Education at OHSU

Foster Respectful and Equitable Education (FREE)

Postbac students outside wearing surgical masks

OHSU values diversity, equity, and inclusion. The FREE initiative aims to enhance the learning environment by fostering culturally relevant and inclusive education, and cultivating a respectful community for all learners.

This initiative is developing OHSU’s learning environment in order to deliver on our values of engagement, achievement and motivationThese values are crucial in preparing our learners to become competent healthcare providers and researchers.

Acknowledgments

We would like to thank the following OHSU faculty, staff, and students for their conversations with us and their feedback to help us create this website:

The CDI team, The TLC team, Kalisha Bonds, Tracy Bumsted, Pat Dickerson, Damien Fair, Jennifer Gossett, Andrea Ilg, Ian Jaquiss, Jeffrey Miller, Iaen Nylund, Alison Roache, Riika Salonen, Kristen Wong, Peggy Wros, and Amy Penkin.

Contact us

Graciela VidalEducation Specialist, Office of Educational Improvement & Innovation

Lisa Hatfield - Director for the Teaching and Learning Center

Andrew Justicia - Program Manager for the Center for Diversity and Inclusion

Events, training opportunities, reports and guides

Events in this calendar include English Conversation Practice, OHSU Pride meetings, Resource Groups (such Employee and Student groups), and more. View the diversity calendar.

  • Belongingness as a Pathway to Diversity and Inclusion in Dental Education by ADEA, the Voice of Dental Education. Webinar. November 30th 2021, 11-12:30 PM EDT. Sign up!
  • Foster Respectful and Equitable Education Series (FREE) - Difficult Conversations in the Clinical Setting. New classes are coming in Fall 2021!
  • Compass: Fostering Respect (asynchronous training). This 20-min video presents an overview of the FREE site and resources available on inclusive and equitable teaching. This training also includes quick tips for being inclusive and respectful that you can easily implement in your in-person and online courses.

Consultations or workshop request: Contact Graciela Vidal at vidal@ohsu.edu to request either an individual consultation, or a workshop for students or faculty.

Unconscious Bias Training: The campus-wide unconscious bias initiative is one of many ongoing efforts to create a fully inclusive OHSU community and to remove barriers to individual and group success. It focuses on everyday bias – positive and negative – which impacts how we interact with people and our decision-making. View Unconscious Bias trainings.

CDI Summer Seminars: Check out the 2020 Center for Diversity and Inclusion summer seminar videos on topics including:  

  • Students on choosing the right program
  • Interviewing skills
  • Admissions, Scholarships and more

You can also learn about our various Student Interest Groups here.

Join OHSU colleagues for Faculty Development Fridays. The School of Medicine and the Office of Educational Improvement jointly present this series of professional education opportunities, including live-streamed presentations, virtual workshops, and facilitated discussions of webinars. Events are open to all OHSU learners, postdocs, staff, and faculty.

Creating an Inclusive Learning Environment

How do we create a culturally inclusive and responsive environment?

One of the goals of FREE is to provide easy to access tips, guides, and "best practices" for creating a culturally inclusive and responsive learning environment. Below are three sets of guidelines that highlight essential ways to help accomplish this task.

Engage in meaningful conversations about course challenges:

Learn about each student and adapt your teaching

  • Provide an identity questionnaire  for learners at the beginning of the term to get information from each learner about their pronouns, special needs or concerns, interest in your class, what they hope to learn, and any other information they want to share.
  • Read this guide, entitled “Understanding LGBTQIA Terminology”.
  • Develop course goals and content using materials that reflect the reality of diverse populations in pictures, case studies, and other materials. Go beyond binary and gender-based scenarios. For example, avoid using only male/female, and discuss "people of all genders."
  • Avoid using stereotypes. Instead, highlight intersectionality, like the following examples: age and economic disparity, race and sexual identity or expression, Indigenous origin, and physical or mental disability.
  • Choose diverse resources (books, articles, videos) from authors of various backgrounds, origins, and nationalities, if possible.
  • Consider adding your pronouns to your OHSU badge. Just stop by the Transportation Office for a free badge switch.
  • Consider including your own pronouns in your email signature and Sakai site to signal that your class is inclusive and supportive. 
  • Use this rubric to help you determine if your course is equitable for all students (please note that this rubric can be applied to face to face or online courses):

Provide key resources

  • Include a list of resources that OHSU offers, such as the website to the Center for Diversity and Inclusion, and the link to contact the OHSU Ombuds. See the Center for Diversity and Inclusion’s Resource Guides in O2.
  • Make sure your Sakai site is digitally accessible - all learners, especially those with a disability, need straightforward access to your online course content. Accessibility of online materials benefits all learners across devices. Check the Accessibility Resource Center (ARC) site for information and resources on making your online materials accessible. Email Sakai Support with further accessibility questions.

Design your curriculum according to principles of universal design for learning:

The three principles of UDL  are to provide multiple means of:

  1. Engagement;
  2. Representation; and
  3. Action & Expression

Find all the details of these principles here, and incorporate them into your work.

Establishing the environment

  • On the first day of class:
    • refer to the Institutional Policies and Resources section on your syllabus, especially the following statements: Statement Regarding Learners with Disabilities, Commitment to Diversity and Inclusion, and Learning Resources Available to Learners.
    • share your pronouns and invite students to share theirs. You could use language such as, "Please introduce yourselves, share pronouns if you'd like to, and feel welcome to share anything important for us to know about working together with you in the classroom."
  • Every learning experience should be learner-centered, so make sure your voice is not the only one heard. Discussions should welcome participation from every learner. Reach out to those whose voices are not being heard.
  • Allow international or multilingual learners to use the languages they feel comfortable speaking with classmates when appropriate.
  • Inspire an environment where everyone feels safe to share, even if their opinions differ from those of the group. Use positive reinforcement and thank everyone for their contributions.
  • Overcome stereotypes. Don't make assumptions about learners' performance due to their names, appearances, preferences, and/or special needs. "To engage students effectively in the learning process, teachers must know their students and their academic abilities, rather than relying on racial or ethnic stereotypes or prior experience with other students of similar backgrounds." Culture in the Classroom (n.d.). Retrieved from Teaching Tolerance.
  • Consent is important. If a role play or a simulation is part of the learning technique, clearly explain what this activity entails and let learners choose who they will work with. For instance, if the activity involves learning physical examination skills, be sure to indicate first every step required for this assignment so students are aware if, for example, they will need to raise their shirt or top. Allow learners to opt out of these kinds of activities. If a learner consistently opts out of activities that are key to their learning, ask them to meet with you to consider alternatives.
  • If you get emails of interesting local and OHSU events that seem relevant to the learning experience, include them in Announcements in Sakai or inform your learners. Do not assume they know about them. This will help all your learners to feel a part of OHSU and the Portland community.
  • Use positive feedback and give equitable opportunities for remediation assignments, if this is possible. Understand that personal circumstances can get in the way and begin with the working assumption that learners are trying their best to comply with the deadlines.
  • If you make a comment that in retrospect may be interpreted as culturally insensitive, acknowledge and apologize. You might say, "Although that was not my intent, I see how what I said/did impacted you and I am sorry." (suggested comment by Kupiri Ackerman-Barger, Ph.D., RN, during Micro-aggressions workshop at the SON, on May 30th, 2019)

Working in an online learning environment

  • As a range of courses operate on online platforms during the COVID-19 crisis, responding to racial bias and micro-aggressions in the online environment is essential to create a respectful learning environment.
  • Please watch this webinar, entitled ‘Responding to Racial Bias and Micro-aggressions in the online environment’. It addresses concepts of racial bias and micro-aggressions in general but more specifically in online platforms (video conferencing, private messages, phone calls, online office hours, discussion boards, emails,etc.), and proposes a framework to respond to these racial biases and micro-aggressions when they occur online.

Availability and accessibility

  • Clearly announce your office hours, and make yourself available at this time, or offer appointments. Remind them of your office hours often, and explain the various ways in which office hours can be used. Be ready to listen to each learner's individual needs.
  • If you are meeting on campus, and your office is not wheelchair accessible, be willing to meet your learners at an accessible location on campus and include a note in your syllabus stating this.
  • Include an ample variety of teaching methods to reach the different learning preferences of your learners with equitable levels of effectiveness.
  • Upload your relevant documents in Sakai before class or session to give learners the chance to preview the content. Be aware that some international learners, or learners with some disabilities, may request to record your lectures if note taking is an issue for them.
  • Consider recording or pre-recording lectures with transcripts so learners can re-watch and/or re-read asynchronously.

Engage in systemic improvement

  • Ask and listen to your learners about how to improve the learning environment.
  • Provide a mid-term survey  to get feedback on how to further improve your course and to check on how your learners are doing. You can use Qualtrics for this survey (find all the details here on O2) or simply provide a paper form. Your learners can share what is going well, concerns, and challenges so you can make adjustments if needed. Share general results of this survey with the learners, so they can see you care and are listening to them.

Assessment Design

  • Test what has been practiced and/or explicitly discussed in class. Do not test what has not been discussed or taught. Students have expressed concern about being tested on materials that have only been stated verbally in class. Our recommendation is that key elements students must know are provided in writing.
  • Use a variety of assessment strategies for learners to demonstrate attainment of competencies. For more assessment strategies, see UDL guidelines for action & expression.
  • Include formative and summative assessments. Formative assessments are those that are considered part of the learning experience and are intended to help enhance the learning (examples are quizzes, homework, forums). Summative assessments are high stakes as they comprise a high percentage of the course's final grade, and they evaluate the student usually at the end of the course or learning experience (such as final exams or final papers).
  • Avoid idiomatic expressions or culturally focused comments that could only be understood by Americans, by locals, and/or native speakers of English. If these expressions are necessary for a particular class, clarify their meaning. For example, comments about a TV show or a local political figure.

Engage students in the process

  • Consider hiding learners’ names so that you do not know whose exam or paper you are evaluating. Even if you need to see learners' names when you upload grades, grading blindly will still reduce bias. You could try blind grading when scoring papers or assignments on paper. You can have your students write their names on the last page or you can cover their name as you begin to grade.
  • Invite your learners to discuss with you their progress often to provide opportunities for improvement. Let them be a part of their learning experience.

Expand your knowledge

  • Consider attending sessions of the Assessment Academy to explore questions on how to know if your students are learning, how to assess them, the effectiveness of your test questions, how to give your students quality feedback, and more.
Three postbac students in garden wearing surgical masks

Learning from your colleagues at OHSU

We want to share examples of best practices happening right here at OHSU. Please read on and follow the links to learn about the valuable work your colleagues are doing, and to learn from their experiences. If you have other examples of best practices on campus or would like to submit your own, please email Graciela Vidal.

Dr. Bonnie Nagel leads the Developmental Brain Imaging Lab (DBIL) in the Department of Psychiatry, School of Medicine. In 2018, Dr. Nagel expressed her commitment to change DBIL's lab culture through discussions and reflections on anti-racism, diversity, and inclusion. Through the Inclusion Ambassador program, DBIL found guidance to make this a reality. This resource page includes information on how DBIL started having discussions as a lab, the lessons learned along the way, and the resources used for discussions. Beyond these discussions, they are actively changing their lab culture, hiring practices, and making improvements to research practices.

View the Discussion Guide.

Created by the Northwest Native American Center of Excellence at OHSU, the new Wy'East Post-Baccalaureate Pathway prepares American Indian and Alaska Native students to excel as medical students and physicians. The pathway gives graduates who faced barriers like a disqualifying MCAT score or the absence of premedical courses on their undergraduate transcripts a chance to earn conditional acceptance to OHSU's M.D. program.

View the Wy'East Post-Baccalaureate Pathway 

View the Wy'east Post-Baccalaureate Pathway - Frequently Asked Questions

Dr. Felver has been at OHSU for more than 30 years. She teaches clinical pharmacology and pathophysiology to undergrads in the School of Nursing. Dr. Felver noticed that the pictures of patients with jaundice used for instructing undergraduate students privileged white patients, meaning that patients with brown or black skin were included "as an afterthought," as Dr. Felver describes. Dr. Felver began including pictures of a patient pool as diverse as the patient pool at OHSU. Dr. Felver's Photo Diversity Project serves as an example so that other instructors use the materials available to them to represent a diverse patient pool in their curriculums, and hence learners know how to respond to the black and brown patients they receive.

View the "Staff News" topic titled - "What Does Jaundice Really Look Like in Black Skin?" 

This article includes two of the initiatives taken on by OHSU. It describes a campus-wide unconscious bias training for staff and faculty provided by the Center for Diversity and Inclusion. The goal was set by the OHSU Board of Directors. Part of the initiative is to change the OHSU culture by facilitating conversations without blame and providing tools to mitigate biases that affect decisions and behaviors that undermine equity and inclusion efforts.

The School of Nursing has a Diversity Team that helps support the recruitment of underrepresented minorities, and helps support them during their studies at OHSU.

The School of Nursing sends new students a list of student services available to them at the OHSU level and SoN level.

The Office of Dr. Tracy Bumsted, Associate Dean, Undergraduate Medical Education, has prepared a resource page for teachers of MD students which includes:

  • a handbook that defines diversity for students
  • a policy statement on commitment to equity, inclusion, equal opportunity, and non-discrimination
  • information on rural clinical experiences
  • guides for students to navigate their medical studies at OHSU.

View the Undergraduate Medical Education Resource Page for Teachers of MD Students

AI/AN faculty are the most under-represented minority in academic health centers. Given the important role that this group plays in training the future health care workforce, we support the professional development and academic success of these unique faculty members. This program provides funding and support to conference proposals that cover AI/AN topics, increases awareness of AI/AN faculty prospects, organizes recruitment, and conducts an annual AI/AN faculty development conference.

View the School of Medicine Northwest Native American Center of Excellence Programs

Resources

OHSU reports, guides and resources

  • Inclusive Online Class Climate video - includes theoretical frameworks and practical applications to make your online course inclusive and respectful of your students (32 minutes long, transcript and captions available).
  • American Indian and Alaskan Native (AI/AN) Medical Students at OHSU: Resources and Framework for Recruitment and Retention (Password: YveishU3) Learn more about Dr Brodt and Dr Vasquez Guzman's published work done in collaboration with three other institutions on recruitment and retention of American Indian and Alaskan Native (AI/AN) medical students. In this webinar you will also learn more about NNACoE and the work on the Native Curriculum for SOM currently being done at OHSU.
  • Working Efficiently with Health Interpreters (Password: AzRt2f63). Prof. Hall at the University of Portland walks us through inclusive ways to work with interpreters in the clinical setting. The recording has closed captions.
  • PADiM Cultural Humility Series: Physician Assistant Diversity in Medicine (PADiM) organized a Cultural Humility Lecture Series that consisted of four lectures to increase cultural competency in future providers. You can find links and passwords to each video at this flyer.
  • Educational Photo Repository - The photos that teachers show in class should represent the patients we serve and the diversity of our students and clinicians. Head to the Educational Photo Repository to learn how to access a range of useful images.
  • Library Resources on Race, Racism, and Health Disparities
  • The Center for Diversity and Inclusion website – this page has curated a list of resources for individuals interested in continuing learning about anti-racism and racial equity, among a variety of other resources to expand one's knowledge about diversity, inclusion, equity and access.
  • SOM - Diversity Resources  A myriad of resources, including information on bystander training, research publications, health disparities reports, best practices for recruitment and retention, anti-racism tools, and more. 
  • CDI Campus Resources – discover institutional resources for students and employees supporting diversity, equity and inclusion at OHSU.
  • Student Academic Support Services – learn more about this office, and how it can help students to find strategies for success. Students can make one-on-one appointments with Learning Specialists, and work to develop personalized tools and approaches to study more effectively and efficiently, decrease stress, improve memory, and develop goals to help them succeed at OHSU.
  • OHSU Ombuds - visit this page for resources available to faculty, employees and students. If your learners find themselves in an interpersonal challenge or crisis, you can recommend them to consult the Ombuds resources for unbiased and confidential support at ombuds@ohsu.edu
  • Respect for All App – use this interactive mobile app to access:
    • Information about sexual misconduct, including harassment, stalking, violence, or intimate partner violence 
    • Definitions of incident types 
    • Safety resources for those who have experienced violence 
    • Confidential resources, both on and off campus
  • Transforming Teaching – discover these strategies and resources for instructional resilience, including how to move your course partially or completely to remote learning. 
  • Intercultural Psychiatric Clinic – Portland  - learn more about these experts in providing culturally sensitive mental health services to immigrant and refugee communities.
  • For learners who are new to Portland (including international):  
    • The Office of International Affairs – access resources mostly dedicated for international students, but also useful to any student that is new to Portland.
    • English Second Language (ESL) – learn more about the School of Nursing’s English as a Second Language writing support, including one-on-one consultation or small group writing workshops.

Non-OHSU resources

AAMC Anti-racism in Medicine Collection. The new Anti-racism in Medicine Collection within MedEdPORTAL provides educators with practice-based, peer-reviewed resources to teach anti-racist knowledge and clinical skills, elevates the educational scholarship of anti-racist curricula, and aims to convene a community of collaborators dedicated to the elimination of racism within medical education.

Racism: Science & Tools for the Public Health Professional  - This book addresses racism and the differences it produces in health and socioeconomic status across the United States.

Writing Through Resistance (NCFDD). August 2, 2021. This article will help you find and maintain the inspiration to write even through challenging times.

Knuckles. Journal of Clinical Oncology by Kathryn E. Hitchcock, M.D. (2020): "The swastikas on his knuckles kept stealing my attention. I tried not to stare but every time he gestured to emphasize his words my gaze snapped back there." This article tells the story of this doctor's relationship with a patient and how they came to accept and trust each other. A must read!

The Time is Now: Transforming Recruitment and Retention of American Indian and Alaska Native Medical Students Using the Medicine Wheel Model   Journal Article by Vazquez Guzman et al (2020). This article argues that specific approaches for recruitment and retention of American Indians and Alaskan Natives (AI/ANs) are critically needed at more medical schools to increase the number of AI/AN physicians, and looks at how AI/AN faculty at four U.S. medical schools established innovative programs to successfully recruit AI/AN medical students and retain them through graduation.

How to Make or Break Implicit Bias Instruction: Implications for Curriculum Development. Journal Article by Cristina M Gonzalez et al. (2018). This article analyzes faculty experiences regarding facilitating discussions as part of the institution's curriculum on racial and ethnic implicit bias recognition and management. 

Patient perspectives on racial and ethnic implicit bias in clinical encounters: Implications for curriculum development. Journal Article by Cristina M Gonzalez et al (2018).  Patients describe feelings of bias and prejudice in clinical encounters; however, their perspectives on restoring the encounter once bias is perceived are not known. Implicit bias has emerged as a target for curricular interventions. In order to inform the design of novel patient-centered curricular interventions, this study explores patients' perceptions of bias, and suggestions for restoring relationships if bias is perceived.

When best intentions aren't enough: helping medical students develop strategies for managing bias about patients. Journal Article by Cayla R Teal (2010). Implicit bias can impact physician-patient interactions, alter treatment recommendations, and perpetuate health disparities. Medical educators need methods for raising student awareness about the impact of bias on medical care.

Teaching social and cultural awareness to medical students: "it's all very nice to talk about it in theory, but ultimately it makes no difference" Journal Article by Brenda L Beagan (2003). This article investigates the effect of exposure to a new course addressing social and cultural issues in medicine on third-year medical students' awareness and understanding of how these issues affect their lives as students, the lives of patients, the work of physicians, and patient-physician interaction.

Recommendations for teaching about racial and ethnic disparities in health and health care. Journal Article by Wally R Smith et al (2007). Racial and ethnic minorities often receive lower-quality health care than white patients, even when socioeconomic status, education, access, and other factors are used as controls. To address these pervasive disparities, health care professionals should learn more about them and the roles they can play in eliminating them, but few curricula are focused on understanding and addressing racial and ethnic health disparities, and well-accepted guidelines on what and how to teach in this complex area are lacking.

Racism in the Margins - This is a UConn-wide initiative that opens up space for educators across disciplines to collaborate on more socially-just approaches to teaching, responding to, and evaluating writing.

Labor-Based Grading Contracts: Building Equity and Inclusion in the Compassionate Writing Classroom. Free downloadable book, PDF format. In Labor-Based Grading Contracts, Asao B. Inoue argues for the use of labor-based grading contracts along with compassionate practices to determine course grades as a way to do social justice work with students.

You can also access more articles and books here which will guide your respectful and inclusive teaching practices.

Alexander Street - Video Library

ProQuest's Alexander Street products are curated, discipline-focused, primary-source collections, websites, and streaming media for learning and research.  This platform delivers more than 66,000 titles spanning the widest range of subject areas including anthropology, business, counseling, film, health, history, music, and more. View Alexander Street Video Library 

Cultural Humility

Cultural Humility: People, Principles and Practices – this is a new 30-minute documentary by Vivian Chávez that mixes poetry with music, interviews, archival footage, images of community, nature and dance to explain what is "Cultural Humility" and why we need it. View cultural humility resources

  • 15 Higher Education Podcasts you should listen to. These podcasts have a higher education focus,  and cover everything from research, teaching and technology.
  • Teaching in Higher Ed. Hosted by Bonni Stachowiak, this podcast focuses on topics such as excellence in teaching, instructional design, open education, diversity and inclusion, productivity, creativity in teaching, educational technology, and blended learning.
  • 11 higher ed podcasts to stream.  Topics range from avoiding burnout as a student affairs leader, to a professor who went the extra mile (literally) to engage her students.
  • @NAACP Founded in 1909 in response to the ongoing violence against Black people around the country, the NAACP (National Association for the Advancement of Colored People) is the largest and most pre-eminent civil rights organization in the nation.
  • @Blklivesmatter Black Lives Matter was founded in 2013 in response to the acquittal of Trayvon Martin's murderer. Black Lives Matter Global Network Foundation, Inc. is a global organization in the US, UK, and Canada, whose mission is to eradicate white supremacy and build local power to intervene in violence inflicted on Black communities.
  • @ACEducation Race and Ethnicity in Higher Education provides a data-informed foundation for those working to close persistent equity gaps by providing a glimpse into the educational pathways of today's college students and the educators who serve them.
  • @QMatters Quality Matters (QM) provides a research-supported quality assurance system to help individuals and organizations deliver on their online promise.
  • @NCFDD Faculty Diversity: On-demand access to the mentoring, tools, and support you need to be successful in the Academy.