Identifying learning outcomes for a reproductive justice curriculum for physicians

Awarded 2016
Complex Family Planning Fellowship Research
Charisse Loder, MD
University of Michigan
$79,540

Background
Reproductive justice is defined as “the right of women to have a child, to not have a child and the right to parent that child in a safe and humane environment”. A reproductive justice framework highlights the need for all people—in particular, people of color and marginalized groups such as LGBQTI individuals—to make reproductive choices free from discrimination, coercion or governmental influence. Applying a reproductive justice framework to reproductive healthcare could help physicians understand how structural, economic, cultural and political factors influence patient care.  This framework could help physicians navigate a number of reproductive healthcare issues such as: family planning, LGBTQI health and environmental health as well. Currently, however, physician education does not include a comprehensive reproductive justice curriculum.
 
Aim: To use qualitative methods to identify critical components of a reproductive justice physician curriculum through collaboration with reproductive justice experts and leaders.
 
Methodology
We formed an Advisory Board of reproductive justice advocates and physicians to oversee the process. We used the Delphi method—a qualitative consensus technique—to survey reproductive justice experts and leaders to determine what should be included in the reproductive justice physician curriculum. Using this three-round survey, experts rated their agreement with including topics in the curriculum. Next, experts were invited to an in-person discussion about the curriculum, which was recorded, transcribed and analyzed.
 
Findings
Reproductive justice experts (n=41) recommended 58 reproductive justice topics for the physician curriculum. Of the 58 topics, experts agreed that 52 of these were essential to include in a reproductive justice curriculum for physicians. Topics were categorized into 11 broad categories: reproductive justice definitions; advocacy training; historical injustices; oppression, power and privilege; health disparities; healthcare access; legal issues; reproductive health topics; LGBTQI health; cultural safety; patient communication. At the curriculum discussion meeting, 13 participants who were RJ experts, physicians and educators agreed that RJ advocates should aid in design of educational materials. Additionally, participants agreed that RJ processes and patient stories were a powerful educational tool to include in the curriculum.
 
Conclusions
Reproductive justice advocates, academics and educators successfully collaborated to identify topics, discuss goals, teachers and design of a reproductive justice curriculum for physicians. Ongoing collaboration is needed to design content and delivery of a reproductive justice physician curriculum

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