Presenter Status
Staff
Abstract Type
Basic Research
Primary Mentor or Principal Investigator
Frances Turcotte-Benedict, MD, MPH, FAAP
Presentation Type
Poster
Start Date
21-5-2026 11:00 AM
End Date
21-5-2026 12:00 PM
Abstract Text
Background: Medical mistrust—rooted in historical and contemporary inequities—remains a critical barrier to optimal healthcare access across all communities. Despite its significant impact on patient engagement and health outcomes, graduate medical education (GME) programs rarely provide structured training on medical mistrust and its effects on patients, families, and medical providers. Understanding how educational interventions influence resident physicians' knowledge and confidence in addressing medical mistrust is essential for developing effective, evidence-based curricula that prepare physicians to deliver equitable, patient-centered care.
Objectives/Goal: To evaluate pediatric residents' knowledge of medical mistrust and self-efficacy in addressing it before and after participating in a case-based educational workshop.
Methods/Design: Four interactive 4-hour workshops were implemented within a midwestern, free-standing academic children's hospital pediatric residency program. The curriculum incorporated multiple evidence-based teaching modalities: an introduction to medical mistrust covering definitions and relevance to health equity; a gallery walk where residents responded to prompts exploring mistrust in clinical contexts and reflected on previous experiences; and historical case analysis examining the Tuskegee Syphilis Study and Madrigal v. Quilligan forced sterilization cases. Facilitated debriefs emphasized trauma-informed care strategies to support patients and colleagues, and the impact of social determinants of health in both historical and present-day contexts.
Participants completed pre- and post-workshop surveys assessing prior exposure to medical mistrust training, familiarity with historical cases of medical harm, and self-efficacy across six critical domains: validating patient concerns, addressing power imbalances, responding to language and health literacy barriers, recognizing personal bias, engaging peers in equity conversations, and exploring cultural beliefs and social determinants of health. Self-efficacy was measured using a 10-point Likert scale for each domain.
Results: Pre- and post-survey response rates were both 100% (n=76). Prior to the workshop, 66% of residents had not received medical mistrust training. Most were familiar with Tuskegee (68% very familiar), while 97% were unfamiliar with Madrigal v. Quilligan. Self-efficacy scores significantly increased across all domains (p< .001): validating patient concerns (+1.61), addressing power imbalances (+1.61), responding to language/health literacy barriers (+1.48), recognizing personal bias (+1.31), engaging peers in equity conversations (+1.34), and exploring cultural beliefs/social determinants (+1.31), with large effect sizes (d=0.90–1.23). Post-workshop, 99% reported being very familiar with both cases. Qualitative feedback highlighted increased awareness of historical trauma's influence on patient trust and the value of case-based learning for practical application.
Conclusions: A structured, case-based workshop significantly improved pediatric residents' self-efficacy in addressing medical mistrust and expanded knowledge of historical contexts. These findings underscore the need for integrating medical mistrust education into GME curricula to equip physicians with skills to foster trust and remove barriers to health and wellness while empowering residents to effect change
Expanding Resident Knowledge and Self-Efficacy in Addressing Medical Mistrust
Background: Medical mistrust—rooted in historical and contemporary inequities—remains a critical barrier to optimal healthcare access across all communities. Despite its significant impact on patient engagement and health outcomes, graduate medical education (GME) programs rarely provide structured training on medical mistrust and its effects on patients, families, and medical providers. Understanding how educational interventions influence resident physicians' knowledge and confidence in addressing medical mistrust is essential for developing effective, evidence-based curricula that prepare physicians to deliver equitable, patient-centered care.
Objectives/Goal: To evaluate pediatric residents' knowledge of medical mistrust and self-efficacy in addressing it before and after participating in a case-based educational workshop.
Methods/Design: Four interactive 4-hour workshops were implemented within a midwestern, free-standing academic children's hospital pediatric residency program. The curriculum incorporated multiple evidence-based teaching modalities: an introduction to medical mistrust covering definitions and relevance to health equity; a gallery walk where residents responded to prompts exploring mistrust in clinical contexts and reflected on previous experiences; and historical case analysis examining the Tuskegee Syphilis Study and Madrigal v. Quilligan forced sterilization cases. Facilitated debriefs emphasized trauma-informed care strategies to support patients and colleagues, and the impact of social determinants of health in both historical and present-day contexts.
Participants completed pre- and post-workshop surveys assessing prior exposure to medical mistrust training, familiarity with historical cases of medical harm, and self-efficacy across six critical domains: validating patient concerns, addressing power imbalances, responding to language and health literacy barriers, recognizing personal bias, engaging peers in equity conversations, and exploring cultural beliefs and social determinants of health. Self-efficacy was measured using a 10-point Likert scale for each domain.
Results: Pre- and post-survey response rates were both 100% (n=76). Prior to the workshop, 66% of residents had not received medical mistrust training. Most were familiar with Tuskegee (68% very familiar), while 97% were unfamiliar with Madrigal v. Quilligan. Self-efficacy scores significantly increased across all domains (p< .001): validating patient concerns (+1.61), addressing power imbalances (+1.61), responding to language/health literacy barriers (+1.48), recognizing personal bias (+1.31), engaging peers in equity conversations (+1.34), and exploring cultural beliefs/social determinants (+1.31), with large effect sizes (d=0.90–1.23). Post-workshop, 99% reported being very familiar with both cases. Qualitative feedback highlighted increased awareness of historical trauma's influence on patient trust and the value of case-based learning for practical application.
Conclusions: A structured, case-based workshop significantly improved pediatric residents' self-efficacy in addressing medical mistrust and expanded knowledge of historical contexts. These findings underscore the need for integrating medical mistrust education into GME curricula to equip physicians with skills to foster trust and remove barriers to health and wellness while empowering residents to effect change
Comments
Poster Board Number: 38