About Anti-Racist Transformation (ART) in Medical Education

In 2021, The Josiah Macy, Jr. Foundation funded a three-year Anti-Racist Transformation (ART) in Medical Education project to replicate Icahn School of Medicine and Mount Sinai’s (ISMMS) change-management strategy at 11 partner medical schools in the United States and Canada.

Capacity Development: Develop the capacity of medical schools to dismantle systemic racism and bias in their work and learning environments by implementing a multi-phased change management strategy.

Community of Practice: Promote shared learning on how to dismantle racism within and across medical schools using systems change tools and processes.

Replicable & Scalable: Determine the conditions in which ISMMS’s Change Management Strategy for transformational change can be replicated at other medical schools and identify which of its features yield the best outcomes in order to scale to all medical schools.

• College of Medicine, University of Saskatchewan
• Columbia University Vagelos College of Physicians and Surgeons
• David Geffen School of Medicine at the University of California, Los Angeles
• Duke University School of Medicine
• The George Washington University School of Medicine & Health Sciences
• The Ohio State University College of Medicine
• University of Arizona College of Medicine - Phoenix
• University of Minnesota Medical School
• University of Missouri-Columbia School of Medicine
• University of the Incarnate Word School of Osteopathic Medicine

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Phase 1: Onboarding and assessment
Worked directly with selected institutions to identify and onboard cohort members from faculty, staff, students, and leadership. After each cohort was identified, we conducted an assessment to determine readiness for transformational change at the individual (cohort members) and school levels. We also assessed the landscape and effectiveness of existing efforts to address racism that have been implemented at each institution.

Phase 2: Preparing for change
Cohorts were introduced to the transformational change phased approach: engaged in learning opportunities to level-set knowledge; envisioned a future state of transformational change; identified elements of change; conducted internal assessments; developed a change management strategy; and prepared leadership to sponsor the change.

Phase 3: Creating a climate for change
Cohorts continued to build a sense of urgency to change from current to future state; engaged in racial dialogue; uncovered what it means to be the change and become deeply committed to the change process; continued to practice and learn while eliciting feedback from those most affected by the change; built a powerful, enthusiastic group of change leaders (guiding coalition) to oversee the change strategy and process; and communicated the vision for change, strategy and process across their institution.

Phase 4: Engaging and enabling the institution for change
Cohorts developed change targets, tactical plans and outcome and performance monitoring frameworks; empowered broad-based action by building awareness; generated short-term wins; and communicated their plans clearly and consistently with stakeholders.

Phase 5: Implementing and sustaining change
Participating institutions aimed to embed the change and ensure that it sticks by actively pursuing information and feedback; learning from wins and mistakes; and turning that learning into appropriate course corrections. This process is not a fixed or formulaic methodology but rather one that accelerates success by building the capacity to be agile and effectively operate within a state of uncertainty.