Monday, July 16, 2018

Cristina Gonzalez Spotlight

Tell us a little about yourself--what are you doing today, and in what areas of medical education are you focused?

Obtaining my Master’s Degree in Medical Education (MEd) at the University of Cincinnati was transformative for my career. I am an associate professor of medicine at Albert Einstein College of Medicine, where I have worked for my entire career as faculty. I initially began as a clinician educator with an interest in health disparities education, which I subsequently honed into a passion for addressing physician implicit bias in clinical encounters.

My MEd allowed me to develop the skills to pursue a career in medical education research. I am currently the principal investigator of a research program working to design, implement, and evaluate curricular innovations to help medical students recognize and manage their implicit biases during clinical encounters. My team and I have developed interventions that address knowledge, attitudes, and initial strategy identification and implementation. We are working to design opportunities to build on those strategies to allow for skill development and practice, and have expanded the research along the spectrum of physician training and practice.

In the very near future, we anticipate collaborating with our interprofessional colleagues to broaden our target audience. To date, I have received funding from the Robert Wood Johnson Foundation as a Scholar in the Amos Medical Faculty Development Program, as well as the Josiah Macy, Jr. Foundation through my selection as a Scholar in the Macy Faculty Scholars Program. This summer I am writing my first grant application to the National Institutes of Health to continue this work (fingers crossed!).

What do you think has been the most significant change in the field of medical education since you began your career?

In my opinion, the most significant change in medical education since I began my career has been the increased focus of the role of medical education in contributing to the elimination of health disparities and ultimate health equity. This focus has moved beyond addressing individual patient behaviors; as a field we are elucidating and striving to address the influences of systemic racism and other systemic inequities, encompassed within the social determinants of health. In addition, there is a focus on our potential to improve our patient interactions and more frequently deliver excellent, equitable care to all of our patients through interventions aiming to help all providers recognize and manage their implicit biases during clinical encounters. Within these innovations is the spirit to move away from blaming of individuals and towards action and capitalizing on each individual provider’s good intentions. I think there is a lot of promise for success and growth in this area.

Of all the things that give me hope for medical education’s potential to positively influence health disparities, the most exciting is the knowledge of the amazing people doing this important work. Over the last several years I have had the great privilege to work with so many wonderful people on my own team from college graduates in a gap year, to medical students, residents, and faculty. I have been extremely fortunate to become part of a national network of colleagues through the Association of American Medical Colleges (AAMC), and the Society of General Internal Medicine (SGIM). AAMC has had a strong focus on implicit bias in its last few annual meetings. In fact, our paper was accepted for presentation at the RIME session during the 2018 annual meeting and it focuses on faculty perceptions of challenges and opportunities when facilitating instruction on implicit bias. The theme for the 2019 annual meeting is “Courage to Lead: Equity, Engagement, and Advocacy in Turbulent Times.” I serve both on the planning committee for this meeting and as co-chair for the society’s Health Equity Commission. The enthusiasm of my colleagues and the scientific rigor with which they are working to help overcome health disparities is simultaneously refreshing and inspiring.

What do you see as the biggest challenges for medical education today?

One major challenge, in my opinion, is that medical educators trying to incorporate new content into the existing, already crowded, curriculum are often asked to demonstrate an impact in patient outcomes before the content is taken seriously and seen as a necessary part of the education of a physician. This is not a requirement of content areas that have traditionally been taught to medical students for decades. I recognize that curricula are often over-crowded and we cannot just keep adding and adding content for our students. At the same time, our patients would likely benefit from being cared for by physicians with not only a firm grasp of basic science, pathophysiology, communication and physical exam skills, but also social determinants of health and other aspects of health systems sciences. Such a well-rounded physician could take even better care of his/her/their patients in the context of the patient’s actual lived experience. If we can work to identify the parts of the traditional curriculum that are essential to becoming an excellent physician, then we can open up space for the integration of these newer content areas.