Diversity vs Pluralism? Notes from the American Experience

Europe is newly concerned with religious pluralism and questions of immigrant inclusion. Seen from the U.S., several issues stand out. First, our experience with diversity suggests that race is as much an issue as religion. Race is not just an American problem; race and religion are everywhere sources of identity and solidarity, just as they are sources of division. The Ellis Island model of immigration, in which churches helped immigrants adjust to American life, may have worked for Whites, but it did not work nearly as well for others. Don’t expect integration on that score. Second, American religious diversity is overstated. Figures show that the apostles of America’s new religious pluralism are talking about at most 9 % of our foreign-born immigrants and 4 % of our native population. The U.S. is still dominantly Christian, though that Christianity is internally diverse. Recently, sectarian Christian diversity has infected our politics, contributing to our current polarization. Racial, religious, and political conflicts are thus alive and well. Is ‘civil religion’ a solution? Not if the civil religion in question is of the priestly or the sectarian kind. At times, however, American civil religion has been prophetic, speaking to the country’s highest ideals. Only then has religion (of any form) been a resource for broad inclusion.https://inspire.redlands.edu/oh_chapters/1038/thumbnail.jp

Sexual boundary violation index: A validation study

This paper explores the psychometric properties of the Boundary Violation Index (BVI), a screening instrument designed to assess the attitudes, thoughts, and behaviors of physicians at risk of sexual misconduct with patients and staff. Items for the BVI were selected and validated using a two phase process of administration of the tool along with the Sexual Addiction Screening Test (SAST) to physicians referred to a CME course for boundary violating behaviors (n = 60 and 272) along with a control group (n = 118). Criterion-related validity in relation to the SAST was strong (r = 0.68, p \u3c 0.001) and construct validity was demonstrated by the difference between intervention and comparison group BVI scores (p \u3c 0.001). A BVI score of ≥6 for interpreting substantive risk had a sensitivity of 83% and specificity of 81%, and represented a greater than 20-fold greater risk (Exp B = 20.5, 95% CI 11.8-35.7, model p \u3c 0.001) for membership in the intervention group. The BVI offers promise as a preliminary tool for identification of physicians at risk for boundary violating behaviors and may have utility for medical education and/or monitoring purposes

A continuing medical education approach to improve sexual boundaries of physicians

Introduction: Physician sexual boundary violations are a public health problem. Few resources exist to address physicians who behave inappropriately with patients. In response, the Center for Professional Health at Vanderbilt University developed a three-day continuing medical education (CME) course about proper professional sexual boundaries in 2000. The mission of this CME course is to offer an educational intervention for those physicians whose professional sexual misconduct has required such education as part of a larger accountability sanction. Previous studies suggest that when such education is offered through non-traditional medical education, it is effective in promoting behavioral change. This paper describes the three-day intensive educational experience offered by a CME course with a particular focus on lessons learned from more than 7 years of experience working with these physicians. Methods: Over 381 physicians from 40 states and Canada have attended. Data about course participants was collected by self-report and aggregated into three categories: demographics, results of assessment tools administered, and quality of the experience. Assessment tools used include the Family Adaptability and Cohesion Evaluation Scale II (FACES II), the Trauma Symptom Inventory (TSI™) and the Sexual Addiction Screening Test (SAST). Results: Most physicians were referred to the course from physician health programs and boards of medical examiners. The majority of physician participants were male and in group or solo practice. A full range of medical specialties was represented with most physicians being internists, psychiatrists, obstetricians and surgeons. Results of assessment tools administered indicate that physicians referred for sexual boundary violations often come from dysfunctional families and demonstrate symptoms indicative of trauma related problems and possible sexual addiction. Physician attendees report being highly satisfied with the new knowledge attained in this course. Discussion: Curriculum aimed at addressing sexual boundary violations should address family of origin issues, trauma coping skills and sexual acting out. Satisfaction data continues to support a small group, experiential, and confidential format as an effective means for intervention. Conclusion: A CME course offers a model for future training experiences for faculty, residents, medical students and community physicians to teach skills that may help prevent and remediate professional boundary crossings

Exploiting the power of information in medical education.

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed. Education programs must shift focus from content delivery to providing students explicit scaffolding for future learning, such as the Master Adaptive Learner model. Additionally, educators should leverage informatics to improve the process of education and foster individualized, precision education. Finally, attributes of the successful physician of the future should inform adjustments in recruitment and admissions processes. This paper explores how member schools of the American Medical Association Accelerating Change in Medical Education Consortium adjusted all aspects of educational programming in acknowledgment of the rapid expansion of information

The Computer-based Lecture

Advancing computer technology, cost-containment pressures, and desire to make innovative improvements in medical education argue for moving learning resources to the computer. A reasonable target for such a strategy is the traditional clinical lecture. The purpose of the lecture, the advantages and disadvantages of “live” versus computer-based lectures, and the technical options in computerizing the lecture deserve attention in developing a cost-effective, complementary learning strategy that preserves the teacher-learner relationship. Based on a literature review of the traditional clinical lecture, we build on the strengths of the lecture format and discuss strategies for converting the lecture to a computer-based learning presentation

'Keeping the story alive' : is ethnic and racial dilution inevitable for multiracial people and their children?

This paper explores how multiracial parents with White partners articulate narratives of ethnic and racial ‘dilution’ and cultural loss in relation to the socialization of their children. In our broader study of how multiracial parents raise their children, we found that parents commonly spoke of concerns around dilution and generational change in relation to four key themes: the loss of cultural knowledge and diminishing practices that connected parents and their children to a minority ancestry; the embodiment of White-appearing children and the implications of this for family relationships; the use of biological or genetic discourses in relation to reduced blood quantum; and concerns amongst Black/White participants about whitening and the loss of racial consciousness. Parental understandings of dilution varied greatly; some expressed sadness at ‘inevitable’ loss; others were more philosophical about generational change; and others still proactively countered loss through strategies to connect their children to their minority heritages. We show that despite growing awareness of the social constructedness of race and an emergent cosmopolitanism among these parents, discourses of genetics, cultural lineage, and the ‘naturalness’ of race continue to hold sway amongst many multiracial parents