Introducing Diversity to the Undergraduate Medical Curriculum Sally Curtis, Kevin Galbraith Medical Education Development Unit, School of Medicine, University of Southampton, UK INTRODUCTION Diversity is an important aspect of undergraduate medical curricula, as recognised by the General Medical Council, 1 and is one of the four professionalism themes in the BM 4, 5 & 6 undergraduate curricula at the University of Southampton (Table 1). Table 1 Examples of diversity integrated in the first 3 years of the BM programmes Course evaluations and staff feedback had indicated difficulty in openly discussing issues around diversity. In order to facilitate discussion of diversity a small group, problem-based session was designed 2. The delivery and timing of the session within the curriculum were important considerations. The session began with an objective discussion point, and expanded to encompass issues experienced by students, such as stereotypes and social group identity. The session was held at the start of the undergraduate programme. Early exposure to this topic to provides a platform for an integrated diversity theme throughout the undergraduate programme. Purposive structuring ensured the groups contained students from a variety of backgrounds. This aimed to increase the breadth of responses and raise awareness of the views of others to enrich the discussion. The session was evaluated by two cohorts of Year 1 medical students. RESULTS – Students reported that the task had: Discussion – Initial evaluation suggests the problem-based design of the session allowed students to comfortably express their opinions and learn from the views of others. Initial evaluation also suggests effectiveness in facilitating change in attitude towards diversity. Addressing this topic early in the curriculum allows the students to develop a more integrated approach to diversity. The topic used in these sessions was disability, but the structure of the session could be adapted to a variety of diversity issues. Conclusion – A small-group, problem-based approach successfully raised awareness of diversity, and encouraged open discussion among students. This was well-received by students early in the curriculum, and resulted in altered perceptions of diversity and stereotyping. It’s not until later at lunch that your friend tells you that the unenthusiastic student has a disabled sister, who gets about in a wheelchair. Discussion points What strategy does this poster use to improve road safety? The poster uses the word “restriction.” What restriction does a wheelchair user encounter? Do you agree with the following statement?: “Disabled peoples’ lives are restricted by their impairment. It is hoped that medical advances will return them, wherever possible, to normal function.” Consider the advantages and limitations of being perceived as an individual, and of being perceived as belonging to a group. A staff development workshop was held for facilitators to introduce the aims and learning outcomes along with the session material prior to the tutorials. Everyone thinks it Would make a great impact, except one student, who says it looks “too sinister.” Feeling rather wounded, you say “Of course – that’s the whole point!” METHOD 56 students from the 2007/08 BM5 cohort and 86 students from the 2008/09 BM5 cohort were given the following paper- based scenario: “You get together with some fellow medical students to do a project on Health Promotion. As there’s currently a campaign by Hampshire police to improve road safety, you decide to contribute by setting up a display in a local shopping centre, warning people about the danger of not wearing a seatbelt. You are quite proud of a poster you downloaded from the internet and suggest using it in the display.” Year 1“The nature of culture” is explored in lectures, symposia and a theatre production Year 2Physical disability and mental illness are explored through symposia Year 3  “Student Selected Units” are offered on Working with Diversity, Global Health and Homelessness, Drugs and Crime.  There are symposia on Alcohol, Depression, Drug Misuse, HIV, Sexuality and Complementary Medicine.  The “Changing Minds” course in the mental health attachment of year 3 gives the opportunity to explore various aspects of diversity in greater depth.  Strengthened their awareness of diversity as an issue  Not resulted in any discomfort or embarrassment  Helped them to gain insight into the thoughts of others  Made them less likely to view individuals according to stereotypes “ I loved the way discrimination and social problems associated with disability arose out of efforts to face other social problems, such as drink driving.” 1. Tomorrow’s Doctors: Outcomes and standards for undergraduate education. General Medical Council, Galbraith K., Curtis S.A. Facilitating discussion of diversity: a problem-based approach. Really Good Stuff; Medical Education 42: 1111–1146, 2008.