time and design effort by the artist to, to create. 

And, we were very happy to partner with Carilion Clinic to together to donate a substantial amount to this cause. And we had an opportunity to go down to a to to see it in person. Um, mayor Sherman Lea is in between me and Nancy Agee the CEO of Carilion as he was sort of hosting us in, in, showing us that the mural. Jellie Witcher is on the left there, Dr. Bishop and then Vice Mayor Joe Cobb. And it was really nice to see the work. You have to really get close to see all of the detailed work done  on each particular letter, which, which gathers up to become this very nice mural. So we were happy to be able to contribute to that effort. 

Group poses in front of a portion of the street mural
From left: Jellie Witcher, Dean Learman, Mayor Sherman Lea, Carilion Clinic CEO Nancy Agee, Dr. N.L. Bishop, Vice Mayor Joe Cobb

Three more initiatives that are in progress

00:40:50 There were three other observations and requests from the class that we are working on. These will occur, we will be solving these soon, but they're not solved yet. One is deciding where to put a multicultural center for medical and our graduate students at the FBRI, the Fralin Biomedical Research Institute, so we're working with Mike Friedlander and looking at our space plans and trying to identify where we might include that kind of a multicultural center.

00:41:20 There's some comments about on-boarding our new students and how they're introduced to the community and how to broaden that approach and be more inclusive in how we address the interactions with the community early on in the process.

00:40:30 And then there were also request to diversify our actors and actresses who play standardized patients, who are interacting with our students to help them be assessed and understand their progress in their clinical skills development. And so these are other things that we're working on and we will definitely provide an update on these as as the next weeks and months go by. 

Eight items referred to the task force

00:41:59 Well, that leaves eight other things. From that first letter, we received eight other things out of 17 that we feel are handled in the task force. They require more discussion, more understanding, more guidance for us before we can move forward on any initiative. We want to make sure it's it's calibrated just right to meet expectations. We'll get, we'll talk about these a little bit later and I'll show you where they will be managed by the task force; in which Working Group. But for now here are the eight. 

Letter from current M4 students outlining six suggestions

00:42:32 We then receive that second letter from our current fourth-year students about phase 2, the clinical part of their curriculum. And of those six concerns that gave us an easy one, which was the dress code.

Can you please remove "clean and neat hair" from the dress code?

Yes, we can. We can definitely do that. But if we look at that dress code, we realize there's a bunch of other out-of-date standards, so we now have changed. The hair should be clean and I certainly hope so. Hairstyle should not interfere with assigned duties. Okay. And then eight other out-of-date standards had been removed. [inaudible] to show to you now, but we took the opportunity to really go through almost point with a red pen and remove things that did not need to be as specified as they were in the old dress code policy. So that was the one that we were able to complete very quickly. 

Bias in performance evaluations

00:43:22 There were two others that we're planning and these are very, very important. Require a little bit more processing time for us. The first was a specific item around bias and performance evaluations. We offer Letters of Distinction in many different areas that is almost… The numbers of Letters of Distinction gives our graduates a sense of where they showed excellence and gives the residency programs recruiting them an idea of that as well. It also feeds into some of their consideration for an Honor Society called AOA. What we had been doing for a while now is revisiting the value for our Letters of Distinction. It was something that we needed to respond to our accrediting body to explain how we were granting Letters of Distinction, by which criteria; how we were making that transparent to students. In the process of going through all of those Letters of Distinction, we realized that as much as they try to stick with more objective criteria, there were some that were less objective. And we were, we've been thinking about the value of the Letters of Distinction. We're not about to make any rash decisions, but we're thinking, you know, is this really getting giving us what we need and giving the students what they need? the National Academy of Medicine has issued guidance on well-being for medical students, and the National Academy says, if you're granting honors, an honors grade or you are giving a Letter of Distinction, you should not create a competition between the medical students for who is relatively better than another student. You should be creating absolute criteria and standards that hypothetically, any student, all students could achieve that standard and receive that honor. It's an ambitious target for the National Academy of Medicine to mention, a lot of schools do use relative criteria, which gets, which allows for biases to intrude upon the decision-making. So we're trying our hardest to redesign this, to keep all these factors in mind. We are updating our AOA nomination process. And now instead of just academic performance, we're adding in a lot of the other characteristics that the AOA national organization is encouraging out of this debate, encouraging people to include such as service, such as leadership and other elements are going to be defining,  very anchored criteria for excellence and each of those areas and using a much larger group to provide assessments of students. So that when we nominate students to the AOA chapter to become new members, the students that we nominate reflect excellence not only an academic performance, but in a lot of other ways. More to come on this, but we do have some action underway. I just wanted to summarize where we were with it. 

Mentoring by minority faculty

00:46:20 And then increasing the visibility, representation and mentoring with by black clinical faculty. There's a component of this concern which had to do with recruitment and retention and that's already in the list we receive from the first student letter. That what was unique about this one is that it really talked also about visibility and mentoring. And we are planning; we had been planning and still are planning to develop mentoring communities that includes students, residents, and faculty with the same self-identification, starting with diversity groups. It's something that creates a sense of safety and support across near peers, folks that are a little bit farther along in our students as well as more senior members of our community as faculty. It allows a place for debriefing and listening and understanding and strategizing, which some of the schools that are a little bit ahead of us that have been a little bit had been intentional around these issues for a year or two longer, they're finding that these mentoring communities are really helpful. And so one of N.L. Bishop’s initiatives in the coming year will be to start establishing these Mentoring Communities. This was underway before we hit June first and has started thinking about the taskforce. The good news is that the task force itself is bringing together members of our community across these different stages of training, and this will really be a helpful way to identify the participants in the mentoring communities that we need to create. 

Referred remaining three concerns to the task force

00:47:50 That leaves three additional concerns by our, our clinical students that are listed here. These will be assigned to the taskforce working groups and I’ll be presenting them at that time a little bit later in the presentation. Alright, so we've gone over the idea of what inclusive VTC School of Medicine is as an initiative. And we've talked about which of our student concerns we were able to manage without the task force and which we are referring to the task force. And we thought it was important to, to kind of triage those or to divide those up because we wanted to show this intentionality of implementing improvements as rapidly as we could. It's kinda that Thinking Fast and Slow thing. But we didn't want to think too fast about some of these other items. We wanted them to undergo a more thoughtful and fulsome discussion by the task force. So that is, that's where we are in terms of catching up on those issues. 

The InclusiveVTCSOM Task Force Web page

00:48:46 So let's talk about the taskforce now, we're very, very excited to have this webpage, which I will now have to make sure everyone can see before telling you about it, which is dedicated to our InclusiveVTC School of Medicine Task Force. Let me stop sharing for a minute. Okay. Let me start sharing again. Maybe it will work this time. Alright, so hopefully everyone can see, as I scroll down, is everyone seeing that? Hope so. Okay.


00:49:22 This is the taskforce web page. And let's start with the mission. “Our mission is to advance an inclusive environment that attracts and retains the best talent, size, diversity of life experiences and perspectives, and encourages innovation in our pursuit of equity.”

00:49:44 In addition, we have some background information describing the origins of the task force. The first forum that we had on June third and The development of the task force being grounded in the various principles of community and diversity statements by Virginia Tech and Carilion. We then move on to commitment statements. “We are committed to creating and implementing strategies that honor and strive to increase diversity in our students, workforce, patients, and community across all dimensions of social and cultural identity. We commit to consistently promoting and practicing inclusivity with all groups that we commit to training physician thought leaders, the mission of our medical school within a culture that promotes compassion and health equity. And we commit to holding ourselves and our institution accountable for these commitments.” Listed also are taskforce resources such as links to the Google Drive, an email addresses. This is where we may be housing a lot of the documents that I mentioned that support the task force work. We’ll be getting to some other aspects of the task force website in just a minute.

Addressing questions posed in the Zoom chat

00:50:49 Let me get back here. Share again. Should I stop and listen to the chat first? Look at all these chatters over here. I'm not able to see you. I'm presenting, so let me look at all  the chats here. Alright. Okay. Let's go back if it's okay with folks. This is only 20 minutes ago. Sorry. Folks.

00:51:25 Lauren asks are there any assessment specific to URM [underrepresented minorities] at VTC School of Medicine to understand how they would describe the climate. That’s a very good question. We have had… The numbers of individuals had been so low that it would be hard to not identify. To create the safety around looking at subgroups of students and how they might respond. With numbers that are low, it's hard to create a safe space for that kind of subgroup analysis. And we, you know, we hope that creating safety in the working groups and in our initiatives moving forward, will allow, will promote more of that, particularly the mentoring communities that we may have to go with more qualitative ways of understanding that aren't... But so far, we have not had adequate numbers in many of the categories for it to be something that we thought would be fruitful at this point to do a subgroup analysis with self-identified URM students. Exactly. Karen already answered the question, okay. Alright. I'm joining this late, huh? Privacy, etc.

00:52:32 So next question: For Letters of Distinction, might it be feasible to provide letters to students who put in the efforts to make these recommendations to the School of Medicine? The efforts are wonderful, they represent unpaid labor amongst individuals. Well, yeah, I think that service to the medical school is one of the AOA’s listed criteria in its most recent update, and this would certainly qualify for for service to the school. No question about that.

00:52:58 Frank Clark. Welcome. Frank asks could ask a question on the application, how can this further diversity, inclusion, equity? Absolutely. That could be a statement for understanding that service to the school component. That's a that's a great suggestion. Thank you. Okay.

00:53:19 We are going back to the slideshow, I think. Alright, so I will come back to the chat a little bit. Let's go through the structure of our task force. 

Task Force Structure

00:53:28 It's going to have a steering committee which is led by three co-chairs and has two liaisons and two consultants. It will have have ten, in addition, ten regular members. The working groups will each have a seat on the steering committee. So seven working group representatives, we encouraged the co-leaders of the working groups. One can come, both can come, but it's not necessary for both to come every time. That way, we’re not over burdening the working group co-leaders.

00:53:57 Each of the seven working groups listed here will have a student co-leader and a faculty or staff or community member co-leader. They will also have a facilitating participant in the working group and six to ten additional numbers. The one exception to this rule in the middle of the sandwich here is the community engagement working group, which will have number maybe more than 20 now. It's going to have a lot of additional numbers because there's so many different facets of the community. We felt that we needed to include all of those facets in as robust a way as we could really get a robust assessment of our community engagement question. So that is the exception to the rule.

00:54:37 And the idea of having so many people involved in this is that together we are co-creating our vision and direction for our diversity equity and inclusion efforts. It's a lot of work and it's going to lead to really meaningful and actionable change. It needs to have all of the ideas at the table to help us move in the right direction in a way that everyone feels is, is, is, is correct and is consistent with our goals. 

InclusiveVTCSOM Leadership chairs, liaisons, and consultants, named in the transcript below.

Task Force Leadership

00:55:04 We are lucky to have these wonderful individuals who will be at the helm of our Inclusive VTC School of Medicine leadership. We have Dr. Michael Jeremiah, who is the chair professor, chair family community medicine, Dr. Fidel Valea, Professor and chair of obstetrics and gynecology, and our wonderful human resources manager, Patricia Wooten. You may remember Patricia from our first community forum. So thank you to our three co-chairs for your service in advance.

00:55:29 Look at those smiles. We want you to smile even more than that at the end of this initiative, and we've already told the chairs that, you know, if things get busy with COVID and we need to take a little more time and we're not quite done by December, we’d rather get it done right than rush it through. As long as we have the information in time for our budget cycle and for curriculum planning, which is about February or March, will be fine. So these folks have made an enormous commitment. We're very happy to have them aboard.

00:55:58 Their liaisons to our diversity inclusion team will include Dr. N.L. Bishop our senior associate dean for diversity inclusion and student vitality, Karen Sanders, our Chief Diversity Officer and two consultants who are very interested in supporting us from their positions at Virginia Tech, the Director of Diversity Programs, Alicia Cohen and Director of Strategic Planning who we've enlisted as for our strategic planning support this year, Erin McCann. And if you're here tonight, welcome. It's great to have you here.

00:56:27 The other members of the steering committee are listed here. As you can see. They include a variety of faculty, several colleagues from Carilion Clinic who can help us with, with connectivity between our health system and our medical school efforts and making sure that we are looking at partnership opportunities at wherever we can, plus the perspectives they bring which are so valuable. We have several medical students participating who are our class presidents of the second, third, fourth years year class, as well as one of the representatives from the students who drafted the initial letter, Kenny Young is joining us as well. So we look forward to a very effective steering committee. A lot of frank conversations around how things are going and how to support the efforts of the working groups.

00:57:13 We will go back to the website to take a look at the working groups. So let me stop sharing again and start sharing again. 


Working Groups

00:57:30 All right, so we're now back on the website for the task force. And if we scroll down, we find the working groups over here. So I'm going to go through folks, come back later to kind of look in more detail, but I'll take a little tour of the working groups so that we can understand what they're focusing on and the members of the groups. And so just, just have a little bit of fun. On a, on a, on a Tuesday evening. We're going to ask the members of these groups as your names come up here to, to do something within the zoom space to let people know that it's you. That you are a member of this group. You can wave, can do something with what some of those emojis that they have, whatever you want to do. And we'll start with phase one. 

Group 1: Phase I Curriculum

00:58:14 Phase one part of our curriculum is the first, second years of the curriculum. The working group for that part of the curriculum will be addressing our how we develop longitudinal curricula in a variety of areas listed here. The group will focus on self-awareness, unconscious implicit bias training, social determinants of health, equity, pedagogic styles, microaggressions and imposter syndrome. Some of these wrapped up in our current curriculum and health system sciences and others that will be highlighted as part of our diversity curriculum. For phase one with the task force’s recommendations. Here are our group members listed, our co-leaders. Emily Holt Foerst from our who's our counseling enrichment services person, then instructor in basic science education Shashank is our M2 student, the participant facilitator is Jellie Witcher and our various participants are students and faculty are listed below. So thank you, phase one working group members. 

Group 2: Phase II Curriculum

00:59:15 Phase two is, are the clinical years of medical school. And they will be looking at the didactic components of the clinical clerkships as well as what we've called “domain days”, which are pull out program opportunity to kinda do intercession like reviewing of principles at various times spaced across the clinical curriculum. This group will also look at some of the same curricular elements that we, Phase one will, but also look particularly at Social Determinants of Health bias and performance evaluations, microaggressions. And this is the curricular side of this. This is the understanding of it. We'll have the learning environment group looking at a different aspect of this. The phase two curriculum working group is listed here. Thank you. In advance to Ayesha Kar, our student co-leader, Dr. Charles Paget, Associate Professor general surgery, Elvir, Student Affairs Manager, who's our facilitator participant. As well as you can see, we have residents, medical students, and faculty, and a cameo appearance by our former student, now alumnus, Dr. Malek Bouzaher. Thanks for not going too far away Malek. We could always get to you through zoom and we appreciate your willingness to be an alumni member of this working group. so, thanks in advance to that working group. 

Group 3: Student Support

01:00:35 Student Support. This working group will be looking at how we provide support to remediation, physical and mental wellness, individual and group mentoring, sense of connecting and belonging and any learning accommodations that we may need to talk about. The group members here include Adenike from the M4 class, Dr. Bankoke associate professor internal medicine, and, Carrie Knopf facilitator participant, student affairs. And we have Ron Bradbury, Director of Admissions here along with faculty and students. We have Hassan Farah, who is a graduate studentfor FBRI, who is executive chair Roanoke Graduate Student Association. We have our head librarian, Rita McCandless, several other faculty and attending physicians on this group. So thanks in advance to the Student Support Team. 

Group 4: Community Engagement

01:01:25 Community engagement. This again, the middle of our will, our sandwich and a very important committee. It's so important that we have limited language here because we know that this group is going to give us all sorts of wonderful advice on the core question. The key question is “how the medical school can be as effective a partner as we can possibly be with our community-based organizations.” So we really look forward to your wisdom and I'm about to show a very large group of names here. A very  impressive group that has agreed to serve with us, including Annette Lewis, who's the president, CEO of total action for progress with working with our co-leader medical student Macy Macucci, Courtney Powell is our facilitator participant. And then a whole bunch of community members as well as faculty and students and staff members who are interested in the, in the community and want to be sure the community is heard and understood. Who can then also act in ways to explain with the medical school is doing to community members as we get to some of those weeds of what we're up to. So we're very, very pleased to have all of these wonderful community leaders coming together for the community. Working groups, Community Engagement Working Group. Thank you so very much for investing your time and providing us guidance. Understanding… To help us understand where are we and where can we go productively in terms of community engagement? 

Group 5: Admissions

01:02:49 Admissions is next, and this group of course will focus on admissions, but also our pipeline programs. And looking also at scholarships, looking at how the admissions process can be as unbiased as, as humanly possible on how to address unconscious biases as well. The group members here include Dr. Violet Borowicz from pediatrics working with Sarah Yosief, who was one of the authors of our first student letter from the M2 class. Karen Burns, my assistant, will be facilitating in this one and participating in it with several other attending physicians from Carilion in OBGYN and endocrinology. Students and faculty from radiology, internal medicine as well. So thank you so much for serving on this important group for Admissions, a very important part of our, of the big picture in our diversity programs. 

Group 6: Faculty & Staff

1:03:44 Faculty and staff, there's a lot… We need to spend a lot of time and attention to understand. How, what sorts of educational programs and training do we need to have as a faculty and staff to be adequately prepared to promote our diversity equity and inclusion goals? So very important discussions will occur here about not only recruitment and retention of faculty, but also mentoring, connection, development, cultural competency, bias, microaggressions, managing difficult discussions. For for this group, I'm very happy that Chukwuemeka , who's also a coauthor of our first student letter is co-leading this, Dr. Shari Whicker. And we have Karyna Nevarez, as our Inclusion Coordinator supporting this as a facilitator participant. And as you can see, a range of faculty and staff and students participating as well in this very important committee. 

Group 7: Learning and Working Environment

1:04:41 And then the learning and working environment. Let me just take a minute to explain how important this is. You know, many of you who are connected to medical education have heard the term the “the hidden curriculum”. And the hidden curriculum has to do with all those professional behaviors that our students witness. And in the way of becoming a physician tend to learn what is appropriate or not appropriate in that professional behavior that they observe. And the learning and working environment very much is going to focus on those kinds of interactions and, and reactions that we have when our students confront something and, and register a complaint. When people observe micro or macro aggressions occurring in the learning environment and how they react to that. How, how when patients make remarks that are inappropriate from their perspective of diversity, inclusion, and equity, that we find a way and develop a way to know how to respond to those situations.

1:05:47 There's some medical schools that are starting to develop tools to support efforts to make sure that the learning and working environments include honesty and respectful approaches to honesty when behaviors cross a certain line. So this is a very sensitive and important topic. It frames the sense of welcoming that are diverse students receive or don't receive in the clinical environment. And when we don't want, we don't react to behavioral problems in that environment, it’s like giving our tacit approval to them. It's a very important topic to discuss honestly and openly so we understand it better and can act appropriately. For this very important committee,  I'm so pleased that our Chair of Surgery Doctor Mike Nussbaum, is co chairing this particular group with Meredith Rahman, from the fourth your class, Dani Backus is our facilitator participant. And as you can see, we have an excellent group of faculty and residents and students involved in this very important task force. So I want to just thank all of you for, for agreeing to be part of this. 

Summation of structure and Next Steps

1:06:55 As you can see, each of these working groups is going to have a very important job. And getting it done and then rolling it up and understanding what to make of it is going to be the work of the steering committee. And I'm just so glad we're going to have enough of these specific working groups to not be distracted by the other agendas of the other groups which are really hunker down and focus on what, what work needs to be done.

1:07:22 So the next steps, we're going to this, this is the launch. We're getting things launched now. Next step is our first meetings. At the first meetings of the steering committee and the working groups we will review the charge and the focus of the groups and and they will be receiving…  some of the student concerns will be assigned to specific working groups to start working on. We're going to provide briefings by the Dean's Office to to kind of level up our starting place. We did a whole lot of work preparing for our LCME accreditation visit, as well as our response to the LCME In the past year. There's a lot of documentation that we can summarize briefly. And then leave those documents for anyone who wants to look at. The Dean’s Office is going to be doing that leveling up presentation for each group at the very beginning.

1:08:14 We're going to review how, how to speak Virginia Tech in terms of the strategic plan deliverables. Because ultimately, when we get to the end of this process, the specific goals and objectives will need to be translated also into some measure of how well they've been implemented. So we want to introduce that early and we can introduce it again later in the process.

1:08:35 We’ll also  orient you to the available resources that we'll be putting for you in a shared web space. And of course, most importantly, scheduling meetings. 

1:08:44 Here's some examples of our mapping process, and these are just initial mappings. And people can refer to two different working groups if they feel the work needs that referral. These are the eight items that we referred to the task force from the 17 that our student letter included. Expand orientation, diversity training. So that happens longitudinally…

[Karen Sanders] Dean Learman, show us your slides, please. Thanks.

[Dean Learman] I thought it was. Ok, let's try again.

[Karen Sanders] And maybe it's just me and my new computer in my lack of technology.

[Dean Learman] I doubt it. How are we doing? Are we on? Can't see anybody's response.

[Audience member] So it's on my screen.

[Dean Learman] Yes. Okay. Thank you. So you've already heard me say this on the next steps. The stuff that's easier to read is here. And this is the mapping of the eight items from the first student letter that are being referred to the different working groups. 

Mapping of eight outstanding items from first letter

1:09:51 The first is to expand the orientation coverage of university training to make it more longitudinal. The second is a mandatory longitudinal curriculum on racism including the roots and consequences of police brutality. The third is mandatory curriculum of pandemics highlighting racial disparities and inequities.

The fourth is to denounce and remove race-based medicine from the curriculum.

1:10:12 And I'm going to pause here for a minute because at 5:24 tonight, I received an email. And the email I received is reporting the outcomes. Student advocacy by two members of our class of 2023, Alyssa DeWyer and Madeline D'Aquila, who had been working with Jon Sweet to move forwards and to successfully move forward I should add,  a request to the Quest Laboratory Advisory Committee to remove the race correction from the estimated Kidney Function Report. This is a laboratory. Excuse me. I'm doing good and doing well. How are you doing? I'm so they're… Not to get too wonky here, but there's an estimate called estimated GFR, which is a calculated measure of kidney function, which has been reported with an index, which isspecific to race, a racial correction, which has no validity, but has been reported from the contracted laboratory. And so, through the efforts of two of our medical students working and learning how pharmaceutics, how laboratory services are managed by a health system, they were able over time to move forward successfully with a well-developed proposal to remove this race correction which has no validity from that laboratory reporting system. And we just heard this evening that has passed its final approval stage. Dr. Sweet offers kudos to our students for raising awareness and effectively advocating for change. And we're just very, very, we're delighted to see the success of this. And perhaps it will, it will not only stimulate additional actions locally, but in other, other health systems that use the same laboratory in other parts of the region. Because what's true here in Roanoke, about the race correction is true everywhere. So congratulations to our students for, for making that happen. That's an example of race-based medicine. We need more clarity on what other aspects of it we should be paying attention to and that's why we're giving it to phase one and phase two.

1:12:24 The fifth item is to increase diversity within our Problem-Based Learning cases, the write-ups that the students are exposed to in the first two years that characterize patients according to their medical illness but also other characteristics. And then the, to increase diversity within the standardized patient cases, not the actors and actresses, but the roles that they play, and both of those will go into the phase one working group.

1:12:49 Transparency regarding recruitment and retention of minority faculty, faculty working group, and the longitudinal curriculum for all faculty, medical educators and administrators on health equity and structural racism in medicine. Faculty working group. 

Mapping of three outstanding items from second letter

1:13:02 The three items from the second letter we received, regarding the clinical years, that we're referring to the working groups are a streamlined, specific and clear management of student complaints regarding the clinical environment. And to understand what that process map looks like, how the different feedback can come in. Whether it's through a clerkship evaluation, a block evaluation, whether it's through a report to a LEAC committee, whether it's through an ombudsman contact, is  to understand all the ways to capture the information in a very safe way, is the first item that go learning working environment, working group. Increasing the safety of our clinic learning environment. That is, when inappropriate behaviors are observed. How do we train active bystander training so that we understand how to respectfully intervene at the time, so we don't offer tacit approval of that comment that went on responded to. That's another issue for the learning and work environment. And then finally, to address the impact of systemic institutional racism on healthcare and healthcare delivery. To do that during our domain days and lectures, that's a curricular issue for phase two goes to that committee. 

Summary of Task Force Structure and Dean's Office involvement

1:14:14 So in summary, we have these seven working groups there, each co-lead by a medical student. They're each co-lead by a staff member, faculty member, community member. And they each have facilitator participant as well as the other participants. They each have a Dean's, a member of the Dean’s team who will be briefing the committee, making a cameo appearance at the very beginning to level up on some of the foundational knowledge of that topic area. My colleagues, Dr. Vari, Dr. Chris, Dr. Knight, Drs. Bishop and Trinkle, Dr. Prusakowski, Dr. Musick, Dr. Harrington. These are the people who will not be serving on any of these working groups or the steering committee. They're to lend assistance and to brief at anyone who needs it. And our briefing for the steering committee will be Dr. Sanders as well.

So this will be a highly staffed and highly resourced venture as it needs to be. We are doing this as a faculty, students, staff, community driven exercise with support from the Dean's Office because we realize that the only way to grow into not only an institution that respects diversity, but one that finds a unity together is for it to be co-created by the 100 plus people that are serving on the Task Force, the working groups representing a much larger number of people. This is how we co-create that future together. I don't know what's going to come of of this taskforce and what the recommendations are going to look like. And I love the fact that I don't know, because it's going to be organic and represent the wisdom of all of our participants together, and that's the goal. So I'm very, very excited to introduce and… this debut of our task force and its leaders and of its structure and its objectives. And we promise to keep checking in with you with updates as, as the work continues over time. 

Transition to Task Force Co-Chairs

1:16:17 So I'm going to stop there. And now I'd be happy to go back to the chat stream to see there any additional questions, and if not, I opened their new. There's some nice comments. Thank you. I'd like to kind of turn over the conversation now to our three co-chairs. And I'm not going to make any sound effects about the transition I'm making to them right now, the handoffs that I'm making to them. But I'm very happy to be making that hand off. We’re here for you. We're here to help you. But here you go. So who'd like to go first among our co-chairs? 

Patricia Wooten

Patricia Wooten

1:16:54 I think I'm up first, this is Patricia. So first of all, I have this whole prepared statement. But I just have to say, wow, the work that has been done is just phenomenal. So thank you, Dean Learman, thank you to our leadership team and our Diversity Inclusion team for the work that has been done up until this point to create this task force. As many of you know, I am an HR manager with Virginia Tech, with the School of Medicine and I get to sort of have meetings with other HR folks across the university. And the work that we are doing is like no other department or college. And so I I want to start with that because I think we need to take a moment and recognize and appreciate that we're going the extra mile and the extra step to ensure that we are diverse, that were inclusive, and that we're listening to the needs of our faculty, staff and students. So I see some congratulations or the hands clapping. And so thank you all for the work that's that's happened up until this point.

1:17:58 You know, I'm I'm a lowly HR manager, right? And I've got these two amazing physicians that I get to co-chair this with and I'm just super, super excited that I get to have these amazing physicians to co-chair this taskforce with. They are amazing individuals, great guys. And I look forward to what we do together. But as I was thinking about what to talk about this evening, I reflected on me personally…

1:18:23 I'm not native to the Roanoke area. I'm actually a Yankee, I'm from Connecticut, and I actively chose Southwest Virginia to be my home. I again, I did not grow up here, but I chose this place. Many of you know that I met my husband here in this area and  that's what drew me back to the area originally. But what I think about the future family that he and I want to have and want to create. This is the kind of work that's really necessary for our children to have a more inclusive community. And so I really think about that as the role that I'm going to have on this task force as really being important work for the future. And that's really personal to me because I want them to grow up in a place where they feel included, where they feel welcomed. And I think it takes all of us, all 139 squares here and beyond… It takes all of us to make sure that that happens for the future.

1:19:30 And then I also thought about the fact that from, from the perspective of my career and the dean's group has heard me say this, I want the school of medicine to be a place that faculty, staff, and students are proud of. Proud to work, proud to learn, proud to thrive. And we can't have that if we have individuals that feel on the outskirts of this community. And so this work is really important to make sure that we are all proud to be part of this. So that's really, really important to me personally.

1:20:04 I've got over 15 years of human resources experience and many of my Professional and personal experiences will hopefully lend us to get to a, a great place in setting some goals and outcomes and solutions. But for me, there's, there's this book called Switch. And many of you know, I like to talk about different books. So if you can get this book called Switch, please do. And there are individuals that you can appeal to their emotion. And there's individuals that you can appeal to via data and logically. And so I like to appeal to your emotions. So I hope that if you have children, if you're going to have children like me, that this is important to you to create that community.

1:20:45 Obviously, we're all faculty, staff and students here. And so hopefully you can, it appeals to your emotion that this should be when you walk through those halls of Riverside. Once we get back there, right? That we are proud to walk through those halls. So that's my thing, that's my schtick to appeal to your emotion. We’ll worry about the data and the surveys and the assessments and all that stuff and  we'll make sure that's part of it. But I think when you think about tonight, I really want you to pay attention to the things that Dean Learman said in the beginning in this presentation about all of the things that are happening around us.

1:21:20 To our taskforce. I just want to say that it's a huge honor to be appointed to the roles that you guys have. I hope that you're going to be actively engaged, that's our expectation, that's our want, is that you're actively engaged, you participate, you come up with some creative solutions. We're not going to be those people knocking out solutions immediately. We want  to hear what you have to say. And we want to partner with you on this. So in closing, I really just want to say and Dean Learman already set me up for this as the late Congressman John Lewis said, I hope that we get into some good trouble together, so I'll end there.

[Dean Learman] That's that's wonderful. Thank so much. Patricia. Hard act to follow. Who'd like to go next? 

Michael Jeremiah

Michael Jeremiah

1:22:06 I think I'm up next, but it is a very hard act to follow. Thank you, Patricia so much. So I'm Michael Jeremiah for those of you that I don't know. I want to first thank Dean Learman for giving me the honor to work with Patricia and Fidel and to co-chair this incredible task force. I think it has been set up with a lot of thought and a lot of support, and that gives me great confidence that it's going to really do some great things. And like he said, we don't know exactly the outcomes and that's part of the, the intention. It's also part of the excitement is that we are going to go where we need to go to be able to look at all these different areas and to address them.

1:22:45 Incredible talent that we have represented here. And on the, the list of the members of the work groups and task force. A couple of things I will say, first of all, I will tell Patricia, that Fidel and I are looking to learn from her. When you've worked 15 years in Human Resources. Nobody could touch that in terms of some of the experiences about some of these issues. And so I think you have a wealth of experience and I'm so glad that we're working with you on that.

1:23:08 I have had the opportunity to work for Carilion for now 25 years. I've seen a lot of changes in our organization. I've also seen some continued areas where we need to grow. And I'm very excited that the circumstances around us have been part of the impetus for this, but I'm especially excited that the voices of our own students had been a big push to address different issues and to set up some of the aspects that we're going to be tackling as a task force. I think that's fantastic and that's the way it should be. And our students are also going to be an integral part of every single workgroup and of the steering committee. And again, I think that's the right way to design this, so I'm very excited about that.

1:23:50 Now, in addition to serving as the chair of the Department of Family and Community Medicine, I also do a lot of work for the organization around population health. And one of the things that's become very clear is that if you really want to change the health of population, you’d better start look at inequities and the barriers to health. And we're understanding more of that each day. And I think this kind of work is going to tie right into that. So I'm extremely excited about that. I have the opportunity to have some discussion with fellow chairs at a, at a national level, and this is something that resonates across the country right now and we need to take full advantage of that.

1:24:24 It's also personal for me as Patricia was saying, I have two children that are internationally adopted and we've tried to help them navigate through their journey. My daughter just graduated from high school. She's getting ready go Richmond to VCU. And of course, there's a lot going in Richmond these days. And so we're having great conversations, but also personally helping them to navigate through aspects of bullying and discrimination that they've experienced. And it has taught my wife and I so much and we want to be able to help, you know, help the school and help in any of these efforts. So it becomes personal in terms of the future for our family as well. So I echo some of the things that Patricia was saying. And again, just thank you and I'm excited about getting started with this work, and I'll turn it over to Fidel. 

Fidel Valea

Fidel Valea

1:25:09 Thank you, Michael. Boy, this is a treat. If you've ever heard the expression, go big or go home, we're going big. You know, I had a discussion with N.L. Bishop… we went to lunch oh it's maybe less than a year ago, to talk about diversity here in our community and how we've made some progress, but we both agreed that we only scratched the surface and we really had a long way to go. And when our dean asked me to be the co-chair, I was thrilled. This has been something that for me has been a lifelong calling.

1:25:44 With a name like Fidel. When you look at me and named some, don't always go together. But I grew up as an immigrant to the United States. And I grew up in a traditional immigrant family. There were three families living in one single family, one bedroom apartment in the Bronx. And I saw discrimination from day one. What happened to my parents; just what I grew up with, and I was fortunate to have an education and, and be able to survive that. And I have always been a staunch supporter of the underdog. And this is just really a real treat for me. So that's my, my passion.

1:26:25 My qualifications: In my whole academic life, I've been an educator and I've run a residency program at every place  I've been. And one of the hallmarks of every residency that I've been a part of is our diversity. I've I, I, I value that from day one. I fought for it and I will continue to do the same for Virginia Tech Carilion. It is absolutely an honor to work with people like Michael and Patricia. I mean, wow, how can you follow her, Michael, I got lucky I got to follow you, not her.

1:27:02 But the thing that really impressed me the most when I met with the Dean about his plan was, wow, the resources that they have deployed to make sure that this taskforce and the working groups come up with something good is impressive. It's very, very heavily resourced and I think that really is, is a recipe for success. So Dean Learman, thank you for asking me to participate. I hope I meet all your expectations and I really look forward to learning from Michael who's got a wealth of experience in this area, aAnd Patricia, my fellow Yankee, I didn't know you were from the wonderful state of Connecticut. And we're going to do great things together as a team and as a, as a society.

Community Forum Close

1:27:50 [Dean Learman] Thank you. Thank you guys so much. I can tell you guys are going to gel really well together as a leadership team. We only have a couple of minutes left left. So if anyone else would like to make some closing comments before we wrap up…

1:28:13 The hour is late, the clock is ticking. I didn't follow my how to interview patients rule book and wait ten seconds. I'll try to be a little bit longer.

1:28:36 And with that, my friends, we will call it an evening. Thank you so much for staying with us for an hour and a half on a busy Tuesday night. Thank you for those of you joining the taskforce. Awesome. It's going to be fantastic. And for those of you supporting us, thank you for that. We’re going to need all this for we can get not only now, but when we implement everything later. Have a pleasant rest of the evening everyone.

[Fidel Valea] Thank you.